Emergency Decision Tree Form – Fill Out and Use This PDF

UNSAFE!

1 - SCENE SIZE-UP

1)Take the necessary Body Substance Isolation precautions

2)Assure Scene Safety for rescuer, patient, and bystanders

3)Determine Mechanism of Injury or Nature of Illness

4)Establish Number of Patients

5)Need for Additional Resources

SAFE

TRAUMA

Patient

Control Scene

Move Patients

Correct Hazzard

2 -

INITIAL

MOI PATIENT ASSESSMENT

MED MEDICAL Patient

Suspect

Spinal Injury?

NO

Assess Mental Status (AVPU)

Assess

Airway

O

P

E

N

Assess

Breathing

A

D

E

Q

U

A

T

E

Assess

Circulation

P

U

L

S

E

Assess

Bleeding

NONE

ASSESS SKINS

P.M.S.

YES

Establish In-line

Stabilization

CLOSED

Perform Jaw-

thrust Manuver

INADEQUATE

Begin Positive

Pressure

Ventilation with Supplemental Oxygen

NO PULSE

BEGIN CPR

APPLY AED

BLEEDING

CONTROL

BLEEDING

Form General Impression: Mechanism of Injury?

Look, Feel Skins, Listen Breathing, L.O.C.

DECIDE: TRAUMA, MEDICA, BOTH ?

(A,B,Cs, Bleed and Shock)

DECAP BTLS:	SAMPLE:
Deformity	Signs and Symptoms,
Evisceration	Allergies, Medications,
Contusion	Past History, Last Oral
Abrasion	Intake, Environment
Penetration
Burns	OPQRST:
Tenderness	Onset, Provocation,
Lacerations	Quality of pain,
Swelling	Radiation and Severity
	of pain, Time
PMS:	(Interventions)
Pulse/Capalary Refil
Motor Function	PRBELLS:
Sensation	Pulse, Respiration,
	Blood Pressure, Eyes,
PEARL:	Lung Sounds, LOC,
Pupils Equal And	Skins
Reactive to Light
	LOC:
JVD:	Level of
Jugular Vein Distention	Consciousness

TRANSPORT

CLOSED

Head-Tilt, Chin-Lift

INADEQUATE

Begin Positive

Pressure

Ventilation with Supplemental Oxygen

NO PULSE

BEGIN CPR

APPLY AED

TRANSPORT

Assess Mental Status (AVPU)

Assess

Airway

O

P

E

N

Assess

Breathing

A

D

E

Q

U

A

T

E

Assess

Circulation

P

U

L

S

E

ASSESS SKINS

EYES

3 - Focused History and Physical Exam

3 - Focused History and Physical Exam

UNCONSCIOUS

or Obvious Injury RECONSIDER THE MECHANISM

OF INJURY

Significant MOI,

Mutiple Injuries, or

Altered Mental Status

Continue Inline

Stabilization

Continually

Reassess Mental

Status

Perform RAPID

Trauma

Assessment

Consider Advance

Life Support

Resources?

Reconsider PUAHA

Transport Decision?

Take Baseline

Vital Signs:

PRBELLS

Record SAMPLE

History:

TRANSPORT

ALERT &

Uninjured

No significant MOI,

Single injury, or

Alert Mental Status

Perform Focused

History and

Physical Exam

Take Baseline

Vital Signs:

PRBELLS

Record History:

Signs and

Symptoms,

Alergies,

Medications, Past

Mediacl History,

Last Oral Intake,

and any

Envioronmental

Conditions.

Perform Needed

Components of a

Detailed Physical

Exam

LOC 3+		CONSIDER
		MENTAL STATUS

Responsive

Assess Complaints

Signs and

Symptoms (OPQRST)

Record History:

Signs and

Symptoms,

Alergies,

Medications, Past

Mediacl History,

Last Oral Intake,

and any

Envioronmental

Conditions.

Perform a Focused

Medical

Assessment

Take Baseline

Vital Signs:

PRBELLS

Consider Transport	YES
Decision?

TRANSPORT

NO

Altered

Unresponsive

Perform a RAPID

Medical

Assessment

Take Baseline

Vital Signs:

PRBELLS

Position Patient

Record SAMPLE

History:

KEY

# Section

Decision

?

Symptom

ACTION

Alert

Responsive

Perform

Components of

Detailed Physical Exam based on patients's Injuries and Complaints

Reassess

Vital Signs:

Pulse, Respiration,

Blood Pressure,

Eyes, LOC, Last

Oral Intake, Skins

RECONSIDER Declining

MENTAL STATUS

Unresponsive

Position Patient

Assess the HEAD:

Feel for soft spots, DECAPBTLS

Assess the EARS:

Look for Fluid

Assess the FACE:

Look for Asymmetry: DECAPBTLS

Assess the EYES:

PEARL, Colors, Symmetry

Assess the NOSE:

Fluid, Symmetry, Air flow

Assess the MOUTH:

Teeth, Tung, Lips, Throat

Assess the NECK:

JVD, Tracheal Deviation, C-SPINE

Assess the CHEST:

Paradoxical Movement,

DECAPBTLS

Assess the ABDOMEN:

4-Quadrents, DECAPBTLS

Assess the PELVIS:

Asymmetrical movement, Genitals

Assess the EXTREMITIES:

PMS, DECAPBTLS, Asymmetry

Assess the POSTERIOR BODY:

Spinal line, DECAPBTLS

Reassess

Vital Signs:

PRBELLS

Procedure

Loop

TRAUMA AREA

MEDICAL AREA

5 - Ongoing Assessment

REPEAT INITIAL ASSESSMENT

REASSESS:

General Impression,

Mental Status, Airway,

Breathing Rate and

Quality, Circulation;

Pulse Rate and

Quality, Skin Color,

Temperature,

Condition, Bleeding.

Reestablish

Patient Priority

Worse	Change in	Stable
	Patient Condition?
Repeat Focused		Reassess
History and
		Vital Signs
Physical Exam
Provide		Reassess
Emergency Care		Emergency Care
Assess
Effectiveness of
Emergency Care
Reassess
Vital Signs
	REPEAT
Every 5 min.	Ongoing
	Assessment