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Moi scene sizeup1/14/2024 Primary Assessment starts with our own critical observation: Sick or Not Sick? By itself, being injured doesn't mean that a life-threat exists, but a patient that "looks sick" should guide us towards greater awareness of the Golden Period (and the associated Platinum 10 minutes) during which pre-hospital interventions and care can have the greatest positive impacts. Once these basics are covered, we're being taught to run through the Primary Assessment quickly (but thoroughly) in order to reach a critical decision point - does this patient have life threats that require immediate interventions or transport, or can we take time to do more thorough assessment and investigation of factors contributing to their condition? These lead us to determining whether we need additional resources including Paramedics, Fire, Hazmat or additional EMTs.įinally, scene size-up concludes by making a quick determination of the potential for any C-Spine (cervical spine, aka your neck) injuries the patient(s) may have, and taking appropriate precautions to ensure we do no further harm while assessing or moving them. It also includes determining the Nature Of Illness (NOI) or Mechanism Of Injury (MOI), as well as the number of patients (such as at a car accident, where there may be multiple parties involved). Even stuff like taking off our gloves is practiced in our drills, and we corrected by the instructors if we fail to ask about scene safety even in classroom-like practice settings. This can include making basic determinations regarding the type of Personal Protective Equipment (PPE) we should be wearing, from gloves and eye protection, to masks, gowns or full-body coverings. Our checklists actually start before we even see the patient, learning how to do a scene size-up in order to ensure our own safety and that of our fellow EMTs. And it comes with learning a bunch of mnemonics, such as AVPU, SAMPLE/OPQRST, and DCAP-BTLS (just to name a few), to ensure we don't miss any critical information. These assessments break down to the Primary Assessment (done when we first arrive on the scene), the Secondary Assessment (which may be done on scene, in the ambulance), and re-assessments as needed or warranted by the specific issues and interventions being undertaken.Īt this point in my EMT course work, we're starting to practice these assessment skills, linking signs and symptoms to the knowledge of anatomy we've been learning, before we move and transport patients anywhere else. And while it's often easy to get the basics when you have a conscious and lucid patient, that isn't always the case.ĮMTs are drilled to take a specific step-by-step approach, called assessments, in order to ensure we first focus on critical life-threats, and then (and only then) identify and prioritize other issues our patients may be having. And we consider it a really good start when you're awake, alert, and able to answer those questions.īefore our EMT classwork can start to talk about interventions for specific injuries or illnesses, it's important for us to identify what, exactly, we're dealing with. If you've ever had the need for an EMT's help, you've probably experienced the barrage of questions we ask.
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