welcome to EMT prep comm this is the patient assessment management trauma skill welcome to the trauma patient assessment and management skill station here we will evaluate your ability to assess a patient interview them and verbalize the treatment of all conditions you find as you move through the skill evaluation I want you to voice everything you are assessing during the assessment you will have two EMT partners to assist you I may have to clarify treatments with you during the assessment as they arise you have ten minutes to complete this skill once you to review the equipment before you at this time okay I'm ready you've been dispatched to a 24 year old female who was ejected during a motor vehicle accident she is lying 30 feet from the car police have cleared the scene and is safe for you to approach and you may begin your assessment at the patient's side psi is my scene safe you're seeing a safe all right based on dispatch information my mechanism of injury is ejection from a motor vehicle is this my only patient this is your only patient okay right away I'm going to go ahead and request ALS intercept and then again based on mechanism we're going to take full c-spine precautions with this patient general impression I have a 24 year-old female who's been ejected from a motor vehicle I'm going to determine level of consciousness really quickly this this can you miss all right my patient responds to painful stimuli we're going to go ahead and assess ABCs I'm going to assess my patients airway and she is there anything in her airway there's nothing in her airway and she's breathing okay awesome so her Airways Payton she's breathing what is her respiratory rate her respiratory rate is 30 breaths per minute 30 breaths per minute all right I'm going to Austin Tate lung sounds all right my patient responded to painful or to palpation of that side painfully patient has decreased breath sounds on the left side okay decreased breath sounds on the left side couple that with her respiratory rate I'm going to go ahead and put her on high-flow o2 I would do that via non-rebreather okay moving on to circulation does my patient have a radial pulse she's a weak radial pulse at a rate of 130 beats per minute okay weak radial at 130 beats per minute I would go ahead and assess for any major bleeding as I look down in her body do I notice any major bleeding just that you what you see on the lower leg okay so I would go ahead and actually expose that right away to see exactly what's going on do I see any active bleeding right now it looks like bleeding is minimal okay bleeding is minimal so I'm going to note that and I'm going to come back to it so based on a Oh Domon assess her skin what does your skin look like her skin is pale cool and diaphoretic okay so based on her pulse rate and her skin presentation I'm also going to treat for shock right now I'm going to make this a priority transfer prior to patient and we're going to transport immediately if she was conscious and able to talk to me at this point I would obtain a sample history because she's not will bypass that secondary assessment I'm going to do a head to toe palpate the head the face I will check her pupils what are people's look like equal and reactive to light awesome inspect the ears do I notice any fluid from coming from the there's no food coming from the ears okay I already inspected her airway neck I'm going to palpate her neck check for g je d or tracheal deviation do I notice anything in her neck no you notice nothing all right chest I'm going to inspect for equal rise and fall I'm going to palpate your chest okay patient again responds painfully to palpation does their chest feel stable though it does feel stable okay moving on to the abdomen I'm going to palpate the abdomen it is soft soft and on all moderns okay awesome pelvis I'm going to palpate the pelvis pelvis is stable okay moving on to the legs help take the upper legs all right patient responds to painfully to palpation there I'm going to go ahead and straighten this out as I expect this leg what do I see here you see a deformity to the lower leg all right deforming the lower leg and how about this over here it's normal normal okay so I'm going to assess fetal pulses do I have fetal pulses there present okay normally I would do a complete CMS check but since my patient isn't really responding to me I'm going to just I know I've got pedal pulses same with wrist do I have full circulation up here both pulses are present okay so I've got a head to toe done now you know we'd be transporting so I'm going to go ahead and manage my secondary injuries the things I'm concerned about are the decreased breath sounds I'm managing that with oxygen and I'm just going to keep monitoring that also this leg when I put my patient on a backboard that would be managing that that would be splinting that leg also when I put the patient on the backboard I would go ahead and palpate the whole back and check that and make sure that there weren't any other injuries there so now let's do a baseline set of vitals your blood pressure is 92 over 68 okay your pulse is 108 okay and your RESP rate is now 22 all right so again we've got these men injuries managed we're going to go ahead and continue reassessing you know continue reassessing the breasts tones continue reassessing the leg checking for distal pulses and then I would continue reassessing vital signs every five minutes because she's a critical patient is there anything else you'd like to do no that's it thank you