Accidents and emergencies can happen at any time in the workplace, and when they do, a swift and systematic response can be a matter of life or death. Trauma assessment is a fundamental skill for Occupational First Aid (OFA) attendants, and one effective method for this assessment is the Priority Action Approach. The Priority Action Approach is taught in first aid courses such as Occupational First Aid Level One, Two and Three. In this blog post, we’ll break down the key elements of this approach to help OFA attendants better understand how to assess and prioritize first aid care for trauma patients.
Scene Assessment: Setting the Stage for OFA Attendants
The first step in the Priority Action Approach is the scene assessment. Before diving into first aid care, it’s crucial for OFA attendants to ensure their safety and the safety of others. This includes evaluating the scene for potential hazards such as traffic, fire, electricity or dangerous chemicals. Assessing the safety of the environment not only protects OFA attendants but also allows them to provide better first aid care to the injured person.
The OFA attendant should also ask any bystanders what happened and how many people are injured. Understanding what caused the injury or illness can tell you a lot about safety of the scene and how to treat the person who needs help.
Primary Survey: The ABCs of First Aid for Trauma
Once the scene is secure, it’s time to move on to the primary survey, often referred to as the ABCs of first aid for trauma. This is a rapid but thorough assessment of the patient’s airway, breathing, and circulation. These are the fundamental components of life support and must be addressed before proceeding with other first aid measures.
- Airway: OFA attendants must check if the patient’s airway is open and clear. Ensure there are no obstructions like foreign objects or swollen tissues that could hinder breathing. If needed, open the airway using techniques like the head-tilt, chin-lift, or jaw-thrust maneuver.
- Breathing: Assess the patient’s breathing rate, rhythm, and effort. Look for signs of adequate oxygenation, such as normal chest rise and fall. OFA attendants should address any breathing issues promptly, which may include providing rescue breaths or administering oxygen.
- Circulation: Check for a pulse to determine if the heart is pumping blood effectively. Assess the patient’s skin color, temperature, and capillary refill to gauge circulation. If necessary, initiate cardiopulmonary resuscitation (CPR) and use an automated external defibrillator (AED).
Transport Decision: Rapid or Non-Rapid Transport?
Based on their assessment during the primary survey, OFA attendants will need to make a critical decision regarding patient transport. Is the patient in need of rapid transport to a hospital due to life-threatening conditions, or can the patient be transported non-rapidly for further evaluation and first aid care? This decision is crucial in providing the right level of first aid care and urgency.
If the patient does need rapid transport to the hospital you need to ensure that 911 is called right away. Ideally, a bystander can call 911 while you are helping the patient, but if you are there alone you need to call 911.
Secondary Survey: A Comprehensive First Aid Assessment
Once OFA attendants have determined the appropriate transport method, they can proceed with the secondary survey. This is a more detailed examination that covers various aspects of the patient’s condition:
- Vital Signs: OFA attendants must reassess the patient’s vital signs, including heart rate, respiratory rate, blood pressure, temperature, and level of consciousness at regular intervals. This ongoing monitoring helps detect any deterioration in the patient’s condition.
- History Taking: Obtain a comprehensive medical history, including the patient’s chief complaint, allergies, current medications, and past medical history. This information guides your first aid assessment and treatment decisions.
- Head-to-Toe Examination: Perform a systematic head-to-toe examination, inspecting and palpating each region for injuries or painful areas. Look for signs of trauma, such as open wounds, lacerations, swelling, and deformities.
- Assessment for Spinal Injury: Assess whether the patient has any signs or symptoms of spinal injury. The Modified NEXUS Rule is a helpful tool for determining whether ongoing cervical spine motion restriction is needed.
Head-to-Toe Reassessment: Keeping an Eye on Changes
After completing the secondary survey, don’t forget to perform a head-to-toe reassessment. Check known injury sites, dressings, and splints for any changes. Monitor the neurological and circulatory status of injured limbs and examine patients with head, chest, or abdominal injuries for any new developments.
Once the secondary survey is completed it’s time to treat the non life-threatening conditions such by bandaging minor wounds, applying cold/heat, using splints or slings, or moving the patient to a safer environment.
In conclusion, the Priority Action Approach is a structured and efficient method for trauma assessment that ensures the right steps are taken in the right order by OFA attendants. Regular practice is essential for mastering this approach, as it can make a significant difference in the first aid care and outcomes of trauma patients. By following these steps and staying vigilant during first aid assessments, OFA attendants will be better prepared to respond to workplace emergencies and provide critical first aid care when it’s needed most.