First Responder EMS Curriculum for Training Centers in Eurasia

can be determined by questioning the patient, family members, and bystanders, as wellas by inspecting the scene. For patients requesting emergency medical services for amedical complaint, determine from the patient, family, or bystanders the nature of theillness or symptoms that led to the call.d. Number of Patients InvolvedSituations with multiple patients will require additional help from law enforcement, fire,rescue, advanced emergency medical units, and/or utility workers (gas, water,electricity). First Responders will be less able to call for additional help once they areinvolved with patient care. Request additional help early if you will need assistance.Then begin triaging patients to determine who requires immediate intervention and whocan wait.e. Additional EMS ResourcesAfter addressing immediate, life-threatening problems, the First Responder can confirmthat additional EMS resources are en route.4. Initial AssessmentThe initial assessment is completed to assist the First Responder in identifying immediatethreats to life.a. General Impression of the PatientThe general impression of the patient is based on the First Responder's immediateassessment of the scene environment and the patient's chief complaint. Determinewhether the patient is ill (medical case) or injured (trauma case). In situations where thisis unclear because of inadequate patient information, treat the patient as though he/shecould be a trauma victim. Determine the approximate age and sex of the patient.b. ResponsivenessIf there is any suspicion of trauma, the patient’s spine must be stabilized from the verybeginning. The head and neck must not be moved in any way in case there is an unstablefracture of the spine that could result in a spinal cord injury with movement.Begin by speaking to the patient. State your name and tell the patient that you are a FirstResponder and are here to help. The “AVPU” scale is used to describe the level ofresponsiveness of a patent:• A – alert• V – responds to verbal stimuli• P – responds to painful stimuli• U – unresponsiveInfants and small children will often not respond to methods used to assessresponsiveness in adults. Instead of providing verbal and painful stimuli, assess thechild’s interactions with the environment and parents.c. Airway StatusFor patients who are responsive, determine if the airway is patent by asking the patientto speak. If the patient can speak, it demonstrates that the patient both has a patentairway and is breathing. If the responsive patient cannot speak, appears to be choking,or has noisy respirations, the patient may have an airway obstruction that needs to becleared right away. Unresponsive patients are at high risk for airway obstruction and82First Responder EMS Curriculum/AIHA, July 2002