SECONDARY SURVEYS LOOK FOR EXTERNAL CLUES FOR CASUALTY
As part of your Assessing the Casualty, “How to check casualty for injury?” look for external clues to a casualty’s condition.
If you suspect drug abuse, take care as he may be carrying needles and syringes. You may find an appointment card for a hospital or clinic or a card indicating a history of allergy, diabetes, or epilepsy horse-riders or cyclists may carry such a card inside their riding hat or helmet.
Food or medication may also give valuable clues about the casualty’s condition; for example, people with diabetes may carry sugar lumps or glucose gel.
A person with a known disorder may also have medical warning information on a special locket, bracelet. medallion or key ring (such as a “Medic Alert” or “SOS Talisman”).
Keep any such item with the casualty or give it to the emerg2ncy services If you need to search a casualty’s belongings, always try to ask first, and perform the search in front of a reliable witness. now we know How to check casualty for injury.
ASSESSING THE CASUALTY HEAD-TO-TOE
Once you have taken the casualty’s history and asked about any symptoms, she has should carry out a detailed examination Use all your senses when you examine a casualty: look, listen, feel and smell.
Always start at the head and work down; this “head-to-toe” routine is both easily remembered and thorough, You may have to sensitively loosen, open, cut away or remove clothing were necessary to examine the casualty, Always be sensitive to a casualty’s privacy and dignity, and ask her permission before doing this, Protect yourself and the casualty by wearing disposable gloves.
Make sure that you do not move the casual?’ more than is strictly necessary If possible, examine a conscious casualty in the position found. or one that best suits her condition. unless her life is in immediate danger.
If an unconscious breathing casualty has been placed in the recovery position. leave her in this position while you carry out the head-to-toe examination, Check the casualty’s breathing and pulse rates.
Then work from her head downwards Initially, note minor injuries but continue your examination to make sure that you do not miss any concealed potentially serious conditions. return to them only when you have completed your examination.
1. Assess breathing Check the rate (fast or slow), depth (shallow or deep), and nature (is it easy or difficult, noisy, or quiet). Check the pulse. Assess the rate [fast or slow), rhythm (regular or irregularly, and strength [strong or weak).
2. Start the physical examination at the casualty’s head. Run your hands carefully over the scalp to fe21 for bleeding. swelling or depression, which may indicate a fracture. Be careful not to move the casualty if you suspect that she may have Injured her neck.
3. Speak clearly to the casualty in both ears to find out if she responds or if she can hear. Look for clear fluid or wat2ry blood coming from either ear. These discharges may be signs of a serious head injury.
4. Examine both eyes. Note whether they are open. Check the size of the pupils (the black areal. If the pupils are not the same size it may indicate a head injury. Look for any foreign Object, blood, or bruising in the whites of the eyes.
5. Check the nose for discharges as you did e) for the ears. Look for clear fluid or watery blood (or a mixture of both) coming from either nostril. Any of these discharges might indicate a serious head injury.
6. Look in the mouth for anything that might obstruct the airway. If the casualty has dentures that are intact and fit firmly. leave them. Look for mouth wounds or burns and check for irregularity in the line of the teeth.
7. Look at the skin. Note the color and temperature is it pale, flushed, or grey-blue (cyanosis); is it hot or cold. dry or damp? Pale. cold, sweaty (clammy) skin suggests shock; a flushed, hot face suggests fever or heatstroke. A blue tinge indicates a lack of oxygen; 100k for this in the Lips, ears, and face.
8. Loosen clothing around the neck and look for signs such as a medical warning medallion Ip.481 or a hole (stoma] in the windpipe. Run your fingers gently along the spine from the base of the skull down as far as possible without moving the casualty: check for irregularity. swelling, tenderness, or deformity.
9. Look at the chest. Ask the casualty to breathe deeply and note whether the chest expands evenly. easily and equally on both sides. Feel the ribcage to check for deformity, irregularity, or tenderness. Ask the casualty if she is aware of grating sensations when breathing and listen for unusual sounds. Note Whether breathing causes any pain. Look for any external injuries, such as bleeding or stab wounds.
10. Feel along with the collar bones. shoulders, upper arms, elbows, hands, and fingers for any swelling tenderness or deformity. Check the movements of the elbows, wrists, and fingers by asking the casualty to bend and straighten each joint. Check that the casualty has no abnormal sensations in the arms or fingers. If the fingertips are pale or grey-blue there may be a problem with blood circulation. Look out for needle marks on the forearms, or a medical warning bracelet.
11. If there is any impairment in movement or loss of sensation in the limbs, do not move the casualty to examine the spine. since these signs suggest spinal injury. Otherwise, gently pass your hand under the hollow of the back and check for swelling and tenderness.
12. Feel both sides of the hips and examine the pelvis for signs of fracture. Check clothing for any evidence of incontinence, which suggests spinal or bladder injury, or bleeding from orifices, which suggests pelvic fracture.
13. Gently feel the casualty’s abdomen to detect evidence of beef, and to identify any rigidity or tenderness of the abdomen’s muscular wall, which could be a signoff internal bleeding. Compare one side of the abdomen with the other.
14. Check the legs. Look and feel for bleeding, swelling, deformity, or tenderness. Ask the casualty to raise each leg in turn, and to move her ankles and knees.
15. Check the movement and feeling in the toes. Check that the casualty has no abnormal sensations in her feet or toes. Compare both feet. Look at the skin color: grey-blue skin may indicate a circulatory disorder or an injury due to cold.