PA HELP

[Rezq304]

Here's how I handle it man.....

The evaluator reads the scenario.

"BSI, is my scene safe?"

Then I ask myself if it's a trauma or a medical.

If a trauma, I'm going to ask about the mechanism of injury.

Then, is this my only patient?

If so, I would state that most likely the crew on scene can handle and wouldn't need additional resources.

Then, consider cervical spine precautions, then state my general impression of the patient.

Then, starts the hands on. My partner takes C-spine. Open the airway with a modified jaw thrust. Look, listen and feel for breathing. If no gag reflex, I'm going to drop an oral at this time. Assess breath sounds. Depending on respirations, I'm going to either place my patient on a non-rebreather or have my other partner deliver respirations via BVM.

Then, I'm going to assess circulation. What's the pulse rate? Is it equal between the carotid & the radial. What's the skin color, temperature and condition? Any major bleeds? If so, control them.

Then, after initial ABC's, I'm making a transport decision. If I decide to make it a load & go, I'm going to DCAPBTLS C-Spine & assess for midline trachea and/or JVD. I'm then, going to assess CNS function. THen, I'm measuring and placing a C-Collar. Rolling the patient, assessing the posterior surface for any DCAPBTLS. Rolling back onto the board making sure to FILL THE VOIDS with sheets. Strapping and securing and moving to the truck assessing CNS function after the move. Once in the truck, I'm doing my detailed exam. DCAPBTLS everything. Pupils PEARL? Vitals? Bebinsky? I'm going to start at least one IV line and bolus fluids if no suspected hemorrhaging in the brain or an aortic tear. Bolus at 20cc/kg. Continue to reassess the patient throughout. I'm going to make sure to keep my patient warm and if they start to exhibit signs of shock, then trendelinberg. Call in report to the hospital and let keep assessing all the way in.

[amartin]

ok so thursday i passed my PA and hare traction, but failed my KED only because my patient kept moving and i didn't tell them to stop so my leg straps weren't tight enough but i get to re-take that part on the 18th and you betcha that i'll get it right even if i have to keep pullin my straps to the point where they can barely move....