Intro to patient assessment system

Facilitator: Grace
Medics: Charis + Greg
Patients:
Time: 10 mins; 0930-0940
Actual time:
Learning Objectives:
Materials: Butcher paper, marker.

Rosehip Triangle

Facilitator draws

big triangle on chart paper.

Facilitator tells students

We teach patient assessment by grouping each step in order inside this triangle.1

Facilitator draws

hand for "stop!" with a line below it.

Facilitator tells students

First, let's review what we do before approaching a patient.

Stop

  1. "Number one, look out for number one" -- your buddy team's safety comes first; deep breath and assess for danger.

  2. "Number two, what happened to you?" -- what's your team's general impression of the mechanism of injury (MOI) or nature of illness (NOI)?

  3. "Number three, don't get any on me!" -- body substance isolation (BSI) time; glove up!

  4. "Number four, are there more?" -- triage; how many injured or ill folks? Any hidden/silent? If there's not enough medic buddy pairs, call for back-up now.

  5. "Number five, can we help you, Clive?" -- buddy roles; patient care buddy reminds self to do introductions, establish and maintain informed consent, be nice, check level of responsiveness (LOR).

Facilitator tells students

The rest of this morning is about mechanism of injury, level of responsiveness, and the next part of the triangle, initial assessment.

Definition of Initial Assessment

"A set of steps that you complete at least once with every patient, to quickly identify immediately life threatening problems and get help fast."

Facilitator writes definition

next to appropriate part of triangle, then breaks it down for students.

"immediately life threatening problems"

Things that will kill a person within minutes or hours

  • Brain swelling from a hit on the head (MOI+LOR).

  • Choking (A).

  • Severe bleeding (C).

"quickly identify"

Want to find these things early, so you can address them and call for help. Don't let blood or pain distract from the initial assessment.

"get help fast"

For any red flag on initial assessment, call 911 as soon as you identify the problem OR for any situation that just feels wrong or dangerous.

"every patient"

Do initial assessment as the first thing you do for every single person you assist.

  • Don't want to miss something serious.

  • Often initial assessment takes 10 seconds. Sometimes it takes longer.

"at least once"

For anyone you are caring for over time, go back and re-do initial assessment every 5 minutes or so, to check for problems that weren't obvious before.

"set of steps"

The steps of initial assessment should be done in the specific order we show you.

  1. The Rosehip Medic Collective in Portland, Oregon adapted this approach from the Wilderness Medicine Institute in Wyoming. Contact: rosehipmedics\@gmail.com.↩