detailed physical exam

Question 1

2. Assess the head

Answer 1

a. DCAP-BTLS, TIC, PERRL
b. Raccoon eyes and battle signs
c. Mouth – teeth/airway obstructions
d. Nose/mouth/ears – CSF/Blood

Question 2

3. Eye laceration

Answer 2

a. Position, remove headgear
i. Seated if conscious, supine w head elevated if not
b. Visually acuity (if able)
c. Examine eyes
i. PERRL, COBBLES – ask about contacts and record – don’t force eyelids open
d. Categorize
i. Surrounding tissues (lac and contusion), globe, extrusion of ee, FOB, impaled obj
e. Initiate tx for injury
i. Bleeding – light pressure, unless eyeball injury, then no pressure
ii. Cover w/ sterile gauze soaked in saline
iii. If no penetrating inj – ice pack (swelling)
iv. Non protruding – FOX eye shield
v. Cover uninjured eye as well

Question 3

4. Assess neck

Answer 3

a. DCAP-BTLS, C spine for TIC/step-offs, JVD, tracheal deviation
b. Apply c-collar PRN

Question 4

5. Assess chest

Answer 4

a. DCAP-BTLS, equal/bilateral rise and fall of chest
b. Auscultate 4 fields for equality and presence of respirations
c. Palpate anterior chest for TIC
d. Observe for progressive resp distress

Question 5

6. Perform needle D

Answer 5

a. 2nd ICS mid clavicular line over the 3rd rib (OR) 5th ICS on anterior axillary line directly over 6th rib
b. Choose needle 10-14ga 3¼ ”
c. Insert over top of rib at 90 degree (to chest wall) and LEAVE NEEDLE in x 10 SEC
d. Remove needle – leave catheter
e. Secure hub to chest

Question 6

7. Assess abdomen

Answer 6

a. DCAP-BTLS, TRD (if no open abdominal wound)

Question 7

8. Treat open wound if present

Answer 7

a. Expose wound
b. Inspect for distention, contusions, penetration, evisceration, obvious bleeding
c. Sterile abdominal dressing – moist dressing for protruding organs
d. Place protruding organs near wound
e. Apply bandage – sterile side down

Question 8

9. Assess pelvis

Answer 8

a. DCAP-BTLS
b. Pelvic binder PRN
c. Gently detect TIC if no s/s of trauma (omit if pelvic binder is already in place)
d. Inspect genitalia and perineum for mutilating inj, amputation, bruising/pooling of perineum

Question 9

10. Lower extremities

Answer 9

a. DCAP-BTLS, TIC, PMS

Question 10

11. Immobilize a suspected fx PRN

Answer 10

a. Sit or lie down
b. Tell Other person – manually immobilize fx extremity
c. Remove foot gear and expose fx site
d. Check distal pulse and cap refill
e. Apply padding to bony prominences
f. Measure and shape splint on uninjured extremity
g. Splint medial and lateral aspect of fx
h. Secure in position of function
i. Wrap both splints around leg w elastic bandage from top to bottom of foot and then up length of splints toward the knee
j. Secure with tape (all the way around)
k. Recheck distal pulse

Question 11

12. Assess upper extremities

Answer 11

a. DCAP-BTLS, TIC, PMS

Question 12

13. Immobilize

Answer 12

a. Sit or lie down
b. Tell other person – manually immobilize fx
c. Remove jewelry
d. Expose site
e. Check distal puse and cap refill
f. Measure and shape splint (on uninjured side)
g. Secure splint to limb in pos of function
h. Place fx forearm in splint w hand in natural curve ontop of rolled end of splint
i. Secure splint to injured arm using elastic bandage
j. Recheck pulses and loosen PRN
k. secure around with tape
l. Sling and swathe

Question 13

14. Assess the posterior

Answer 13

a. DCAP-BTLS, TIC and step-offs, BUDS
b. Log roll patient onto litter/stretcher
c. Reassess all interventions

Question 14

15. Perform ongoing assessment (while waiting on transport q 5-15 min) PRN

Answer 14

a. Primary assessment
b. Vital signs
c. Repeat detailed PE on injuries and re-eval interventions and tx
d. Reeval evac category

Question 15

16. Don’t cause further injury, and met all admin tasks

Answer 15

do that shit