Danger and Response can be assessed simultaneously as you approach a scene:
- Pause and plan your approach towards a potential patient to make sure that there is no danger to yourself or bystanders, or further danger to the patient.
- Apply PPE as you approach your patient, if required.
- Remove any danger if safe to do so. This will involve checking the area as you enter the incident.
- Check for a response via “talk and touch” as you enter the scene and approach the patient. Any combination of words, e.g., giving simple commands, can be used. Attempting to recall or use specific acronyms may delay time to assess for a response. Tactile stimuli include firmly grasping and squeezing the patient’s shoulders to elicit a response. It is quick and easy to identify a non-responsive patient as you approach them – they often appear different to someone who may be “asleep”, including abnormal skin colour and muscle tone.
Note:
- Infants respond more to touch— you can place one hand on an infant’s forehead and use your other hand to gently squeeze their shoulder while talking loudly to them. The infant may respond by making a noise, moving or opening their eyes.
The unconscious patient
If there is no response to talk or touch, the patient is deemed ‘unresponsive’ and you may provide first aid treatment under the ‘doctrine of necessity’, meaning you can carry out actions to save the patient’s life. All persons who are unconscious require treatment using the principles of basic life support. All body tissues, especially the brain, must be supplied with adequate oxygen.
Assessment of the patient’s airway and breathing now become the priority. A patient who shows only a minor response, such as groaning without opening their eyes, should be managed as if unconscious.
The conscious patient
The management of a conscious patient is covered in Chapter 7 – Primary assessment – conscious patient.