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Toronto Fire Services / Emergency Patient Care Scenario Assessment Checklist Participant’s Name: ______________________________ Date: _____________ Instructor: _______________ Spinal Immobilization Primary Assessment Introduction Scene Survey ( EMCAP ) Assessment Items Environment is safe Mechanism of Injury Count the casualties Additional resources requested Personal protective equipment Approaches patient from front Introduces self and intent Cautions patient to remain still and obtains consent Delegates C-Spine manual stabilization LOC / LOA ( Alert, Verbal, Pain, Unresponsive ) Airway: - visualizes / clear if required - delegates airway adjunct Breathing: - looks, listen, feel for breathing - determines adequacy of breathing - delegates ventilation / O2 if required Circulation: - carotid and/or radial pulse for 6 seconds - notes overall skin condition - capillary refill assessed - gross bleeding and control if required Neck: - CLAPS-D / TICS-D - JVD - midline/deviated trachea Chest: - delegates required critical interventions - appropriately exposes chest to examine - examines for CLAPS-D / TICS-D - auscultate for air entry - determine adequacy of breathing based on findings Abdomen: - exposes to examine - looks for pulsation/distention - feels with one hand for rigidity - palpates 4 quadrants Pelvis: - CLAPS-D / TICS-D - palpates in 3 planes for stability Femurs: - CLAPS-D / TICS-D Priority Decision ( Critical / Non-critical ) Keeps patient warm Packaging patient for transport Selects appropriate collar size Co-ordinates log roll and maintains alignment Examines back while rolling patient on backboard Lowers and positions patient on backboard Properly applies straps and tightens Secures head last and appropriately Yes No N/A Comments Acronyms Completes Full Body Survey Patient Interview Vital Signs Assessment Items Yes No N/A Comments LOA ( person, place and time ) Pulse ( rate, rhythm and volume ) Blood pressure Respirations ( rate, rhythm and volume ) Pupils ( pearl, unequal ) Overall skin condition Chief complaint Signs and symptoms Allergies Medications ( prescribed and over the counter ) Past medical history ( relevant ) Last oral intake ( meals, drinks, etc ) Events leading up to problem Head / Face: - CLAPS-D / TICS-D - examines for fluid from nose and ears - battle’s / raccoon signs - reassess airway, breathing, pupils Neck: - CLAPS-D / TICS-D - JVD - Trachea is midline/deviated Chest: - CLAPS-D / TICS-D - auscultates for air entry - reassesses/adjusts critical interventions Back: - CLAPS-D / TICS-D Abdomen: - CLAPS-D / TICS-D - looks for pulsating mass/distention - feels for rigidity/tenderness - palpates 4 quadrants Pelvis: - CLAPS-D / TICS-D - examines 3 planes for stability - checks for incontinence/priapism Femurs: - CLAPS-D / TICS-D - circulation, sensation, mobility ( CSM ) Legs: - CLAPS-D / TICS-D - circulation, sensation, mobility ( CSM ) Arms: - CLAPS-D / TICS-D - circulation, sensation, mobility ( CSM ) EMCAP LOC LOA AVPU CLAPS-D TICS-D JVD SAMPLE OPQRST CSM PEARL CC Comments / Points To Work On: Environment, Mechanism of Injury, Count Casualties, Additional Resources, PPE Level of Consciousness Level of Awareness Alert, Verbal, Painful, Unresponsive Contusions, Lacerations, Abrasions, Punctures, Symmetry/Swelling, Deformity Tenderness, Instability, Crepitus, Subcutaneous Emphysema, Discolouration Jugular Vein Distention Signs & Symptoms, Allergies, Medications, Past Medical History, Last Oral Intake, Events Onset, Provoking factors, Quality of Pain, Radiating/Referring, Severity (1-10), Time of Pain Circulation, Sensation and Mobility Pupils Equal and Reactive to Light ( be aware of glass eyes or other false positives 0 Chief Complaint