first aid

1. Chapter 4
Finding Out What is Wrong

2. Assessment Overview
• Assessment: Sequence of actions that
helps determine what is wrong
• A primary check will determine:
− Illness or injury
− Responsiveness or unresponsiveness
− Existence of life-threatening condition

3. Assessment Overview
© Jones & Bartlett Learning.

4. Assessment Steps
• Perform a primary check.
• Perform a physical exam.
• Obtain the person’s SAMPLE history.

5. Scene Size-up
• Look for hazards.
• Be aware of the potential for violence.
• Be observant for weapons.
• If scene appears hazardous, do not go in.
• Reduce exposure.
• Determine whether problem is injury or
illness.

6. Primary Check
• Identify life-threatening conditions so that
you can immediately take action to treat
the conditions.
− Responsiveness
− Circulation
− Breathing
− Severe bleeding

7. Primary Check
• Form a first impression.
− Injury or illness?
− Responsive or unresponsive?
− Breathing adequately? Talking?
− Bleeding?
− Chance of exposure to blood or body fluids?
− Danger to you, injured or ill person, or
bystanders?

8. Primary Check
• Check responsiveness.
− Tap the person on the shoulder and ask, “Are
you okay?”
• If the person does not respond, call 9-1-1.
• If you cannot detect breathing, begin CPR.

9. Primary Check
• Check for breathing.
− Chest movement
− Normal and abnormal breath sounds
− Cyanosis and skin color
© Jones & Bartlett Learning.

10. Primary Check
• Check for severe bleeding.
− Check for a large amount of blood.
• Around the person
• On the person’s clothing
− Control bleeding.
− Wear exam gloves.

11. Primary Check
• Position the person.
− Most people should not be moved.
− Exceptions:
• Unsafe location
• Person is face down and needs CPR
• Person has difficulty breathing from vomit
• First aid provider must leave to get help
• Signs of shock develop

12. Placing an Unresponsive Breathing
Person in the Recovery Position
• Kneel next to the
person’s side.
• Straighten both
legs.
• Place the arm
nearest you out
from the body.
© Jones & Bartlett Learning.

13. Placing an Unresponsive Breathing
Person in the Recovery Position
• Bring the other arm
across the person’s
chest.
• Grab and raise the
far knee until it is
bent.
© Jones & Bartlett Learning.
© Jones & Bartlett Learning.

14. Placing an Unresponsive Breathing
Person in the Recovery Position
• Grab the person’s
bent knee and
shoulder and roll
the person toward
you, onto the side. © Jones & Bartlett Learning.

15. Placing an Unresponsive Breathing
Person in the Recovery Position
• Adjust the top leg
so that both the
knee and the hip
are bent at right
angles.
• Keep the top hand
under the person’s
cheek.
© Jones & Bartlett Learning.
© Jones & Bartlett Learning.

16. Physical Exam
• Determine whether the cause of injury was
significant.
− Assume a person with a head injury also has
a spinal injury.

17. Physical Exam
• For a responsive person
− Ask if he or she can feel or wiggle the fingers
and toes.
• For an unresponsive person
− If you suspect a spinal injury, do not move the
person’s head or neck.

18. Physical Exam
• Assess the person’s entire body.
− Signs—conditions you can see, feel, hear,
and smell
− Symptoms—things the person feels and is
able to describe
• The chief complaint

19. Physical Exam
• D = Deformity
• O = Open wounds
• T = Tenderness
• S = Swelling
© American Academy of Orthopaedic
Surgeons.
© Jones & Bartlett Learning. Courtesy of
MIEMSS.
© Johnathan Noden-
Wilkinson/ShutterStock.
© American Academy of Orthopaedic
Surgeons.

20. Significant Cause of Injury
• Check the head.
• Check the eyes.
• Check the ears
and nose.
• Check the mouth.
© Jones & Bartlett Learning. Courtesy of MIEMSS.

21. Significant Cause of Injury
• Check the neck.
• Check the chest.
− Gently press inward.
© Jones & Bartlett Learning. Courtesy of MIEMSS. © Jones & Bartlett Learning. Courtesy of MIEMSS.

22. Significant Cause of Injury
• Check the abdomen.
− Gently press on all four quadrants.
© Jones & Bartlett Learning. Courtesy of MIEMSS.

23. Significant Cause of Injury
• Check the pelvis.
− Gently press inward on tops of hips.
− Press downward.
© Jones & Bartlett Learning. Courtesy of MIEMSS.© Jones & Bartlett Learning. Courtesy of MIEMSS.

24. Significant Cause of Injury
• Check all four
extremities.
− Circulation
− Sensation
− Movement
• Check the back.
© Jones & Bartlett Learning. Courtesy of MIEMSS.

25. Special Considerations
• Skin condition
− Temperature
− Color
− Moisture © Jones & Bartlett Learning.
© Jones & Bartlett Learning.

26. Special Considerations
• Capillary refill test
− Press fingernail or toenail for a few seconds
and release.
© American Academy of Orthopaedic Surgeons. © American Academy of Orthopaedic Surgeons.

27. Special Considerations
• Expose injury.
− Explain what you
are doing.
− Maintain privacy.
− Prevent exposure
to cold.
© American Academy of Orthopaedic Surgeons.

28. Special Considerations
• Check for medical
identification tags.
− Wallet
− Purse
− Necklace to cold.
− Bracelet
Courtesy of the MedicAlert Foundation®. © 2006, All Rights
Reserved. MedicAlert® is a federally registered trademark
and service mark.
Courtesy of the MedicAlert Foundation®. © 2006, All Rights Reserved.
MedicAlert® is a federally registered trademark and service mark.

29. SAMPLE History
• Helps identify what is wrong with the
person
• Can indicate what first aid is needed
© Jones & Bartlett Learning.

30. What to Do Until Medical
Help is Available
• Recheck a serious illness or injury
regularly.
• Remaining calm and reassuring the
person may be the best treatment you can
provide.