1. Scene Size-up 3A. Rapid Focused P. E. and History 3B. Rapid Focused P. E. and History 3C.

3B. Rapid Focused P. E. and History 3C. Detailed physical 4. Baseline Vitals
a. Body (MEDICAL) Signs
Substance (TRAUMA) a. Rapid focused physical exam examination a. Pulse
Isolation a. Rapid focused physical exam (using DCAPBLS-TIC-PMS) a. Head b. Ventilations
b. Is my scene safe (using DCAPBLS-TIC-PMS) (1) Head b. Face c. Blood pressure
c. Mechanism of injury (1) Head (2) Neck c. Ears d. Skin color and
Nature of illness (2) Neck (3) Chest d. Eyes temperature
d. # of patients (3) Chest (4) Pelvis e. Nose e. Level of
e. Call for help (4) Pelvis (5) Abdomen (TRDG) f. Mouth consciousness
f. Begin Triage (5) Abdomen (TRDG) (6) Extremities g. Neck (AVPU)/LOC Level
2. Initial Assessment Tenderness Rigidity Distension Guarding (7) Back h. Chest 1. Person
(6) Extremities (8) Baseline vitals i. Abdomen 2. Place
Use a General Impression (7) Back Evaluate chief complaint (OPQRST) j. Pelvis 3. Time
to Assess the patients (8) Baseline vitals (1) Onset k. Extremities 4. Event
Position/Signs/Activity Signs of Trauma (DCAPBLS-TIC-PMS) (2) Provocation l. Back f. Pupil Reaction
“Hey, Hey are you okay” (1) Deformities (3) Quality m. Reassessment of g. SAMPLE History
(1) Alert (2) Contusions (4) Radiation Baseline vitals (Reassess vitals
(2) Verbal stimulus (3) Abrasions (5) Severity every 5 minutes for
(3) Painful Stimulus (4) Punctures/Penetrations/Paradoxial Mvmnt (6) Time Trauma every 15
(4) Unresponsive (5) Burns b. Rapid focused history (SAMPLE) minutes for other)
TAKE CSPINE (6) Lacerations (1) Signs
(ABCDEF) (8) Swelling (2) Allergies
a. Airway assessment (9) Tenderness (3) Medications
b. Breathing assessment (10) Instability (4) Pertinent medical history
Look/Listen/Feel (11) Crepitus (5) Last oral intake ABBREVIATIONS/MEANINGS
c. Circulation assessment (12) Pulses (6) Event AMI Acute Myocardial Infarction
d. Determine Patient Priority (13) Motor response ASHD Ateriosclerotic Heart Disease
(14) Sensory ROOT WORDS/MEANINGS BP Blood Pressure
e. Expose the patient
f. Focused exam CARDI Heart C Centigrade
b. Rapid focused history (SAMPLE) OSTE Bone CA Cancer
(1) Signs GASTR Stomach CCU Cardiac Care Unit
(2) Allergies NEPHR Kidney CHF Congestive Heart Failure
PCR Pre-hospital Care 4
(3) Medications PHLEB Vein COPD Chronic obstructive Pulminary Disease
Report CSF Cerebrospinal Fluid
(4) Pertinent medical history TRACHE Trachea
PPE CVA Cerebrovascular Accident
(5) Last oral intake THORAC Chest
Personal Protective DX Diagnosis
(6) Events leading to
ON-GOING injury/Illness
ASSESSMENT PREFIXES/MEANINGS
Equipment ECG Electrocardiogram
LOC Level of Further evalinitial
1. Repeat chiefexam
complaint (OPQRST) AMBI Both, Both Sides
F Fahrenheit
2. Vital signs PRE Before, In Front
Consciousness FX Fracture
3. Recheck what was found during focused exam HYPO Under, below
PTSD Post Traumatic GI Gastrointestinal
Stress Disorder 4. Recheck interventions EPI Upon
GM Gram
OSHA Occupational Safety INTER Between ICU Intensive Care Unit
and Health Secure the Airway POST After, Behind IV Intravenous
Administration SUFFIXES/MEANINGS O2 OXYGEN
DABDA Denial Anger Barganing Heat Conservation in the Body -ECTOMY Exicion RN REGISTERED NURSE
Depression Acceptance Oxygenation of RBCs -IT IS Inflammation RX Treatment
