In today’s micro-lecture, Australian Paramedical College Hon. Snr. Lecturer Sam Willis talks about undertaking a head to toe survey.
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In this micro lecture, we’re going to talk about undertaking a head to toe survey. So let’s try and put this first into context. You arrive on scene at somebody who’s collapsed in the street. You’ve done your danger, your response, your airway breathing circulation. Now you’re moving on to your disability and exposed parts. Now you have a patient whose ABCs are all fine. Now because they’re unconscious, they require the oropharyngeal tube to help keep the tongue off the back of the airway. And now before you put them into the recovery position, for a nontrauma related incident, you need to do a head to toe survey, just to try and identify any issues.
Now I know that I’m saying it’s for an unconscious patient, but imagine if your patient was conscious. You would still do the same thing for them, and of course there are slightly different responses that you would get from your patient. So in your workshop, one and two, you are gonna be expected to be able to undertake a head to toe survey. And I’d like to just start by giving you a bit of a hint. Now a head to toe survey starts at the head and ends at the toes. Far too often students have got so much on their mind when they’re dealing with a situation. And they go to a head to toe survey, or they’re given a prompt, go into a head to toe survey, and they start at the shoulders. Make sure you start at the head and finish at the toes.
Okay, so let’s work through this together. So when we’re feeling around the back of the head, we’re feeling for any types of body masses. In other words, if the patient’s sustained major trauma to the back of the head, they may have a skull injury. And therefore they may have injuries to the back of the head that’s allowed the brain to protrude through. So you’re generally patting down. And you’ve got your gloves on as well, so if there’s any bleeding, you’re not going to be … There’s no infection risk to yourself. You move systematically down, and you start with the face on the front. Check the pupils at this point. So get your pen torch out, check the pupils. Checking that they’re reactive to light and they’re equal.
Check the ears to see if there’s any cerebral, spinal fluid. Check down the neck for any distended neck phase that could indicate heart failure or cardiac tamponade. Or tension in the thorax to make sure also that the neck is centralized. In other words, the cricothyroid membrane or the voice box is central and not pushed away, which would indicate tension in the thorax. Then you feel down the rest of the body like this with both hands. Don’t cup the patient like this because you could miss the injury. Feel down like this. And you go down the chest. You go down the abdomen. Be gentle palpating the abdomen to see if there’s any swelling or internal bleeding. And that would be hard if that was the case. And just before we move on, make sure when you go down the chest you take your stethoscope and have a listen as well to see if there’s any added sounds.
Then you would go down both the legs at the same time like this. And the same down the arms and check a pulse. And check the [inaudible 00:03:00] time with both the feet. And the hands. Now in the conscious patient, you’re not only feeling for any abnormalities, so for example running the hand down the chest like this if there was some kind of abnormal swelling, you would feel it. But you’re also looking at the patient’s face to see if they give you any type of grimace in response to you palpating them. When you are logrolling your patient, that’s when you get to check the back as well. And of course if it’s major trauma, you’d need to expose the patient and take the look as well. So that’s the micro lecture on the head to toe survey.
For more information about courses and becoming a Medic / Paramedic or any other professional in the pre-hospital emergency health care sector Contact The Australian Paramedical College today:
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