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ABCDs
AMS
Applies cooling method to help reduce swelling/bruising
Applies gentle traction/tension as needed, rotating extremity if necessary and if tolerated by patient.
Applies high flow oxygen via nonbreather
Applies occlusive dressing
Applies Sterile dressing and direct pressure
Applies the stabilizing device to stabilize the object from movement.
Apply suction in a side to side or circular motion as you withdraw the catheter
Arranges for rapid transport
Arranges for transport of patient.
Assesses airway, breathing, circulation (%Q{"ABCDs"}%)
Assesses %Q{"CMS"}%.
Assesses CMS in each extremity.
Assesses respirations for the following
Assesses the ABCDs, controls any bleeding
Assessing Respiration Rate
Assists breathing, manages/treats life threats.
Attach the oxygen connective tubing to the flow meter.
Attach the regulator/flow meter to the valve stem
Bandages any wounds as necessary
Bandages the wound and immobilizes as appropriate
Based on the chief complaint, gathers information by asking OPQRST questions.
Boot Removal
Calls for transport, equipment, and/or additional assistance.
Calls for transport, equipment, and/or additional assistance, EMS if needed.
Check for/correct any leaks. Check for adequate pressure in tank.
Checks for and controls any major bleeding.
Chooses the correct device/material for splinting/stabilization.
Clears/maintains airway and manages secretions.
Close regulator and release pressure from tank.
Communicates to the patient the procedure you will perform.
Confirms and monitors %Q{"LOR"}% (%Q{"AVPU"}% or %Q{"GCS"}%).
Continue until the flange rests against the skin.
Continues manual stabilization until the patient is secured to a backboard.
Controlling Bleeding
Correctly sizes and applies cervical collar.
Counts number of breaths for 30 seconds
Covers the injured eye with a moist sterile dressing.
Crosses ends of cravats that are behind patient to make a figure eight.
Crosses torso straps over the patient’s shoulders and secures to board
Determines if patient can speak in complete sentences.
Determines if patient has breathing problems.
Determines number of lifters available
Determines scene is safe
Determines the MOI (mechanism of injury) and/or NOI (nature of illness)—patient’s chief complaint.
Directs helper to stabilize above and below the injury site
Do not suction an adult for more than 15 seconds.
Draws ends of sheet together over pelvis
Establishes or maintains manual stabilization of head and C-spine.
Evaluate patient mental status.
Executes the lift
Explains commands, procedures
Exposes and assesses the injury to determine the location and proximity to hip or knee joint
Exposes and inspects injury to identify level of emergency and formulate treatment plan.
Exposes injury to access and manage the %Q{"ABCDs"}%
Exposes the chest
Exposes the wound site.
Exposes/visualizes injured area to determine that a figure eight is appropriate.
Extremity is splinted and stabilized with minimal movement
Figure Eight Application
Starting at the wrists fold 1st glove inside out
Folds sheet lengthwise
Forms a tight blanket roll.
Forms general impression
Gently advance the airway.
Gently moves the patient’s head
Gloves inside out
Grasp exterior of glove
HAZWOPER
Hold the adjunct against the side of the face
Identifies substance
Identifies the number of patient(s) and the %Q{"LOR"}% of each.
Identifies the severity of the bleeding
If bleeding continues
If bleeding continues despite direct pressure
If necessary, realigns/recenters the patient on the board using axial movements.
If nerve gas is suspected, obtains nerve gas antidote kit.
If SEVERE signs/symptoms exists
If suspected spinal injury
Initiates Standard Precautions
Insert the lubricated airway into the larger nostril
Inspect the tank, regulator, and O ring or washer for any visible damage.
Introduce self
Keeps patient's knees flexed
Kneels beside or above the patient’s heads.
LAR and HAR
Lifting Techniques: Bridge/Bean Lift
Loads patient onto long spine board
Log rolls patient on to backboard
Looks for chest rise and fall
Lowers the patient into a supine position on the long board
Maintains airway, uses BVM or suction if needed. Monitor vitals
Maintains direct pressure; applies additional dressing if needed
Maintains spinal alignment
Maintains spinal immobilization if applicable.
Manages/treats life threats.
Managing an Open Chest Wound
Manually stabilizes the head/cervical spine
Measures and applies a C-collar per local protocol
Measures patient for C-collar per manufacturer’s recommendations.
Minimizes further exposure
Moves the patient to a long board
Moving as a unit and maintaining spinal stabilization, the rescuers lower the patient to the ground.
Obtains baseline set of vitals.
Obtains SAMPLE history
Obtains %Q{"SAMPLE"}% history from patient and/or witness (if available).
Open the O
2
system by turning the valve stem on top of the cylinder or using the wrench, counterclockwise
Open the patient’s mouth and insert the catheter only as far as you can see.
Open the patient’s mouth with the cross-finger technique.
Opens coat or shirt and removes any bulky clothing around neck/shoulder area.
Palpates entire chest
Patient Assessment—Trauma Patient
Peal second glove off
Pelvic Stabilization
Performs detailed head-to-toe body assessment physical exam %Q{"DCAPBTLS"}%.
Place fingers inside second glove
Place removed glove in dominant hand
Places blanket on flat surface, sizing the roll by folding the blanket to fit the size needed.
Places board behind the patient’s back
Places four cravats crosswise on one end of folded blanket; rolls blanket firmly, including cravats.
