Learning how to test and diagnose emergency trauma is an essential part of training for EMS practitioners. Diagnosing an emergency trauma involves everything from chest pain to amputations to snakebites. When an EMS professional encounters any of these conditions, there are specific steps called protocols or standing orders to be taken to deal with them speedily and effectively to ensure the safety of the patient.
Diagnosing emergency trauma involves a variety of skills. One of the first criteria that an EMS professional learns is known by the acronym AVPU. This stands for Alert, Verbal, Painful and Unresponsive. Is the patient alert and conscious? Is the patient responsive to verbal stimuli. Are they responsive to painful stimuli? Are they completely unresponsive?
Obviously if the patient is alert, conscious and responsive it’s easier to diagnose their condition. If it’s not obvious what their medical diagnosis is, the protocol for the EMS worker is to verbally gather as much information as possible as to their condition. This would determine their chief complaint, associated symptoms, the time and duration of the onset, their past medical history, any allergies, their current medications and their primary physician.
If they’re unconscious, the EMS workers check for their response to painful stimuli by pinching or lightly pricking them to see if they respond. All information gathered is carefully documented by the EMT or paramedic.
Another part of testing and diagnosing emergency trauma involves checking the patient’s vital signs. The first vital sign is respiration. If the patient isn’t breathing, immediate steps must be taken to get them breathing again, whether it involves administering oxygen or removing an airway obstruction.
The next step is to take their pulse, which indicates whether their heart is beating and beats per minute. If it’s not beating, immediate steps to resuscitate the patient to get their heart started are taken, including CPR or using a defibrillator.
Observing skin color and temperature is also a part of EMS trauma diagnosis. EMS will check if the skin is pink, pale, bluish or flushed, as well as whether it’s hot or cold to the touch. Dryness and perspiration are also checked for. The next observation is the patient’s eyes to see how their pupils react when a penlight is shone into them. Blood pressure is also a vital sign as high or low blood pressure can indicate their condition and lead to a diagnosis.
In the event of injuries, one of the first things EMS workers do to diagnose trauma is to determine neck pain, stiffness or tenderness. Stabilizing the spine and neck is always a priority as movement could cause further injury.
In cases of injuries like bone fractures, lacerations, burns and punctures, EMS also must diagnose if they indicate that trauma to organs may have taken place.
Diagnosing emergency trauma also involves documenting all information, including patient responses and any observations and testing that the EMS personnel undertake. Once the diagnosis is made to the best of the EMT or paramedic’s ability, then proper assistance can be rendered to help the patient.
