the grating sound or feeling of broken bones rubbing together
detailed physical exam
an assessment of the head, neck, chest, abdomen, pelvis, extremities, and posterior of the body to detect signs and symptoms of injury.
It differs from the rapid trauma assessment only in that it also includes examinations of the face, ears, eyes, nose, and mouth during the examination of the head.
It may be done less rapidly, and it may be done en route to the hospital after earlier on scene assessments and interventions are completed.
a condition of being stretched, inflated, or larger than normal.
history of the present illness (HPI)
information gathered regarding the symptoms and nature of the patient's current concern.
"How did this happen?"
jugular vein distention (JVD)
bulging of the neck veins
movement of a part of the chest in the opposite direction to the rest of the chest during respiration.
past medical history (PMH)
information gathered regarding the patient's health problems in the past.
persistent erection of the penis that may result from spinal injury and some medical problems.
rapid trauma assessment
a rapid assessment of the head, neck, chest, abdomen, pelvis extremities, and posterior of the body to detect signs and symptoms of injury.
a memory aid in which the letters stand for elements of the past medical history, last oral intake, and events leading to the injury or illness.
a permanent surgical opening in the neck through which the patient breathes.
a surgical incision held open by a metal or plastic tube.
a patient suffering from one or more physical injuries.
sometimes called a secondary survey
After scene size-up and primary assessment
1 - CC & HPI
2 - secondary survey based on CC & MOI
3 - baseline vitals
4 - PMH
How do you do a secondary assessment of a trauma patient with no significant MOI?
After scene size-up and primary assessment
1 - CC & HPI
2 - C-spine stabilization
3 - consider ALS
4 - rapid trauma assessment
5 - baseline vitals
6 - PMH
How do you do a secondary assessment of a trauma patient with significant MOI?
1 - abnormalities in symmetry
2 - color (pale flush, black & blue, blisters)
3 - shape (DCAP BTLS)
4 - movement (strength and equality of hand grip strength, ability to raise an arm)
When you INSPECT, you are looking for:
What does DCAP BTLS stand for?
1 - abnormalities in shape
2 - temperature (hot, cold)
3 - texture (smooth, wet, abraded)
4 - sensation (tenderness, ability to detect touch)
When you PALPATE, you are looking for:
chest abnormalities (decreased or absent breath sounds)
When you AUSCULTATE, you are looking for:
a major difference in the shape of body part or organ compared to the average shape of that part.
medical term for bruises
medical term for scrapes; a wound caused by superficial damage to the skin, no deeper than the epidermis.
punctures and penetrations
medical term for holes in the body
a type of injury to flesh caused by heat, electricity, chemicals, light, radiation or friction.
pain or discomfort when an affected area is touched.
pain upon removal of pressure rather than application of pressure to the abdomen.
cuts, open wounds that sometimes cause significant blood loss; a jagged wound or cut.
a very common result of injured capillaries bleeding under the skin; to increase in size or volume as a result of internal pressure; expand.
Signs and Symptoms
over the counter?
Past Medical History
Have you been having any medical problems?
Have you been feeling ill?
Recent surgery or illness?
Seeing a doctor?
Last oral intake
Last time you ate and drank and what was it?
Events leading up to the injury and/or illness
What events lead up to today's problem?
SAMPLE stands for:
what you can see/observe,
objective, indication of some medical fact or characteristic that may be detected by the EMT while examining the patient.
what the patient tells you is wrong,
subjective, observed by the patient, and not measured.
(fossa jugularis sternalis), also known as the jugular notch, found at the superior border of the manubrium of the sternum, between the clavicular notches.
Whenever there is a possibility of spinal injury, this is the first step you do and it doesn't stop until the patient is completely immobilized and secured to a backboard.
Adult fall > 20 ft.
Child fall < 15 y/o: fall > 10 ft. or 2-3 x child's ht.
Intrusion > 12in. to occupant site or > 18in. to any site
Ejection (partial or complete)
Death in same passenger compartment
Vehicle telemetry data consistent with high risk of injury
Auto vs. pedestrian/bicyclist thrown, run over, or significant (> 20mph) impact
Motorcycle crash > 20mph
These are all situations that require transport to a trauma center.
Pupils Equal and React to Light and Accommodation
PEARLA stands for:
a serious allergic reaction that is rapid in onset and may cause death. It typically results in a number of symptoms including an itchy rash, throat swelling, and low blood pressure. Common causes include insect bites, foods, and medications.
shortness of breath is also called ________.
ecchymotic areas surrounding both eyes, suggestive of a basilar skull fracture
a discoloration behind the ear in the line of the posterior auricular artery, often associated with a basilar skull fracture.
an abnormal collection of air or gas in the pleural space that separates the lung from the chest wall, and that may interfere with normal breathing.
compression of the heart that occurs when blood or fluid builds up in the space between the myocardium (heart muscle) and the pericardium (outer covering sac of the heart).
When you see "flat neck veins" think _____.
a crackling or crunching sensation under the skin that occurs when gas or air is present in the subcutaneous layer of the skin.
one cause of abdominal distention can be __________.
a surgical procedure in which a stoma is formed by drawing the healthy end of the large intestine or colon through an incision in the anterior abdominal wall and suturing it into place.
a surgical opening constructed by bringing the end or loop of small intestine (the ileum) out onto the surface of the skin.
palpate that site last.
When palpating all four abdominal quadrants, if the patient tells you he has pain in a specific area of the abdomen, you ______________.
Press in on the abdomen with the palm side of your fingers, depressing the surface about _____ inch(es).
Military anti-shock trousers (MAST) or pneumatic anti-shock garments (PASG)
used to treat severe blood loss. They are also indicated for the stabilization of unstable pelvic fractures in the field prior to transport.