Emergency Action Principle

1. First Aid
- Emergency Action Principle

2. Emergency Action Principle
Pre-hospital Emergency Care is a
series of decisions about treatment and
transport. For you to make good decisions
about how the best care for your patients,
you must first gather information as you
progress thru the patients assessment
process:
- Perform scene seize up
- Perform an initial assessment
- Provide Spinal Immobilization
- Identify and treat life threatening conditions
- Perform a focused history and physical exam
- Provide transport for patients with obvious life
threatening situation
- Reassess vital signs
- Perform ongoing assessments

3. Emergency Action Principle
 Plans of action for any emergency. The principles conducted in the following
order can ensure you safety and that of the victim and other bystanders and
increase the chance of survival of the victim.

4. The Stages of Pre-Hospital Care
1.) Survey the Scene
- Consider scene characteristic
- Identify possible hazards
- Is it safe for me to approach the victim?
- Is there any hazard to the patient?
- Environmental Hazards
example: Fire, Smoke, Heat or Cold
- Structural Hazards
example: Unstable vehicle or structure
- Am I going to need help in this emergency?
 Are there any other services need?
 Do I need any special equipment to reach the
victim?

5. The Stages of Pre-Hospital Care
1.) Survey the Scene
- Once the scene is safe, determine the nature of the problem
A. Trauma
- Is the physical injury caused by external force or violence?
- If suspected Trauma is at hand, you’ll be working with Mechanism of Injury (MOI)
- How’s the patient injured? MOI is the basis for the index of suspicion for trauma injuries
B. Nature of Illness (NOI)
- A patient who is not injured but suffering from a medical condition.
- Determine the number of patients / victim

6. The Stages of Pre-Hospital
Care
2.) Primary Survey (Rapid Assessment)
- To identify and treat conditions that involves
and immediate threat to life.
Possible intervention
to interrupt the
Journey from Life to
Death

7. The Stages of Pre-
Hospital Care
Components of the Primary Survey
 Determine if the patient is conscious or not.
 Form a general impression
 Mouth Check and Finger Sweep
 Assess the airway
 Indication of partial airway occlusion
 Assess the breathing
 Assess the pulse
 Identify major bleeding
 Assess perfusion
 Asses mental status

8. The Stages of Pre-Hospital Care
3.) Activate Medical Assistance (AMA) / Preparation of Transport Facilities
- Cyanosis of pale skin / Significant blood loss / Multiple wounds
- Injuries to the head, chest, abdomen and pelvis
- Multiple injuries of the extremities and posterior thorax
- Unresponsive patient who is not obeying commands
- Inability to maintain a patent airway
- Patient with possible shock condition / Patient with open wound on the chest
- Patient with chest pain and with systolic blood pressure of less than 100mmHg

9. The Stages of Pre-Hospital Care
4. Secondary Survey / Focused History and Physical Assessment
The overall purpose of the Secondary Survey is to detect problems that do not post an immediate threat to
life but may become more serious, life threatening even, if they are not promptly managed.
2 Phase of Secondary Survey
Information Gathering
- Trying to determine the nature of the patient’s problem by making questions and observing where the
patient is found.
Examination Phase / Physical Assessment
- Making a rapid but complete hands on evaluation of the patient to determine his vital signs and detect
injuries or signs of illnesses.

10. Secondary Survey
 Obtaining Medical History
The fundamental reason for taking a history
background is to find out:
- What Happened? What hurts? What else is
wrong?
- To obtain data that might otherwise be
unavailable to the doctor or the medical staff.
 Sources of Information
The scene
- Clues to underlying illnesses
- Mechanism of injury
- Severity of injury
- The patient
- Other informants
- Bystanders, family and friends
- Medical Identification Devices

11. Secondary Survey
 Know the Chief Complaints
Apply SAMPLE – OPQRSTA format
Explore the patient’s chief complaint with a few
questions, you may be able to obtain a clear picture
of the patient’s problem.
 Reassess General Appearance
- Position
- Level of Consciousness
- Behavior and Degree of Distress
- Obvious Wounds and Deformities
- Skin Color, Temperature, and Moisture
Reassess Vital Signs
 Pulse – assess rate, force and rhythm
 Respiration – assess rate, rhythm, abnormal noises,
quality and unusual odor
 Blood Pressure
 Capillary Refill

12. Secondary Survey
Head Toe Examination
 When performing the Rapid Trauma Assessment, it is
necessary to:
Inspect - Look - Colors, Contours and Symmetry
Palpate - Feel - Texture, Consistency, Temperature
Auscultate - Listen - For Sounds
Use sense of smell:
D -Deformities
C – Contusions
A - Abrasions
P – Penetrations / Punctured
B - Burns
T - Tenderness
L - Lacerations
S – Swelling

13. Secondary Survey

14. Secondary Survey
Abdomen
 Shape – outward or inward, flat or distended
 Surface – Laceration and Contusion
 Tone – Soft and rigid, inspect each quadrant and compare to upper and lower quadrants
 Abdominal Distention – abdomen appears to be abnormally large or swollen. It is an indication that a
significant amount of blood has been lose in the abdominal cavity. Inspect discoloration around the
umbilicus and in the flank areas side.
 Palpate each of the four quadrants of the abdomen with your fingers. Place one hand on top of the
other and roll the hand across the quadrants. It should be quickly palpating once for tenderness,
guarding, and rigidity.

15. Secondary Survey
The Abdominal Cavity
 Right Upper Quadrant (RUQ)
- Liver, right kidney, stomach, colon, pancreas, and the gall bladder
 Left Upper Quadrant (LUQ)
- Liver, spleen, left kidney, stomach, colon, pancreas, the female reproductive organ, bladder
 Right Lower Quadrant (RLQ)
- Colon, small intestine, major artery and vein to the right leg, ureter, appendix, female
reproductive organ
 Left Lower Quadrant (LLQ)
- Colon, small intestines, major artery and veins to the left leg, ureter, female reproductive organ
 Midline Area
- Aorta, pancreas, small intestine, bladder and the spine

16. Secondary Survey
Pelvis
 Check for stability by pressing downward and inward. Apply pressure over the anterior, superior iliac spine.
Note whether bleeding around the meatus is present
Genitalia
 Check if there is blood on the patient’s clothing. Suggestive of injury to genital region
Upper and Lower Extremities
 DCAPBTLS
 Neuro Vascular Check
 P – Pulses – Check the distal pulse, dorsalis pedis, tibial pulse, radial pulse
 M – Motor Function – if the patient can obey command, ask the patient to wiggle his toes and squeeze his
fingers
 S – Sensation – pinch the hand and feet, watch for response

17. Secondary Survey
Examination of the Back
 Without moving the patient, slide your hands beneath the grove of the patient’s back and
palpate for deformity or tenderness, withdraw your hands and inspect for blood.