Places hands on either side of the patient’s head
Places one cravat around each shoulder
Places patient in a sitting position.
Places patient in supine position, with blanket roll under shoulder blades.
Positions hands underneath patient
Positions rolled blanket and cravats snugly in the axilla (armpit) of the dislocated shoulder.
Positions the lifters
Posterior S/C Dislocation Reduction
Pre-oxygenate patient prior to suctioning.
Prepares and applies splint, keeping movement of injured extremity to a minimum.
Prepares and position all of the equipment needed.
Prepares patient for transport
Prepares patient for transport, activates EMS.
Primary Assessment
Provides any necessary interventions related to airway/breathing
Provides interventions per protocols.
Provides oxygen/treat for shock if appropriate
Pulls ends of sheet tight over pelvis
Re-evaluates patient, monitor vitals.
Readjusts occlusive dressing tape
Reassesses %Q{"CMS"}%
Reassesses CMS after splint is applied.
Reassesses CMS in each extremity.
Reassesses vital signs and primary assessment
Remove regulator from tank
Removes boot/shoe per local protocol.
Removing Contaminated Gloves
Rescuer #1 applies traction to the wrist on affected side by pulling arm out and downward toward ground.
Rescuer #1 continues to gently remove the helmet.
Rescuer #1 directs other rescuers in lowering the patient onto the backboard as a unit.
Rescuer #1 directs the roll
Rescuer #1 grasps the helmet straps and pulls apart, spreading the helmet.
Rescuer #1 kneels above patient’s head and takes/maintains spinal stabilization.
Rescuer #1 manually stabilizes head/C-spine by placing hands on either side of the helmet.
Rescuer #1 manually stabilizes the fracture site above and below the injury.
Rescuer #1 pulls the helmet axially from the patient’s head with forward rotation of the helmet.
Rescuer #1 stabilizes injured area of leg/ankle
Rescuer #1 stabilizes the boot to be removed.
Rescuer #1 stands beside or behind the patient; manually stabilizes the patient’s head/C-spine.
Rescuer #2 assesses CMS
Rescuer #2 checks CMS in each extremity; sizes and correctly applies cervical collar.
Rescuer #2 ensures that the patient is centered on the backboard
Rescuer #2 firmly grasps ankle hitch with one hand
Rescuer #2 gently removes boot by sliding heel away from foot
Rescuer #2 opens/removes the face shield or goggles.
Rescuer #2 removes ski or snowboard if present and then applies the ankle hitch.
Rescuer #2 removes the chin strap and places one hand at the patient’s occiput
Rescuer #2 simultaneously places counter-traction on the other side of body by pulling on cravat tied around upper chest.
Rescuer #2 slides backboard into position
Rescuer #2 slides the fingers up to the patient’s occiput, ensuring no loss of stabilization.
Rescuer #2 spreads the boot open.
Rescuer #2 stabilizes the boot/shoe or the ski/snowboard if the equipment is still in place.
Rescuer #2 unbuckles/unlaces the boot completely.
Rescuer #3 assesses CMS.
Rescuer #3 connects ankle strap if needed and turns crank/knob
Rescuer #3 positions backboard beside the patient
Rescuer #3 positions the splint according to manufacturer’s directions and secures the groin strap around upper thigh.
Rescuer #3 prepares and positions backboard behind the patient.
Rescuer #3 prepares traction splint
Rescuer #4 kneels beside the patient’s knee/lower leg
Rescuers #2, #3, and #4 kneel along one side of the patient.
Rescuers #2 and #3 stand next to the patient, one on either side
Rescuers exchange immobilization without loss of stabilization.
Rescuers secure Velcro support straps or cravats.
Rotate the airway 180°.
Rotates extremity if necessary and as tolerated by patient
SAMPLE
SAR
Secondary Assessment
Secure the bottle from falling.
Secures patient to a backboard.
Secures second cravat around the patient’s waist.
Secures the C-collar using Velcro closures, ensuring a proper fit.
Secures the object with the appropriate materials covering both eyes.
Secures the patient on the backboard in the usual method.
Secures the patient's knees and ankles with cravats, padding any voids.
Secures the patient to the backboard
Set the regulator to the proper flow based on the delivery device.
Sizes splint properly; padding as needed and positions splint
Sizes splint properly; uses pads as needed and positions splint.
Slides posterior neck portion of the collar behind the patient’s neck.
Sling and swathe correctly applied and restricts movement of injured extremity
Splinting an Upper Extremity Injury
Splints and stabilizes extremity with minimal movement.
Stabilizes hand and forearm on the blanket with the remaining two cravats.
Stabilizes the cervical region in a neutral, in-line position. (Aligns patient axially.)
Stabilizes the cervical spine if injury is trauma induced.
Swings the chin portion of the C-collar up the patient’s chest until it cups the chin.
Technician chooses the correct device/material for splinting/stabilization
Ties cravats with square knots, ensuring that the shoulders are in normal position.
Ties sheet in overhand knot
Ties wide cravat around upper chest, under armpits.
Tightens cravats so that the position of the shoulders is the same as if the patientwere sitting normally
Traction Splinting
Transports patient and transfers to EMS personnel.
Treats for shock.
Treats for shock and maintains body temperature
Treats for shock as indicated
Treats for shock/provides oxygen.
Using an oxygen wrench or valve stem
While helper holds blanket roll in place, ties one set of cravats over the opposite shoulder around the neck.
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