Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

9)Scene Size Up

5,953 views

Published on

  • Be the first to comment

9)Scene Size Up

  1. 1. Scene Size-Up
  2. 2. Scene Size-Up Body Substance Isolation <ul><li>BSI </li></ul><ul><ul><li>Gloves </li></ul></ul><ul><ul><li>Eye protection </li></ul></ul><ul><ul><li>Gowns </li></ul></ul><ul><ul><li>Masks </li></ul></ul><ul><li>Protective Gear </li></ul><ul><ul><li>Head gear </li></ul></ul><ul><ul><li>Eye protection </li></ul></ul><ul><ul><li>Respiratory protection </li></ul></ul><ul><ul><li>Gloves </li></ul></ul><ul><ul><li>Boots </li></ul></ul><ul><ul><li>Coat </li></ul></ul>
  3. 3. Scene Size-Up <ul><li>“ An assessment of the scene and its surroundings” </li></ul><ul><li>Constant reassessment </li></ul><ul><li>Includes: </li></ul><ul><ul><li>Personal protection </li></ul></ul><ul><ul><ul><li>“ Is it safe to approach the scene” </li></ul></ul></ul><ul><ul><ul><ul><li>Crash/rescue scenes </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Toxic substances </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Crime scenes – Potential Violence </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Unstable surfaces- Slopes, Ice, Water, etc. </li></ul></ul></ul></ul><ul><ul><li>Safety of the scene </li></ul></ul><ul><ul><li>Nature of illness – Medical </li></ul></ul><ul><ul><li>Mechanism of injury- Trauma </li></ul></ul><ul><ul><li># of pts </li></ul></ul><ul><ul><li>Need for additional help </li></ul></ul><ul><ul><li>Need for spinal immobilization </li></ul></ul><ul><ul><li>Protection of the pt and bystanders </li></ul></ul>
  4. 4. Scene Size-Up <ul><li>BSI </li></ul><ul><li>Is the scene safe??? </li></ul><ul><ul><li>If not make it safe </li></ul></ul><ul><ul><li>If you cant DON’T enter!!! </li></ul></ul><ul><li>Nature of illness </li></ul><ul><li>Mechanism of injury </li></ul><ul><li>Number of patients </li></ul><ul><li>Request additional help if needed </li></ul><ul><li>Rule in/out spinal stabilization </li></ul>
  5. 5. Motor Vehicle Accident Scenes <ul><li>STOP </li></ul><ul><ul><li>Ideally 100 ft </li></ul></ul><ul><li>Look and listen </li></ul><ul><ul><li>How many cars? </li></ul></ul><ul><ul><li>How many pts? </li></ul></ul><ul><li>Assess resources </li></ul><ul><ul><li>Do you have what you need </li></ul></ul><ul><ul><li>Can you get it? </li></ul></ul><ul><li>Windshield survey </li></ul><ul><ul><li>Are the pts moving? </li></ul></ul><ul><ul><li>Do you see any starbursts? </li></ul></ul><ul><ul><li>Steering wheel deformity? </li></ul></ul><ul><li>Stability </li></ul><ul><ul><li>Is the car stable and safe to enter? </li></ul></ul><ul><li>Lug Nut principle…. </li></ul>
  6. 10. Starburst
  7. 11. Steering wheel deformity
  8. 12. WHATS WRONG WITH THIS PICTURE???
  9. 14. Crime Scenes <ul><li>NEVER enter a crime/violent scene without police </li></ul><ul><li>If you arrive and signs/indications of violence are made- Retreat! </li></ul><ul><li>DOCUMENT!!!!!!! </li></ul><ul><li>Don’t cut through bullet/knife wounds </li></ul><ul><li>If you’re inadvertently in area with a violent person: </li></ul><ul><ul><li>Don’t block their escape </li></ul></ul><ul><ul><li>Don’t challenge them </li></ul></ul><ul><ul><li>Identify yourself as a medical provider </li></ul></ul><ul><ul><li>Acknowledge they seem upset and emphasize you’re there to help </li></ul></ul><ul><ul><li>Explain exactly what you are doing </li></ul></ul><ul><ul><li>Keep distance </li></ul></ul><ul><ul><li>Avoid making quick moves </li></ul></ul>
  10. 15. Environmental Hazards <ul><li>“ Is it safe to approach the pt?” </li></ul><ul><li>Water rescues </li></ul><ul><li>Ice </li></ul><ul><li>Rain </li></ul><ul><li>Slopes </li></ul>
  11. 16. Mechanism of Injury Trauma <ul><li>Mechanism of Injury (MOI) </li></ul><ul><ul><li>“Manner in which an injury occurred during a trauma” </li></ul></ul><ul><ul><ul><li>Type </li></ul></ul></ul><ul><ul><ul><li>Strength </li></ul></ul></ul><ul><ul><ul><li>Direction </li></ul></ul></ul>
  12. 17. Mechanism of Injury Trauma Patients <ul><li>MOI </li></ul><ul><ul><li>Pt, family, bystanders, inspection of scene </li></ul></ul><ul><ul><li>Allows you to anticipate injuries </li></ul></ul><ul><ul><ul><li>Fall with landing on feet </li></ul></ul></ul><ul><ul><ul><li>Unrestrained driver </li></ul></ul></ul><ul><ul><ul><li>Side collision passenger </li></ul></ul></ul><ul><ul><ul><li>Stab wound/location/depth </li></ul></ul></ul><ul><ul><li>Did medical event precede trauma? </li></ul></ul><ul><ul><li>If more pt than units on scene can handle initiate MCI </li></ul></ul><ul><ul><li>Obtain help prior to pt contact </li></ul></ul><ul><ul><ul><li>Less likely to call during care </li></ul></ul></ul><ul><ul><li>Begin triage </li></ul></ul>
  13. 18. Hidden Injuries <ul><li>Safety devices cant prevent everything </li></ul><ul><li>If they had one on it does not exclude all injury </li></ul><ul><ul><li>Deceleration = Sheering Forces </li></ul></ul><ul><ul><li>Loose lap belt </li></ul></ul><ul><ul><ul><li>Compression of abd </li></ul></ul></ul><ul><ul><li>Shoulder belt minus lap belt </li></ul></ul><ul><ul><ul><li>Neck injury </li></ul></ul></ul><ul><ul><li>Airbag deployment </li></ul></ul><ul><ul><ul><li>Pt could still have hit the wheel </li></ul></ul></ul><ul><ul><ul><li>“ Lift and Look” </li></ul></ul></ul><ul><ul><ul><ul><li>Inspect steering wheel </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Steering Wheel deformity= SERIOUS injury </li></ul></ul></ul></ul>
  14. 19. Nature of Illness Medical patients <ul><li>“ Why EMS was activated” </li></ul><ul><ul><li>Determine from pt, family, bystanders </li></ul></ul><ul><ul><li>Obtain # of pt </li></ul></ul><ul><ul><ul><li>Call for assistance if need be (ALS, fire, etc) </li></ul></ul></ul><ul><ul><ul><li>Begin triage </li></ul></ul></ul>
  15. 20. Remember… Scene safety FIRST!!

×