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NREMT-B Trauma Assessment


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#1 shep3368

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Posted 05 December 2012 - 06:32 PM

I am currently in an EMT class. We have started the trauma assesment. I have looked around on the internet for sample videos of the Trama Assesment practical to see examples. I have noticed that in all of them the person taking the test goes over the body twice. Once to look for DCAP-BTLS and the other as the secondary assessment. But when I look at the sheet we have printed off from the NREMT website, it seems we only go over the body once. I did notice that the videos were from 2007-2010 and were labled NREMT-P. It that something for paramedics of older material that has been updated?
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#2 fakingpatience

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Posted 07 December 2012 - 04:37 AM

The first assessment shouldn't necessarily be looking for DCAP-BTLS, you are doing a much faster exam, looking for major life threats. Obviously airway and breathing compromises, and major bleeding. Broken wrist? Not something you care about on your first exam. Major bleeding from a wrist lac? Big deal. The initial assessment should focus on the pt's head (mental status, airway) and core (breathing), and a "bigger picture" look for the major bleeding (including skin color, pulse quality). I start by looking at my pt before I even have approached them. How are they positioned? Are they moving at all, making any sounds? Do I see any major pools of blood forming around them? Then going closer, are they breathing? Do I hear any obvious sounds (ie snoring respirations, gurgling). Do we need to open the airway? Does their respiratory rate appear adequate? Do we need to assist ventilations? Do they have a pulse radial and carotid? Rate feel adequate? Any injuries to the chest that may need rapid intervention (ie. flail segment, open wound). Major bleeding I need to control?


Only once those are all determined, and you know if you need to immediately "load and go" or "stay and play" do you move onto the full body assessment looking for DCAP-BTLS. On that second assessment, you do typically re-check everything that you checked initially, just to ensure that there haven't been any changes.

Here is a link to the most updated skills sheet
https://www.nremt.or... Assessment.pdf
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