Trauma assessment guideline 2020

One of the most popular areas on our website has been people checking for trauma assessment guidelines, so here is an updated version.

Please note that this is written for a very specific audience and is not necessarily the right guidelines for all. Please contact us [on info@lazarustraining.co.uk] if you have any questions or doubts.

Trauma Assessment guide 2020

• Safety & Scene Management
  • Note time of arrival- let control know
  • Check for safety- 1,2,3
    • You [Gloves, glasses etc]
    • Environment [cars, crowds etc]
    • Patient [are they a threat- do a frisk or take a risk]
  • Read the scene- ask what happened
  • Consider the mechanism of injury

• CABCDE
  • If required stabilize head and neck
    • Knees if possible
    • One-hand
    • Equipment
  • Four points of spine alignment
    • Nose
    • Sternum
    • Nice bits
    • Eyes looking forward
  • Call for backup
  • Talk to patient[s] to establish the level of consciousness
    • Alert
    • Verbal
    • Pain
    • Unresponsive
• Catastrophic bleeding
  • Tourniquet- compressible
  • Pack wound- junctional bleed
• Airway
  • Is the airway noisy or silent- noisy is a partial obstruction
  • Is the patient silent?
    • Complete obstruction
    • Normal breathing?
    • Stopped breathing?
      • Pocket mask/BVM/iGel
  • Is there an obstruction?
    • Bubbling=Fluid- turn then suction
    • Snoring= Tongue- airway positioning
  • Assess soft tissues of upper airway
    • Lips
    • Tongue
    • Nose- [milk it for signs of bleeding]
    • Larynx
  • Assess the hard tissues of the airway
    • Jaw
    • Cheekbones [maxilla]
    • Teeth & dental work
  • Open mouth to look for bad stuff
  • Clear the airway
  • Create an airway
    • Jaw thrust*
    • Head tilt. Chin lift
    • Chin lift
  • Consider airway adjuncts
    • NP [6 female 7 male]
    • OP- “hands and plastic”
• Breathing
  • Expose to the waistline- RVP FLASH
  • R- Count the rate [goalposts 10-30]
  • V- Assess volume and effort of breathing
    • P- PUT OXYGEN ON
  • FLASH
    • Feel the chest [fractures]
    • Look at the chest
      • Holes
      • Bruising [internal chest problem]
    • Armpits [hidden injuries]
    • Search the back, sides and shoulders- check clavicle
    • Holes- seal them- vented one per side,
• Circulation
  • Blood on the floor plus four more
    • Chest
    • Abdomen
    • Pelvis
    • Femurs
  • Blood sweep
  • Stop all external bleeding
    • Tourniquet
    • Pressure
      • Direct
        • Clotting agent
      • Indirect
    • Elevation
    • Windlass dressing
  • Splint pelvis if unstable or suspected fracture
    • DO NOT ROCK or SPRING
  • Look for internal bleeding
  • Pulse- check the radial pulse in both arms
    • Is the rate good [less than 120 bpm]
    • Is the volume good
  • Shock- Skin colour- [pale and clammy]
  • Recheck pulse- if no radial pulse raise legs to 45 degrees unless suspected fracture of pelvis or femur
• Disability
  • Assess LOC- repeat and record- trend over time
    • Alert
    • Voice
    • Pain
    • Unresponsive
• Exposure & Evacuation
  • Protect from elements
  • Prepare evacuation
  • Reassess and record
    • Most important assessment is a reassessment
    • If it’s not written down it didn’t happen
  • Hand over using AT MIST format- [you have 30 seconds]
    • Age
    • Time of incident
    • Mechanism of Injury
    • Injuries found/suspected
    • Signs and Symptoms
    • Treatment given
  • Document incident
  • Restock