Emergency medical responder (EMR)/Scene/patient assessment

Both the scene and patient assessment must be done before approaching the patient. The purpose of this assessment is to gather as much information about the scene and patient(s) as possible and insure the EMR’s safety.

Scene assessment

1. Time. Upon arriving on scene an EMR must first note the time of arrival. This will prove vital in assessing the patients progression.
2. Body substance isolation (BSI). An EMR must determine what BSI will be required and apply it, prior to exiting the ambulance.
3. Hazards. Determine what hazards are present on the scene before approaching the scene. If the scene is outside and visible from the ambulance, asses prior to exiting the ambulance.
4. Number of patients. Note the number of patients.
5. Method of injury or illness (MOI). Try to determine the MOI before becoming engrossed in a single patient. This will help to understand what is wrong with the patient.
6. Bystanders. Take note of any bystanders and try to determine their demeanor. Could they provide important information? Could they become violent? Have they already started first aid?
7. Call for backup. After performing all of the above, the EMR should now know what backup is required if any. Police for crowd control? Fire fighters for vehicle extraction? More ambulances?

Patient assessment

1. Skin condition. As an EMR approaches a patient, the EMR should note the skin condition. This is a strong and immediate indicator of the patients condition.
2. Patient positioning. Note the position of the patient. Is the patient sitting up comfortably? Is the patient hunched over as if struggling to breath? Is the patient lying in an unnatural position?
3. Level of distress. Determine how the patient is handling the situation. Is the patient calm? Does the patient seem panicked?
4. Tracking. Is the patient tracking the EMR? Does the patient seem aware of his/her surrounding.
5. Angulated fractures. Note if the patient has any unnatural angulations, which would indicate a fracture.
6. Pooling of fluids. Is there any blood or other fluids pooling around the patient?

Emergency Medicine