In FIRST AID and SAFETY did you do a Patient Assessment System INSPECTION checklist

Regardless if you are 12 blocks or 1200 miles to the nearest hospital are the think in your FIRST AID PAS?   And YES THIS INFORMATION IS REALLY USEFUL in tool box meeting and staff training drills.

Occupational First Aid Attendants perform a unique service in industry. They alleviate suffering and on occasion save lives through their skills at an accident scene. Furthermore, effective injury management can often shorten the healing time of the injury, allowing the worker to resume normal activities sooner. Attendants in industry must be well trained in all aspects of emergency care, from minor injury management to the most serious trauma care involving airway, breathing, and circulatory emergencies. Consequently, Attendants in industry are required to take on more responsibility than the public first aid courses prepare students for. Frequently, the Attendant must decide when to refer the injured worker to medical attention. Many minor injuries can be properly treated by the well-trained Attendant without referral to a physician. In isolated work locations.

• Recognize potential hazards and barriers to action that may limit your ability to adequately evaluate and treat victims of a wilderness accident.
• Be able to describe and demonstrate the primary survey that one should perform in the evaluation of the ill or injured victim in the wilderness.
• Be able to describe and perform the secondary survey with a focus on the following acronyms: AMPLE, COLDERR, CARTS, AEIOUTIPS
• Describe the Glasgow Coma Scale and be able to use it in determining the score for an injured patient.

Surveying the scene involves many factors of which safety is just one. Surveying the scene means approaching the victim with caution and alertness. Assess the mechanism of injury, the number of victims, the number of bystanders, and other factors specific to the situation which might influence management of the victim.

 Is It Safe?

Reasons for not helping a victim are called barriers to action.

Common barriers include: o The presence of bystanders o The physical safety of the scene (fire hazard, high avalanche danger, heavy traffic, etc.) o The environment itself (inaccessibility to the patient, extremely cold temperature, harsh weather, etc.) o Fear of disease transmission (bleeding, vomiting, open wounds, etc) o The imminent possibility of the scene becoming unsafe at a later time

Approaching, Identifying, and Getting Permission to Treat the Victim

 If possible, approach the victim from the side, in the line of sight of the patient, always keeping the patient in view.

 Stabilize the head of the victim with both hands and ask for permission to treat. If the victim does not consent then treatment cannot be instituted unless the victim is unable to communicate or is mentally incapable of giving consent.

 Ask the victim’s name and location of the pain. If the patient is unconscious or semi-conscious, commence with the primary survey. Primary Survey: A, B, C, D, E Wilderness medicine requires that the caregiver prioritize a patient’s injuries. The acronym A B C D E helps to stratify the victim’s problems, giving first attention to the most life-threatening dangers. The primary assessment will cover, in order of importance, functions essential for life and conditions which may compromise survival.

 Always TEST and think about your knowledge what items would consider in SITE safety drills and tool box meeting, how would staff answer them, are you willing to stake your life on their knowledge.  Although these question may not be part of your normal work area make up questions that could be applied and see how people answer them.

• You are rock climbing with some of your friends when one of them falls approximately 25 feet, landing of rocks at the bottom of the cliff. He appears to be asleep but will open his eyes when you talk to him. He is confused when answering questions but does complain of a bad headache. He will move his arms and legs to command. What is his GCS? a) 10 b) 11 c) 12 d) 13 e) 14 f) 15
• You are rock climbing with several of your friends when there is a rock slide and 3 of your friends fall 10 to 20 feet to the bottom of the cliff. There are also 2 other people who were injured by falling debris while standing at the bottom of the cliff. Which one of the following is correct in terms of managing this situation? a) You should move all of the injured people away from the base of the cliff. b) You should not move anybody as there is a risk of spinal injury by moving them. c) You should put an overhead shade over those at the base of the cliff but not move them. d) You should triage the injured, only moving those without concern of spinal injury from the base of the cliff. e) You should leave all patients where they are lying and leave immediately to get help.
  
• Secondary Survey: GLASGOW COMA SCORE Adults # Infants/Children EYE OPENING spontaneous to voice to pain none 4 3 2 1 spontaneous to voice to pain none VERBAL RESPONSE oriented confused inappropriate words incomprehensible words none 5 4 3 2 1 alert cries irritable restless, moaning none MOTOR RESPONSE obeys commands localizes pain withdraws abnormal flexion abnormal extension none 6 5 4 3 2 1 spontaneous localizes pain withdraws abnormal flexion abnormal extension none
• A hiker falls down a steep embankment 150 feet and lands at the bottom. She is pale but awake. She has a thready carotid (neck) pulse of 130 beats / minute and complains of feeling very thirsty. Her primary survey is normal. Which one of the following explains her increased heart rate, paleness, and thready pulse? a) Abrasions on her lower legs and hands that are dirty but have no active bleeding b) Deformity of her left wrist without any significant swelling. c) Deformity, pain and swelling in her right ankle. d) Neck pain and stiffness e) Severe tenderness on palpation of her abdomen 4) Which one of the following is not correct in regards to obtaining a history from a patient in the secondary survey? a) A = Allergies b) M = Medications c) P = Past medical history d) L = Last meal e) E = Exposure to elements
• Which one of the following is not an area that is concerning for occult blood loss in the trauma victim? a) Abdomen b) Buttocks c) Chest d) Pelvis e) Thigh
• You are snowshoeing in the mountains during winter. It has been in the mid 20’s most of the day when you come upon a 35 year-old man off to the side of the trail. He is breathing and has a strong regular pulse but is very confused and slow to respond to you. He does not complain of anything. Which one of the following is a potential etiology for his altered mental status? a) Hypoglycemia due to too much insulin b) Seizure with a post-seizure confusion c) Stroke d) Intoxication with alcohol e) All of the above should be considered