aspirating of vomitus. Never give an unconscious person any substance by mouth.
9. Always carry a litter patient feet first so that the rear bearer can constantly observe the victim for respiratory or circulatory distress.
ASSESSING THE PATIENT’S CONDITION
The following procedures for assessing a patient’s condition under various circumstances are based upon Department of Transportation recommendations. These are general guidelines that can be modified to suit the situation.
DETERMINING THE PROBLEM
A. If the patient can communicate, determine if the problem is medical or trauma related.
1. If medical, follow the sequence below.
a. Evaluate diagnostic and vital signs.
b. Develop the patient’s history.
c. Examine for the medical problems.
d. Examine for a trauma-related problem.
2. If trauma-related, follow the sequence below.
a. Evaluate diagnostic and vital signs.
b. Examine the injury.
c. Develop the patient’s history.
d. Examine for a medical related problem.
B. If the patient cannot communicate, follow the sequence below.
1. Evaluate diagnostic and vital signs.
2. Develop the patient’s history, then determine if the problem is medical or trauma related.
3. If medical, examine first for the medical problem then for a trauma related problem.
4. If trauma related, examine first for the trauma related problem then for a medical problem.
EVALUATING THE DIAGNOSTIC AND VITAL SIGNS
A. Sequence of taking vital signs
1. If the patient with a traumatic injury is communicative, assess the injury site after taking vital signs.
2. If the patient with a medical problem is communicative, take vital signs after the preliminary assessment and in conjunction with the medical history, if possible.
3. If the patient is noncommunicative, take vital signs immediately after the primary assessment.
B. Essential diagnostic and vital signs
1. Mental status
a. Consciousness—avoid descriptive words like “stupor” or “semi-conscious”; be specific.
b. Reaction to stimulus—describe
c. Orientation
d. Responsiveness
2. Respirations
a. Tracheal deviation
b. Rate—tachypnea
c. Depth
(1) Hyperpnea
(2) Hypopnea
d. Dyspnea
e. Breathing sounds
f. Flaring of anterior nares on inspiration
g. Retraction of suprasternal notch on inspiration
h. Retraction of intercostal spaces
3. Pulse
a. Rate
b. Rhythm
c. Strength
4. Blood pressure
EXAMINING FOR TRAUMA-RELATED PROBLEMS
A. Assess each of the following
1. Head
a. Inspect for
(1) Obvious hemorrhage
(2) Ecchymosis, erythema, or contusions
(3) Scalp lesions