Basic steps before I post any tutorials

Know these things whenever you go to a patient! Use the acronyms provided

1) Scene Survey

EMCAP-PE

E - Environment
M- Mechanism of injury
C- # of casualties
A - Additional Assistance (if necessary)
P-PE - Personal Protective Equipment (gloves, mask, hazmat)

2) Patient Communication and Consent

- Introduce yourself
- Obtain patient consent
- Obtain event history (you should always find an answer to, what happened?)

3) Primary Survey (the actions done in all acronyms happen simultaneously) and Treatment.


AVPU (level of consciousness/mental status)
A - Alert
V - Verbal
P - Pain
U - Unresponsive


Cervical Spinal Injury Considerations,

General Appearance of the Patient



ABC (are there vital parts compromised?)
A - Airway - Treat it as needed
B - Breathing - Treat it as needed
C - Circulation - Treat it as needed

CLAP-STICD (evidence supporting ABCs)
C - Contusions
L - Lacerations
A - Abrasions
P - Penetrating wounds
S - Subcutaneous Emphysema
T - Tenderness
C - Crepitus
D - Deformity

Head to Toe examination* see bottom of blog

4) Determine if Transport is needed. Is it too much for you to handle? Find a sufficient reason why and call the ambulance.

5) Take Vitals (if possible)

- Heart rate
- Respiratory rate
- Blood pressure
- Blood glucose
- SPO2%
- Temperature
- Pupils
- Skin
- Glasgow Coma Score

*This is when Medications can be administered or assisted with after pronouncing the 5 rights.
The 5 Rights to medication is in the acronym TRAMP, however I'll teach you TRAMP-E.

T-Timing (is it taken as needed, interval between dosages, can it be taken at this time?)
R-Route (is it by oral, spray, injection?
A-Amount (is it the right amount?)
M-Medication (is it the right medication?)
P-Patient (is it the right person?)
E-Expiration date

If you cannot find answers to ALL of the 5 rights above than you cannot administer or assist someone with their medication.

6) Take History

SAMPLE and OPQRSTU

S - Signs and Symptoms
A - Allergies
M - Medications
P - Past medical history
L - Last meal (this is not a joke)
E - Events leading up to

As part of Signs and Symptoms

O - Onset of sign/symptom
P - Palliative/provocative (what makes it better/worse?)
Q - Quality/Quantity
R - Region/Radiating
S - Severity (on a scale of 0-10)
T - Timing
U - Understanding of what is happening

You're done!

*The head to toe examination may be placed at the very end here since it is unnecessary most of the time and yields little information for most patients. Use it to provide supporting evidence for what you already know.

*Update Jan 25, 2013. Added 5 rights to medication. Grammar fixes in head to toe disclaimer.