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PATIENT PATIENT

ASSESSMENT MODEL ASSESSMENT MODEL

(PAM )(PAM )

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PATIENT ASSESSMENT MODELPATIENT ASSESSMENT MODEL

PAM1-1 PAM1-1

ScopeIntroductionThe SEVEN Components of PAMRescue Scene EvaluationPrimary SurveySecondary SurveyConclusion

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Objectives

At the end of the lesson, trainees should be able to

List the SEVEN COMPONENTS of PAM correctly

Explain the steps in rescue scene evaluation correctly

Explain the steps in Primary Survey correctly Explain the steps in Secondary Survey correctly

PATIENT ASSESSMENT MODELPATIENT ASSESSMENT MODEL

PAM1-2 PAM1-2

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1. RSE

2. Primary Survey

3. Secondary Survey

4. Protocol

5. Treatment

6. Load & Transport

7. Record & Report

SEVEN COMPONENTS OF PAMSEVEN COMPONENTS OF PAM

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RESCUE SCENE EVALUATION RESCUE SCENE EVALUATION (RSE)(RSE)

Environmental Conditions

Hazards

Mechanism of Injury

PAM1-4PAM1-4

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Environmental Conditions detrimental to patient?

- too hot or too cold

- dangerous traffic conditions

look for important clues about patient’s

condition

check for other victims

look for witnesses or family members who

can provide information

PAM1-5PAM1-5

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Hazards any potential hazards to you, crew or

patient

- gasoline, fumes, electrical wires, smoke,

fire

- unstable vehicles

police presence (at the scene of an

assault)

PAM1-6PAM1-6

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Mechanism of Injury event or agent which caused the patient’s

injury or injuries

Mechanisms of injury indicating a

probable unstable patient

- pedestrian struck by a vehicle

- fall from a height > 15 feet

- severe deceleration accident

- ejection from vehicle

PAM1-7PAM1-7

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IMPORTANT

AN UNSTABLE PATIENT

needs to be transported

IMMEDIATELY

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Primary SurveyPrimary SurveyAim : To discover and treat life or limb-threatening

conditions LOC - Level of Consciousness

- use AVPU Alert Verbal Pain Unresponsive

D - Delicate spine

- stabilize as required A - Airway

- tongue jaw lift

- modified jaw thrust B - Breathing

- ventilate as required

- check for adequacy

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Primary SurveyPrimary Survey C - Circulation

- check for rate and character

- NO radial pulse, check carotid pulse

- NO carotid pulse, perform CPR

- control hemorrhage

RBS - Rapid Body Survey (max. 30secs)

- check for external bleeding and deformities

- expose and examine injury site

- provide appropriate emergency treatment

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Primary SurveyPrimary Survey Skin

- check for colour and condition

Oxygen

- administer appropriate volume

Decision point

- UNSTABLE > transport IMMEDIATELY

- STABLE > provide necessary treatment

before transportation

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SECONDARY SURVEYSECONDARY SURVEYAIM : To identify problems that do not pose an

immediate threat to survival. However, it

may threaten survival if undetected

Consists of History

Vital Signs

Head to Toe Examination

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History

chief complaint

history of chief complaint

medical history - past and present

medications

allergies

identifying data

PAM1-10PAM1-10

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Vital Signs level of consciousness - GCS pulse, respiration, blood pressure skin color & condition temperature (if appropriate)

NOTE : if UNSTABLE transport

IMMEDIATELY( Complete secondary survey enroute

to hospital )

PAM1-11PAM1-11

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Head to Toe Examination

(inspection & palpation) head neck chest abdomen pelvis lower extremities upper extremities back

PAM1-12PAM1-12

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L O CDABC

R B SS K IN

O X Y G E N

D E C IS IO N P O IN T

H IS T O R Y V IT A L S IG N S H E A D T O T O E

P R O T O C O LST R E A T M E N T

L O A D & T R A N S P O R TR E C O R D & R E P O R T

R S E

SEVEN COMPONENTS OF PAMSEVEN COMPONENTS OF PAM

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The EndThe End