CHAPTER 4 Assessing the Victim (Video – Assessing the victim and recovery position) © 2016 National Safety Council Chapter 4 • Assessing the Victim Lesson Objectives 1. Explain how to check the victim’s responsiveness and normal breathing. 2. Demonstrate how to move a victim into the recovery position and explain when this is done. 4-2 © 2016 National Safety Council Chapter 4 • Assessing the Victim Lesson Objectives continued 3. Explain the importance of each element in the SAMPLE history. 4. Demonstrate how to perform a physical examination of a responsive victim without a life- threatening problem. 4-3 © 2016 National Safety Council Chapter 4 • Assessing the Victim Assess the Victim • Check scene for safety • Initial assessment for life-threatening conditions • Unresponsiveness • Lack of normal breathing • Severe bleeding • Secondary assessment • Monitor the victim for any changes 4-4 © 2016 National Safety Council Chapter 4 • Assessing the Victim Initial Assessment • Check for life-threatening conditions: • Unresponsiveness • Lack of normal breathing • Severe bleeding 4-5 © 2016 National Safety Council Chapter 4 • Assessing the Victim Initial Assessment continued • Takes just a few seconds • Do not move victim unless: • Imminent danger to victim • Cannot give life-saving care because of victim’s location or position 4-6 © 2016 National Safety Council Chapter 4 • Assessing the Victim Check for Responsiveness • A victim who is speaking, coughing or moving is responsive. • A victim who may be paralyzed may have purposeful eye movements or other signs 4-7 © 2016 National Safety Council Chapter 4 • Assessing the Victim Check for Responsiveness continued • Tap person on shoulder and shout “Are you OK?”: • A person who is speaking, coughing or moving is responsive. • A person who may be paralyzed may have purposeful eye movements or other signs. • Check the person first in the position found. • Use the AVPU scale. 4-8 © 2016 National Safety Council Chapter 4 • Assessing the Victim Unresponsiveness • A sign of a life-threatening problem • Call 9-1-1 immediately • At same time look for normal breathing 4-9 © 2016 National Safety Council Chapter 4 • Assessing the Victim Check for Normal Breathing • A victim who can speak or cough is breathing. • Gasping is not normal breathing. • Check victim first in position found. 4-10 © 2016 National Safety Council Chapter 4 • Assessing the Victim Breathing Normally? • If victim is breathing normally, continue assessment. • If unresponsive victim is not breathing normally, start CPR. • A person whose heart has stopped beating will also have stopped breathing 4-11 © 2016 National Safety Council Chapter 4 • Assessing the Victim Check for Severe Bleeding • Severe bleeding is life-threatening. • Control with direct pressure. 4-12 © 2016 National Safety Council Chapter 4 • Assessing the Victim Provide Care Care for life-threatening conditions found: • Immediately care for any threats to life found during the initial assessment. • Move on to secondary assessment only if no life-threatening conditions. • Position breathing unresponsive person in recovery position. 4-13 © 2016 National Safety Council CHAPTER 4 Skill: Initial Assessment © 2016 National Safety Council Chapter 4 • Assessing the Victim Skill: Initial Assessment 1. Ensure scene safety. 2. Check the victim for responsiveness. 4-15 © 2016 National Safety Council Chapter 4 • Assessing the Victim Skill: Initial Assessment continued For a responsive victim: 3. Ask the victim what happened and about his or her condition. 4. Have someone call 9-1-1. If alone, correct any life- threatening conditions you see first (such as severe bleeding) before calling 9-1-1 and continuing to check the victim and providing other care. 4-16 © 2016 National Safety Council Chapter 4 • Assessing the Victim Skill: Initial Assessment continued For an unresponsive victim: 3. Call for help: a. Shout for someone to call 9-1-1 and get an AED. Keep the phone at the victim’s side. b. If alone, call 9-1-1 from your mobile device if you have one, and follow the dispatcher’s instructions. 4. If alone without a mobile device, find a phone and call 9-1-1, and get an AED if available.* *Correct any immediate life threats (such as opening the airway or controlling severe bleeding) before leaving an adult victim to call 9-1-1. 4-17 © 2016 National Safety Council Chapter 4 • Assessing the Victim Recovery Position • Helps keep airway open • Allows fluid to drain from mouth • Prevents aspiration • If possible, put victim onto left side • Continue to monitor breathing 4-18 © 2016 National Safety Council CHAPTER 4 Skill: Recovery Position © 2016 National Safety Council Chapter 4 • Assessing the Victim Skill: Recovery Position 1. Position the victim’s arm farthest from you across the victim’s body. 4-20 © 2016 National Safety Council Chapter 4 • Assessing the Victim Skill: Recovery Position continued 2. Grasp the victim at the shoulder and hips, and roll them toward you. 4-21 © 2016 National Safety Council Chapter 4 • Assessing the Victim Skill: Recovery Position continued 3. Bend both legs so the victim’s position is stabilized. 