Notes

RSE (Rescue Scene Evaluation)
- Environment
- Hazards
- Mechanism of Injury (MOI)
LOC (Level of Consciousness)
- Head grip
- AVPU
_ N from NACTO
D (Delicate Spine)
- Check for Laceration, Deformities & Tenderness
- Check MOI for possibilities for Spinal Injuries
- Ask Patient if they fall from any height
- Sound off Spinal injury from Trauma & Toxins
A (Airway)
- If patient is able to talk to you, his airway is open
- If patient is unable to talk to you, check for any obstruction to airway after head tilt chin lift and cross-finger technique
B (Breathing)
- Look for chest rise
- Listen for any breathing difficulties
- Feel for respiratory quality
- Complete A from NACTO
C (Circulation)
- Check for radial pulse, if radial pulse is not present, check for carotid pulse
- Complete C from NACTO
RBS (Rapid Body Survey)
- Palpate body quickly, finish within 30 seconds
- Complete T from NACTO
T (Temperature)
- Must do if MOI suggest Heat Injury
- If MOI does not suggest heat injury, can choose not to do (must explain)
O (Oxygen)
- Apply NRM at 100% oxygen 10 liters a minute.
- Sound off everything
P (Positioning)
- Move to more comfortable positioning if patient is fine with it
DP (Decision Point)
- Decide to Stay & treat or Load & Go

NACTO
N (Neurological)
- Loss of Consciousness / Decreasing loss of Consciousness
- Able to answer TPP
A (Airway)
Breathing Difficulty
Obstruction to Airway
Asthma Attack
Smoke Inhalation
C (Circulation)
Profuse Bleeding
Chest Pain
T (Trauma & Toxins)
Severe Limb Injury
Head / Eye Injury
Insect / Snake Bite that leads to allergic reaction
Penetrative Wounds
Gunshot Wounds
Spinal Injury - in Delicate Spine stage
O (Others)
Burn Injury
Electrical Shock
Drug Overdose

Unconscious Protocol
SMS - Call Stretcher, Medical Centre, Safety Vehicle
OPA insertion
AED - After AED make sure to re-access ABC
During Treatment, insert IV at maintenance rate if patient has radial pulse or chest pain. If patient has chest pain, only maintenance rate can be given. If patient does not have radial pulse, give IV at a bolus rate. Must give IV no matter what when there is heat Injury.
During Treatment, 2nd AED is done, reacess ABC

Chest Pain Protocol

Administer GTN, follow ASHLEAN when using GTN, cannot use more than 3 times

Allergies
Sexual Drugs taken within the last 24 hours
Hypotensive
Last Use
Expiry
Angina Pectoris
Name

Administer IV, only maintenance rate can be applied.

Burn Injury Protocol

Flush all burns with room temperature water - this is a critical intervention (unless there are internal electrical burns)
Cut off clothing that cannot be removed easily that are near burn wounds.
Apply PU film after air drying wet wounds (from flushing)

Shortness of Breath Protocol

Recognize Asthma or IRF (Impending Respiratory Failure)

IRF
1 Incomplete Sentences
2 Recognize if Accessory Muscles used for breathing
3 RR <10 or <30
4 Nasal Flare
5 Pursed Lip breathing
6 Tracheal tugging
7 Cyanosis

Asthma

Cannot be identified aside from having a wheezing symptom

Shake
Expiry
Allergies
Name

Shake
Ask them to hold
Tight Seal with mouth
Hold breath for 10 seconds if possible
Repeat for other dosage

2 puff per dose every 5 minutes

Heat injury

Apply EMCOOL