CISD Critical Incident Stress Core perfusion improved by elevation of legs CENTESIS Surgical Puncture P- Pulse
Debriefing Keep the field time short -METER Instrument to Measure R- Respiration
PEARL Pupils Equal And React -SCOPY Visual Exam
to Light -PARESIS Partial Paralysis

Compensated – Hypoperfusion/Hypoxia starts – compensated by reduced container

constricted blood flow increased respitory rate increased force of heart contractions TYPES: Hypovolemic: low volume Cardiogenic: pump failure Psychogenic: emotional Septic: infections
Uncompensated – Decreased perfusion of organs – no longer maintains normal BP ext time cells die Anaphylactic: allergic reaction
 COMMON DIRECTIONAL TERMINOLOGY SKELETON
TORSO Trunk of the body The chest is located in the TORSO CARTLIDGE between bones lubricate and cushion
MIDLINE Line vertically down the middle The nose is located in the MIDLINE LIGAMENTS hold bones together
MEDIAL Toward the midline The heart is MEDIAL to the right arm 206Bones divided into eight parts
LATERAL Away from the middle The ear are located LATERAL to the head JOINTS
PROXIMAL Closer to the trunk The elbow is PROXIMAL to the trunk Ball and Socket, Hinged, Pivot, Fused/Sutured
DISTAL Farther from the trunk The wrist is DISTAL to the elbow Ellipsoid, Saddle, Plane/Gliding Joints connect bone to bone
SUPERIOR Above The head is SUPERIOR to the shoulders SKULL (4 major areas
INFERIOR Below The feet are INFERIOR to the knees Frontal Occipital Temporal Parietal
MIDAUXILLARY Line down mid armpit to ankle Divides body into anterior and posterior BONES of the FACE (5 major bones)
ANTERIOR Toward the front The abdomen is located ANTERIOR to the spine Nasal 2 Maxilla 2 Zygomatic Mandible Orbit
POSTERIOR Toward the rear The spinal column is located POSTERIOR to the heart SPINAL COLUMN
MIDCLAVICULAR Line down clavicle to pelvis The nipples are located in the MIDCLAVICULAR line 33 bones called vertebrae
BILATERAL Pertaining to both sides The patient had BILATERAL wrist deformities 7 Cervical, 12 Thoracic, 5 Lumbar, 5 Sacrum, 4 Coccyx
DORSAL Toward the back The buttocks are located on the DORSAL side of body THORAX
VENTRAL Toward the front The abdomen is located on the VENTRAL side of body 12 Ribs attached posteriorly to thoracic vertibre
Of 12 only 10 attached anteriorly to the Sternum
PALMAR Relating to the palm The patient had a PALMAR wart
PLANTAR Relating to sole of the foot The patient had a PLANTAR wart Sternum divided into 3 parts Manubrium, Body, Xiphoid Process
PELVIS
PRONE Lying face down The patient was found PRONE
Iliac Crest, Ishium, Pubis
SUPINE Lying face up The patient was found SUPINE
UPPER EXTREMITIES
FOWLER position Sitting up The patient was placed in the FOWLER position
Shoulder blade (3 parts) Scapula, Acromoin, Clavicle, Humerus, Ulna, Radial
TRENDELENBURG pos Feet up, head down The patient was placed in the TRENDELBERG position
Carpals, Metacarpals, Phalanges
RECOVERY position On side
LOWER EXTREMITIES
ASPICES Plural of APEX The uppermost portion of the liver is the APEX
Femur Hip Joint Patella Tibia Fibula
INTEGUMENTARY SYSTEM Ankle (Medial and Lateral Malleolus)
2 Divisions, Foot (Tarsals and Metatarsals)
The Central Nervous System (CNS) composed of Brain and Spinal column Largest organ of the body
CARDIOVASCULAR
Command center of the body Brain = Brain Stem, Cerebellum (big), Cerebrum (little) Protects the body from environment
