Examination and priorities of assistance for the injured person
PATIENT ASSESSMENT AND PRIORITIES OF ASSISTANCE
After assessing the danger, the patient’s consciousness, calling emergency medical assistance and other services, and providing a comfortable position for examination and first aid, continue the primary assessment following the ABCD principle.
A (Airway) Assess the condition of the airway and ensure it is open.
• Do not move the spine if you suspect it may be injured. If you are not alone, ask for help to support the head and neck in a neutral position.
• If the patient is unconscious and you suspect a spinal injury and you are a medic, open the airway by pushing the jaw forward without moving the head, after stabilizing the spine in a neutral position. If you believe the spine is not injured or you are not a medic, ensure an open airway by using one hand to tilt the head back and the other to lift the chin.
• Do not tilt the head back or push the jaw forward if the patient is conscious and can cough and show the tongue when asked.
• Check for obstructions in the mouth that could cause choking:
-vomit;
-blood;
-loose or knocked-out teeth;
-dentures.
B (Breathing) Assess and ensure breathing
• If the patient is unconscious, place your ear near the patient’s mouth and observe the chest to determine if the patient is breathing – look for chest movements, listen for and feel the exhalation from the patient’s mouth.
• Determine the approximate rate and depth of breathing.
• If the patient is not breathing or it is unclear, perform 2 rescue breaths (see “Initial Resuscitation”).
• Reassess the level of consciousness by interacting with the patient.
C (Circulation) Assess and ensure circulation
• Control external bleeding (apply pressure to the wound).
• If the patient is unconscious, not breathing, and you are not a medic, perform 2 rescue breaths (see “B”) and start chest compressions (pulse check not necessary). If you are a medic, check the carotid pulse for no longer than 10 seconds before starting chest compressions (see “Initial Resuscitation”).
• If the patient is conscious, check the radial pulse and note: presence, rate (slow, normal, fast), regularity.
• Assess skin signs: pale, pale or, conversely, red, hot.
• If shock has occurred or is suspected, provide assistance (see “Shock”).
D (Defibrillation, Disability) Assess neurological damage or perform defibrillation if necessary
-If the patient is unconscious and not breathing, perform defibrillation (see “Initial Resuscitation”).
-If the patient is conscious, check if they can move their arms and legs with equal strength. Ask them to smile, raise their arms and legs, and say “six geese with six goslings.” If one side is weaker, one side of the lips droops, and they cannot say the phrase correctly, it may indicate a stroke.