Patient Assessment Model (PAM) Flashcards
Introduction
“Hi I’m a medic of the SAF, if you can hear me please do not move your head.”
Ask someone perform head grip
Rescue Scene Evaluation
What is the ENVIRONMENT?
Are there any HAZARDS?
What is the MECHANISM OF INJURY?
Order of primary survey
RSE Introduction + Head grip Level of consciousness (LOC) Delicate Spine Airway Breathing Circulation Rapid Body Survey Temperature Oxygen Position Decision Point
When do you activate Stretcher, Medical centre, Safety vehicle (SMS)?
NACTO factor hit
Neurological Airway + Breathing Circulation Trauma + Toxin (RBS) Others (RBS)
Temperature > 38.0 degree Celsius
Remember to sound off ______ if have/don’t have.
What to do if have?
NACTO factors + temperature >38.0 degree Celsius.
“Under NACTO, _____________”
If have, remember activate SMS. Physically say “You get a stretcher, you call the medical center, you get the safety rover.”
Level of consciousness
Alert,Verbal [Conscious]
Pain,Unresponsive [Unconscious]
- Rmb to trapeze squeeze if unconscious
Time: What time of day is it now?
Place: Where are you?
Person: Who am I?
- NACTO(N): Fainting, unconscious (FUN), Losing conscious, Ability to answer TPP
Delicate Spine
“Did you fall and hit your head? Did you fall from height” –> Yes, activate SMS
Palpate and check for deformities,tenderness,laceration (DTL) on neck
- -> Yes, activate SMS
- -> No, no spinal injury suspected, remove head grip
- NACTO (T): Spinal injury/fall from height
Airway
Patient conscious + talking (LOC:A) = Airway clear
If not, open airway and check (Head tilt chin lift, Jaw thrust if spinal suspected)
CI: Insert OPA if unconscious
“Measure from tip of lip to earlobe. Open mouth with cross finger technique. Insert OPA hard palate to soft palate. Rotate 180 degrees. Flange resting on tip of lips. OPA inserted”
Breathing
Look Listen Feel (Look for chest rise, Listen + Feel breathing)
- NACTO (A): [BOAS]
- Breathing difficulties
- Obstruction of airway
- Asthma attack
- Smoke inhalation (check nose for soot)
Circulation
Check radial pulse (wrist, trace from thumb)
If absent, check carotid pulse (neck, near Linus’ apple)
- NACTO (C): [PROC]
- PROfuse bleeding (Shock)
- Chest pain
CI: Do AED for unconscious patient here (Mention the 4 hazards to check for + HJPMS)
- Flammable gas
- Water
- Metal
- Explosives
Hair Jewelry Pacemaker Medicinal patch Sweat
Place pads, turn on AED, stand clear, no shocked advised, turn off AED
Rapid Body Survey
“I’m going to perform a rapid body survey to check for any life/limb threatening injuries.”
Inspect and palpate while maintaining constant eye contact (see when they react)
Head, neck, chest, abdomen, pelvis (pelvis rock, push down one side other comes up), lower extremities (One leg at a time,further leg first), upper extremities(further arm first, back (Ensure actually checking the part, esp for back)
Check for medication
Expose area in pain
For back, check upper, mid and lower 3 times each, ask witness if any blood on hands.
- NACTO (TO): [SHIPS SPIN,BED]
- Severe limb injuries
- Head/eye injuries
- Insect bites with rxn/ snake bite
- Penetrating wound
- gun Shot wound
- SPINal injury/fall from height
- Burn injuries (2nd degree or higher)
- Electric shocks
- Drug overdose
CI: Gunshot/puncture wound: Chest seal
CI: Burns (2nd/3rd degree: Flush wound with r.t. water)
Temperature
Oral/Tympanic thermometer
Change to °C, adult mode
- Temperature > 38.0°C, activate SMS
(MOI no suspected heat injury no need take)
Oxygen
Give 100% oxygen at 10L/min using NRM
(Recall NRM steps)
Let the reservoir bag fill up
Straps tighten
Nose clip fit
Misting seen
Position
“Are you comfortable in this position?” If yes don’t move casualty
- > Unconscious/Drowsy/spinal: Supine
- > Breathlessness/Chest injury: Semi fowler
Decision Point
Voice out all reasonings for decision
a) Suffering from any NACTO conditions?
b) Temperature above 38.0°C?
If any a/b = LOAD AND GO
If none of a/b = STAY & TREAT`
