A rapid trauma assessment is performed only on critically injured patients, if the initial assessment discloses significant wounds, problems with the airway, circulation or breathing or an altered mental state, the patient is regarded to be in a critically injured state (Rahm, 2004). A rapid trauma assessment is necessary in order to determine how to package and transport a patient (American Academy of Orthopaedic Surgeons, 2006); it should take between 60 and 90 seconds (National Association of EMS Physicians, 2002).
A rapid trauma assessment consists of nine basic steps:
1) Assessment of the head: The head should be checked for deformities, contusion, abrasion, puncture/penetrating injury, burns, tenderness, laceration & swelling (DCAP-BTLS). The scalp and the ears of the patient should be inspected visually for obvious hemorrhage and injury and by palpation to look for deformities, tenderness or crepitus etc. The eyes and the eyelids should be inspected, checking for swelling, bruising and discoloration, foreign objects etc. A penlight should be used to check for pupil distention and reactivity to light. The face and the nasal and oral areas should be visually inspected and palpated (National Association of EMS Physicians, 2002).
2) Assessment of the neck: The neck should be checked for DCAP-BTLS. The neck should be inspected visually and by palpation to determine tracheal deviation. In case of suspected neck injury, a rigid cervical collar should be used to immobilize the neck (American Academy of Orthopaedic Surgeons, 2006). Distention in the neck veins is a sign of a tension pneumothorax or cardiac tamponade (National Association of EMS Physicians, 2002).
3) Assessment of the chest: The chest should be checked for DCAP-BTLS. The chest should be examined visually, by palpation and by auscultation (National Association of EMS Physicians, 2002).
4) Assessment of the heart: To ascertain the presence of heart sounds, auscultation should be done at the left lower sternal border or the apex (National Association of EMS Physicians, 2002).
5) Assessment of the abdomen: The abdomen should be checked for DCAP-BTLS. The abdomen should be visually examined for bruising, bleeding and swelling etc. and palpated firmly, looking for rigidity, tenderness, distention or pulsating masses, a pulsating mass more than an inch across in the midline above the umbilicus suggests an aortic aneurysm (National Association of EMS Physicians, 2002).
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