Module
Trauma Assessment
Three phases of assessment
- 1. Scene assessment — safety, number of casualties, equipment needed, mechanism of injury
- 2. Initial assessment of the casualty — ODDO
- 3. Full examination OR focused examination depending on mechanism
Initial assessment — ODDO
- O — Odzivnost (Responsiveness) — assessed using AVPU
- D — Dihalna pot (Airway)
- D — Dihanje (Breathing)
- O — Obtok (Circulation)
AVPU consciousness scale
- A — Alert: oriented to person, time, place
- V — Voice responsive
- P — Pain responsive
- U — Unresponsive (no response even to pain)
SAMPLE history
- S — Signs and symptoms ("What's wrong?")
- A — Allergies
- M — Medications
- P — Past medical history
- L — Last meal
- E — Event ("What happened?")
Approach with severe mechanism
Approach from the front, secure the C-spine with both hands until full immobilisation. Introduce yourself, ask the casualty/witnesses what happened (gives info on mechanism AND consciousness).
Suspect spinal injury when…
- Diving/jumping into shallow water
- Watercraft accidents
- Hitting rocks
- Belly-flopping from height
- Falls down stairs
- High-speed water-slide collisions
- Severe head injury
- Unconscious patient with unknown cause
- Substance-impaired with unknown event
Signs of spinal injury
- Pain in neck, occiput, or back
- Tenderness on pressure
- Limited neck mobility
- Tingling, weakness, numbness in limbs
- Loss of bowel/bladder control
- Painful posture on movement
- Visible deformity along the spine
Capillary refill test
Press the nail bed or sternum for 5–10 sec until pale, then release. Normal refill <2 sec. Prolonged → possible dehydration or shock.
DO NOT lateral-roll onto a backboard if…
- Painful pelvis
- Suspected bilateral femur fracture
- Loss of motion or sensation in BOTH lower limbs
- Large impaled objects in chest or abdomen
Re-check intervals
- Severe injuries: every 5 minutes
- Minor injuries: every 15 minutes
- Always re-check after moving the patient or any new intervention