Chapter 3

Victim Assessment and Urgent Care

Lesson Objectives
Explain the importance of performing a detailed and
systematic assessment.
List what to look for during the scene survey.
Identify and describe the steps of the initial assessment.
Use the SAMPLE mnemonic to obtain a victims history.
Assess a victims vital signs and perform a physical exam.
Know how to perform ongoing assessment of a victim.
Know how to handle multiple-victim incidents (ie, triage).
Assessment (1 of 2)
Perform a rapid, accurate assessment.
Skills must be learned well and practiced
regularly.
Assessment (2 of 2)
Five-part victim assessment:
Scene survey
Initial assessment
Victims history
Vital signs and physical exam
Ongoing assessment
Scene Survey (1 of 2)
Provides first impression and reveals hazards
Protect yourself from blood or bodily fluids.
Scene Survey (2 of 2)
What to look for
What is cause of condition and related
problems?
Is the scene safe?
Is the victim injured or ill?
What is the mechanism of injury?
Is the victim responsive or unresponsive?
How many victims are there?
Initial Assessment (1 of 4)
Initial assessment is designed to detect
life-threatening conditions.
Determine if the victim is responsive or
unresponsive.
If unresponsive, prepare to evacuate.
Assess breathing problems and bleeding;
attend to these problems before
proceeding further.
Initial Assessment (2 of 4)
Assess the airway
If responsive person
cannot speak or
cough, treat for
obstructed airway.
What to do: Open
airway using head tilt
chin lift maneuver.
Initial Assessment (3 of 4)
Assess breathing
Determine whether victim is breathing normally
and adequately.
Look, listen, and feel for movement of air.
What to do:
Recovery position
Rescue breathing
Initial Assessment (4 of 4)
Check for hemorrhage
Severe bleeding,
external or internal, can
be life threatening.
Check entire body for
blood.
Expose affected area.
Apply direct pressure.
Victims History (1 of 2)
Use SAMPLE mnemonic to remember
steps in obtaining history.
If victim cannot provide history, obtain it
from companions.
Check for a medical identification tag.
Victims History (2 of 2)
SAMPLE mnemonic
Symptoms
Allergies
Medications
Past relevant medical
history
Last oral intake
Events leading up to
the injury or illness
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Vital Signs and Physical Exam
(1 of 9)
Assess level of responsiveness, pulse, breathing,
body temperature, skin condition.
Check vital signs at the start of physical exam.
Assess vital signs frequently for unstable victims.
Vital Signs and Physical Exam
(2 of 9)
Level of responsiveness: AVPU scale
A = Alert
V = Responds to verbal stimuli
P = Responds to painful stimuli
U = Unresponsive to voice or pain
Vital Signs and Physical Exam
(3 of 9)
Pulse
Radial pulse
Practice until you
can find pulse
easily and quickly.
Vital Signs and Physical Exam
(4 of 9)
Breathing
Snoring
Stridor
Wheezing
Gurgling
Rattling
Vital Signs and Physical Exam
(5 of 9)
Temperature
Can alert you to fever, heat illness, or
hypothermia.
Carry a thermometer in your first aid kit.
Estimate body temperature by placing the back
of your hand on the victims forehead.
Vital Signs and Physical Exam
(6 of 9)
Skin condition
Color and temperature
Moisture
Vital Signs and Physical Exam
(7 of 9)
Physical examination
Perform a thorough, systematic physical
assessment.
Victims with minor injuries or illnesses might
not require a complete physical assessment.
Vital Signs and Physical Exam
(8 of 9)
Physical examination
DOTS mnemonic:
D = Deformities
O = Open wounds
T = Tenderness
S = Swelling
Vital Signs and Physical Exam
(9 of 9)
Physical examination
After the physical exam
You should have a good idea of what is
wrong with the victim.
Suspect a spinal injury in any unresponsive
person injured in a high-velocity episode.
Ongoing Assessment
Used to monitor victims condition.
Determine whether victims condition is
staying the same.
Reassess:
Breathing, mental status, vital signs
Every 5 minutes for unstable victims
Every 15 minutes for stable victims
Monitor results of first aid care.
Multiple-Victim Incidents (Triage)
(1 of 2)
Emergency situations with two or more victims
Decide who to care for and evacuate first.
Tell mobile victims to move to specific area.
These victims are in lowest-priority category.
Find highest priority victims by performing
assessment on remaining victims. Go to
motionless victims first.
Spend fewer than 60 seconds with each victim.
Multiple-Victim Incidents (Triage)
(2 of 2)
Triage categories:
Highest priority
Second priority
Lowest priority