3 components/ Heart, Blood, Blood vessels (Pump, Pipes, Fluid)
The Peripheral Nervous System (PNS) composed of 2 types of nerves, Sensory and Motor 3 Layers
Two circuits, Pulmonary (Lungs) and Systemic (Body)
Sensory nerves (carry messages from body to CNS) Epidermis
Heart made of 3 layers, Epicardium, Myocardium, Endocardium
Motor nerves (carry messages from CNS to body) Dermis
Pericardium is the thin sack or layer around the heart
Autonomic nervous system carries out voluntary and involuntary actions Subcutaneous
Arteries flow away from the heart/Veins flow to the heart
Sympathetic nervous system, speeds up heart rate
Aorta, Arteries, Arterioles, Capillaries, Venules, Veins Vena Cava S/I
Parasympathetic slows down heart rate
MUSCULAR SYSTEM Artery: Aorta, Coranary, Carotid, Femoral, Brachial, Radial, Iliac, Pedis, Tibial,
Muscles divided into 3 types Mouth, Nose, Oropharynx Veins: Vena cava S/I, Iliac, Femoral, Great saphenous
DIGESTIVE SYSTEM Voluntary Nasopharynx 4 Heart Valves, Tricuspid, Pulmonary, Mitral, Aortic
Processes solids and liquids Contract/Relax at will Pharynx, Epiglottis Larynx, Vocal Pulmonary arteries- take waste blood to the lungs
Transcends oral, thoracic, abdominal, and pelvic cavaties Tendons connect bone to cords Pulmonary veins- bring O2 rich blood to the heart
Food taken into mouth, esophagus, stomach, small intestine, muscle creating pull when Trachea, Carina Blood composed of plasma and three types of cells
Large intestine, colon, rectum the muscle contracts Bronchi, Bronchioles Plasma, suspends the blood cells and nutrients(45% blood fluid)
Striaped Alveolus Red cells (erythrocytes) contain hemoglobin (binds O2 to tissue
Extension (muscle relaxes) Lungs 3 lobes right/ 2 left White cells (Leukocytes) (fights infection)(5 types)
Flexion (muscle contracts) Diaphragm Platelets (thrombocytes)(clots blood)(damaged red cells)
Involuntary Visceral Pleura, lung ext Adult has 5-6 liters of blood (5000ml) Infants 800 ml, Newborn 300ml
Secretes chemicals called hormones from glands into Smooth muscles Parital Pleura, chest wall Blood pressure, Adult normal is 120/80 with females normally 10 lower
bloodstream Cardiac Intercostal mucles, between ribs Systolic (left ventricle contracts) high #
The hormones regulate body activities and functions Found in heart (smooth) Ventilation Diastolic (left ventricle rests) low #
Two major hormones are epinephrine(adrenalin) and insulin 12-20 adult Perfusion circulation of blood through organ/structure
Insulin is produced by the pancreas and metabolizes Generates own contraction 15-30 child Heart pumps out of blood/cycles blood in about 1 minute /called Cardiac Output
glucose for energy Has 3 layers 25-30/50 infant Radial most used pulse, Carotid easiest to find, check Rhythm, Character, Rate
Epicardium (outer) Measure – Rhythm: Intervals between beats, regular/irregular
BODY CAVATIES Myocardium ( mid contracts) Rate/Rhythm/Quality/Depth Character : Full=Strong, Bounding=Extremely Strong, Thready = Weak, Rapid
Skull Cavity, Thoracic Cavaty Endocardium (inner) Mediastinum, cavity behind lungs Pulse Rate: Adult=60–100 / Child=80–100 / Infant=100–140 Newborn=130-140
Abdominal Cavity/divided into four quadrants Tidal Volume = 500ml is normal Tachycardia = high pulse >100 Bradycardia = low pulse <60