4-22 © 2016 National Safety Council Chapter 4 • Assessing the Victim Skill: Recovery Position continued 4. With victim now in position, check the airway and open the mouth to allow drainage. 4-23 © 2016 National Safety Council CHAPTER 4 Learning Checkpoint 1 © 2016 National Safety Council Chapter 4 • Assessing the Victim Secondary Assessment • Performed only for victims without life-threatening conditions • Do not interrupt care for serious problem • Can provide additional information • Usually performed on responsive victims • Includes history and physical examination • Focused primarily on injured area 4-25 © 2016 National Safety Council Chapter 4 • Assessing the Victim Get the Victim’s History • Talk to a responsive victim. • Ask bystanders or family members what happened. • Consider the mechanism of injury. 4-26 © 2016 National Safety Council Chapter 4 • Assessing the Victim SAMPLE History S Signs and symptoms A Allergies M Medications P Previous problems L Last food or drink E Events 4-27 © 2016 National Safety Council Chapter 4 • Assessing the Victim Unresponsive Victim • Ask family or bystanders what happened. • Check the scene for clues. • Consider effects of environmental extremes. • Consider victim’s age. 4-28 © 2016 National Safety Council Chapter 4 • Assessing the Victim Physical Examination • Do the physical examination only if you are not giving first aid for a serious condition! 4-29 © 2016 National Safety Council Chapter 4 • Assessing the Victim Physical Examination continued • Examine a responsive victim from head to toe for: • Bleeding or other open wounds • Pain, tenderness when victim is touched • Swelling or deformity • Skin color, temperature, condition • Abnormal sensation or movement 4-30 © 2016 National Safety Council Chapter 4 • Assessing the Victim Physical Examination continued • Ask a responsive victim for the consent to do a physical examination (head-to-toe check) and describe what you are going to do before touching him/her 4-29 © 2016 National Safety Council Chapter 4 • Assessing the Victim Position of Victim • Keep unresponsive victim without possible spinal injury in recovery position. • Monitor victim’s breathing, and observe for bleeding and other signs of serious injury. • Allow responsive victim to remain in position of comfort. • No need to move victim onto his or her back. 4-31 © 2016 National Safety Council Chapter 4 • Assessing the Victim Clothing Removal • Remove some clothing if needed to examine injured area. • Protect victim’s privacy. • Prevent exposure. • Prevent movement of injured area. 4-32 © 2016 National Safety Council Chapter 4 • Assessing the Victim DOTS: What to Look For D Deformities O Open injuries T Tenderness (pain) S Swelling 4-33 © 2016 National Safety Council CHAPTER 4 Skill: Physical Examination © 2016 National Safety Council Chapter 4 • Assessing the Victim Skill: Physical Examination Check head and neck: • Skull • Eyes • Ears • Nose • Breathing • Mouth • Neck 4-35 © 2016 National Safety Council Chapter 4 • Assessing the Victim Skill: Physical Examination continued Check chest: • Deformity? • Wounds? • Tenderness? • Bleeding? • Even breathing? 4-36 © 2016 National Safety Council Chapter 4 • Assessing the Victim Skill: Physical Examination continued Check abdomen: • Pain/tenderness? • Swelling? • Bleeding/bruising? • Rigidity? 4-37 © 2016 National Safety Council Chapter 4 • Assessing the Victim Skill: Physical Examination continued Check hips and pelvis: • Pain? • Deformity? 4-38 © 2016 National Safety Council Chapter 4 • Assessing the Victim Skill: Physical Examination continued Check upper extremities: • Bleeding? Deformity? Pain? • Medical alert ID? • Normal movement, sensation, temperature? 4-39 © 2016 National Safety Council Chapter 4 • Assessing the Victim Skill: Physical Examination continued Check lower extremities: • Bleeding? Deformity? Pain? • Normal movement, sensation, temperature? 4-40 © 2016 National Safety Council Chapter 4 • Assessing the Victim Examining a Child or Infant • Use simple questions. • Involve parents or guardians. • Perform physical examination toe to head. • Talk calmly and soothingly. 4-41 © 2016 National Safety Council Chapter 4 • Assessing the Victim Monitor the Victim • Give first aid for any injury or illness. • For unresponsive victim or victim with serious injury: • Make sure condition doesn’t get worse. • Repeat breathing assessment at least every five