Drill of the Month for February 2017

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This month's drill was prepared by
MFRI Field Instructor Mark Goldstein


Instructor Guide


Topic: Rapid Trauma Assessment (RTA)

Level: Cognitive

Time required: 1 hour

Materials needed:
  • Note taking guidae
  • Dry erase board
  • Full body CPR mannequin (to demonstrate assessment)
  • Rigid cervical collar
  • Stethoscope

Reference:

Limmer & O'Keefe (2012). Emergency Care (12th edition) Upper Saddle River, NJ: Pearson Education, Inc.

Motivation:

Time is of the essence when dealing with high priority trauma patients. EMS personnel must be able to quickly and accurately locate and prioritize injuries. Failure to do so could result in additional harm being caused to the patient.

Objective:

The student will be able to describe the steps to perform a rapid trauma assessment

Overview:

1. Review terminology
2. Review of a rapid trauma assessment

Review of terminology:

D - deformities
C - contusions
A - abrasions
P - punctures/penetrations
B - burns
T - tenderness
L - lacerations
S - swelling
"Crepitus" - broken bones rubbing together
"Palpate" - use of hands (feel)
"Inspect" - use of eyes (look)
"Auscultate" - use of ears (listen)

Rapid trauma assessment

  1. Skull & Facial Bones (inspect & palpate)
    1. dcap-btls & crepitus
    2. check ears for fluid (CSF) & bruising behind the lobes
    3. check nose for fluids
    4. check eyes for PEARL, blood in chamber, racoon eyes
    5. check mouth for obstructions, broken teeth, odors
  2. Throat (inspect & palpate)
    1. dcap-btls & crepitus (back of neck)
    2. Jugular Vein Distention (JVD)
    3. Tracheal Deviation
    4. Medic Alert bracelet
    5. Trachea / Stoma
  3. Clavicals (inspect & palpate)
    1. dcap-btls & crepitus
  4. Measure & place a Rigid Cervical collar (this is not covered in this review)
  5. Chest (inspect & palpate)
    1. dcap-btls & crepitus
    2. rise and fall of the chest
    3. auscultate lung sounds (compare left & right side)
    4. assess for Flail Chest
  6. Abdomen (inspect & palpate)
    1. dcap-btls
    2. rigidity
    3. distention
    4. pulsating masses
  7. Pelvis (inspect & palpate)
    1. dcap-btls & crepitus
  8. Groin (inspect & palpate)
    1. priapism
    2. buff (blood, urine, feces, foreign objects)
  9. Extremities (inspect & palpate)
    1. dcap-btls & crepitus
    2. CMS (circulation/pulse, motor, sensory)
  10. Posterior (inspect & palpate)
    1. perform a log roll (this is not covered in this review)
    2. ensure the entire posterior,from the skull to the ankles, are assessed
    3. dcap-btls
    4. crepitus (where applicable)
    5. buff (anus)
    6. place patient onto a backboard & obtain vital signs (this is not covered in this review)

Overview:

1. Review terminology
2. Review of a rapid trauma assessment

Objective:
The student will be able to describe the steps to perform a rapid trauma assessment