Traumatized Patient's initial evaluation.

Evaluation is the cornerstone of excellence in the care of patients with severe trauma in which time is essential. Patients who have the opportunity to reach a ward within the approximate time of one hour have a better chance of survival and this was called the Golden Hour which means that any action should be aimed at saving a life. The nose trauma patients treated at the scene, there are only made critical interventions. Understand that this does not include immobilization; it should be on the scene. The Golden Hour begins when the patient suffers the injury, not the arrival of TEM. It is important to note that a fast handling is not move the victim as soon as possible, you should also give a positive critical care to ensure the life of it.

Steps Office - gets the call and dispatches the unit with the most clear and precise to save time. Transfer to the scene - rapid response and careful use of good sense to take shorter routes. Actions on the scene - safety, universal precautions, patient assessment, immobilization, Tx. and transportation. Transfer to hospital - As its discretion and magnitude the closer to the scene and calling the same for reporting what happened. This helps when you get the service more effective. Arrival at hospital - medical staff notifies all related to the incident, mechanism of injury, existing trauma, etc. Evaluation The first consideration when approaching the security scene is the TEM, there are three key factors for assessing the scene. Security - to assess all the dangers scene - panorama, many wounded, num of vehicles involved if an accident facts - that actually happened or happened Primary Assessment It is a rapid assessment, but effective (it should not take more than two minutes), it helps us determine the facts and situations that threaten the patient's life. This information helps us determine the best treatment and help provide the patient. The primary assessment panoramic vision begins with the scene; it must be done

simultaneously and not be interrupted unless you see breaks in the airway, respiratory or cardio respiratory arrest. It consists of 5 steps: A - open airway with cervical screening, assess the potency of the airway this with the help of chin lift maneuver or pull maneuvers. Should take into account the possible neck injuries and sudden movements can cause irreversible neurological damage. B - Ventilation, corroborating the spontaneity of the vents through the VOS technique for 5 seconds. Once you open the airway approached her face nose and mouth of the victim: V - see chest movement O - hear the breathing S - feel the exhalation C - Circulation and bleeding - in the position you twist your hand that holds the chin to the cricoids cartilage (Adam's apple) to locate the carotid pulse. Assess you and pulse again for 10 seconds, will witness the same, the quality and regularity. Then look for visible bleeding quickly. D - neurological deficit, determine the patient's consciousness through technology A V P P E - outline and review, physical assessment and primary end to the upper extremities, the general rule is to expose the suspected area of injury or hemorrhage removing part of the dress with care and ensuring patient privacy by using the technique : D C A P P B L S T I C Decision critical interventions and transport It is a dynamic process so that during the evaluation of TEM determines the next steps in the area before you upload it to the ambulance. Example the use of KED, Long Back

Board, Splints, bleeding control, etc. Secondary Assessment This is a quick assessment, but in order to detect all injuries, this process is cephalocaudal (head to feet). Includes A, B, C, D, E, Monitor, S / V, Hample, Reappraisal Constant monitoring of the patient during transport to hospital with power S / V, communication with dispatch and delivery and hospital until the patient presents in the emergency room.