Perform a visual head to toe assessment of the injured person. If the person is conscious, give them your name and let them know you are there to assist until emergency responders arrive. Ask them what is hurting and what happened. If you are not alone, ask another person to activate the emergency response system by dialing 911 or EMS while you check the injured person. If you are alone, you may have to leave the victim to summon help after you have assessed the person’s injuries.
If you are certain that an injured person has no life-threatening conditions, you should perform an injury assessment, known as a Secondary Survey, which is a systematic method of gathering additional information about injuries or conditions that may need care. An important point to remember is that if life-threatening conditions exist, such as unconsciousness, no breathing, no pulse, or severe bleeding, the victim needs the immediate care of a Certified First Aid or CPR provider to provide basic life support and stabilize any conditions until professional medical help arrives.
The Secondary Survey injury assessment process has two basic steps:
The first step is to interview the victim and bystanders. If the victim is conscious and can speak, learn whether he or she has any signs or symptoms that would indicate a condition that could become life-threatening. Find out what happened, what is wrong, or what hurts.
The second step is to perform a head-to-toe examination to look for injuries. Be sure to tell the victim what you are doing and why. Do not aggravate injuries, contaminate wounds, or move the victim if you suspect a neck or spinal injury. Begin at the head and check the scalp for bleeding or deformities such as a “goose egg”. Check the ears and nose for any clear fluid or bloody discharge. Check the mouth for blood or foreign materials.
Notice whether the eye pupils are constricted or dilated. Cover and uncover the eyes to see whether the pupils react. Look for unequal pupils because a difference in size almost always indicates a medical emergency. Check the chest and abdomen for cuts, bruises, penetrations, and embedded objects. Check the arms and legs by feeling and looking for injury, deformity, and/or tenderness. A good tip is to compare one side of the body to the other.
Finally, for a potential spinal injury, check sensations and strength in the extremities by pressing the victim’s foot against your hand and having him or her squeeze your hand. If a person is unresponsive and breathing normally, it may be reasonable to place him or her in a lateral or side lying recovery position. This is acceptable if you do not suspect that the person has any pelvic or spinal injuries and if you must leave the area. Extend one of the person’s arms above the head and roll the body to the side so that the person’s head rests on the extended arm. Once the person is on their side, bend both legs to stabilize the body. 911 or EMS should be alerted, as there are many different conditions that can cause someone to become unresponsive. Some conditions, such as fainting, may not require additional medical care, but a medical professional should make that determination. If they are unresponsive and not breathing normally, and you know CPR, begin CPR until emergency responders arrive. Otherwise, an injured person should only be moved when you are faced with immediate danger, such as fire, lack of oxygen, risk of explosion, or a collapsing structure.
Some people suffer from certain medical conditions. These people may wear a form of medical identification, usually a special bracelet or, less commonly, a necklace. These are often Medic Alert bracelets, but other types are available. Be sure to look for such medical IDs, which will notify you of specific medical conditions. Do not remove a medical alert tag from an injured person for any reason.
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