Backpacker Magazine – September 2011

Saving Lives: Perform a Focused Assessment

Use these three assessment tools to examine every patient thoroughly after you've stopped any immediate threats to life. Trauma victims are more common in the backcountry; start your inspection with a head-to-toe exam. For ill patients, begin by asking about medical history and taking vitals.

by: Steve Howe

Tags:
• Survival
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• Skills
|
• Firs aid
|

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VITAL SIGNS | HEAD-TO-TOE EXAM | PATIENT HISTORY

Establish a baseline and get insight into tricky diagnoses.

Normal	Seriously Abnormal
Responsiveness Judge alertness: Ask questions or cause minor pain (like pinching).
Knows name, day, place, and what happened	Can answer two or fewer of these key questions
Heart Rate Press two fingers into the wrist artery (below the thumb). Count pulse for 15 seconds and multiply by 4.
50-100 beats per minute, regular and strong	Less than 40 bpm or more than 130 bpm
Respiratory Rate Look, listen, and feel the abdomen for breathing. Count the rise and fall of the chest as one breath.
12-20 breaths per minute, regular and unlabored	Less than 8 or more than 20 breaths per minute
Skin color, Temperature, moisture Examine non-pigmented skin (nailbeds, palms, eyes), and feel near core.
Pink, warm, and dry	Hot and dry, or frozen and chalky
Blood pressure Look for responsiveness, skin condition, and pulse indicators.
Systolic: 90-150 mmHg	Systolic: Under 70 mmHg
Pupils Briefly shine light into each eye and watch for response. In sunlight: Shade the eyes, then remove the shade.
Equal, round, light-reactive	Not light- reactive
Temperature Use a thermometer orally, rectally, or in the armpit; estimate by feeling forehead.
98.6°F	Less than 95°F; more than 101°F

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