Travel Reference
In-Depth Information
Eyes:
Eyebrows and eyelids, eye movements, vision, pupil size and equality, reaction of
pupils to light, inflammation
Nose:
Appearance, discharge, bleeding
Mouth:
Sores, bleeding, dryness
Throat:
Inflammation, purulent exudates
Ears:
Appearance, discharge, bleeding
Neck:
Limitation of movement, enlarged lymph nodes
Lungs:
Respiratory movements, breath sounds, voice sounds, bubbling
Heart:
Pulse rate, regularity, blood pressure
Abdomen:
General appearance, tenderness, rebound and referred pain, spasm of muscles,
masses
Genitalia:
Tenderness, masses
Rectum:
Hemorrhoids, impacted feces, abscesses
Back:
Tenderness, muscle spasm, limitation of movement
Extremities:
Pain or tenderness, limitation of movement, deformities, unequal length,
swelling, ulcers, soft-tissue injuries, lymph node enlargement, numbness, sensitivity
to pin prick and/or light touch (a wisp of cotton), muscle spasm
EXAMINING TRAUMA VICTIMS
Individualswithtraumaticinjuriesmayhaverespiratoryimpairmentorseverebleedingthat
must be cared for immediately (
Chapter 3: Life-Threatening Problems
)
. After these emer-
gencies have received attention, however, the care provider must pause and, essentially,
start from the beginning. An account of the accident and the time and circumstances in
which it occurred should be obtained. Frequently the nature of the accident provides clues
toinjuriesthatshouldbeanticipated. Ifthepersonisunconscious,witnesses mustbeasked
whether unconsciousness caused the accident or resulted from the accident. Witnesses and
companions also should be asked whether the individual had any preexisting medical con-
ditions that may have contributed to the accident or that may require treatment.
The individual's pulse, respiratory rate, and blood pressure should be measured and re-
corded immediately and every ten to fifteen minutes until they are clearly stable. If a blood
pressure cuff is not available, blood pressure should be estimated as described under Hem-
orrhagic Shock in
Chapter 3: Life-Threatening Problems
.
If the individual is moved, the
vital signs should be rechecked immediately; an increase in pulse rate or fall in blood pres-
sure at such times is often an early sign of shock. For individuals who have an extremity
fracture, the pulses in both extremities must be compared; a weak or absent pulse on one
side indicates that the fracture has interfered with the arterial blood supply.
Although a few injuries, such as fractures, may have to be cared for first, any individual
mustbecompletelyandthoroughlyexamined.Concealedinjuriesmustbecarefullysought.
Injuries of the back are most frequently overlooked, even in hospital emergency rooms. If
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