In this micro-lecture, Australian Paramedical College Hon. Snr. Lecturer Sam Willis discusses approaching the scene and the general approach to the patient. This is one of the most important lessons and it’s generally something that you will develop over the course of your time working as a paramedic.
In today’s micro-lecture, we’re going to talk about reading the scene and general approach to the patient. Now this is one of the most important types of lessons and it’s generally something that you will develop over the course of your time working as a paramedic, in whichever capacity you’ll be working in. Now, there is a lot of focus in all of the permanent courses on patient assessment, patient management, but approaching the incident and the scene is very, very important too. So when we talk about approaching the scene, what we’re talking about is using the clues in our environment to work out what’s occurring in the first place to help and aid our assessment and diagnosis and therefore management of the patient. We’ll also use that information to work out how fast we need to move to the hospital, if at all, or whether or not somebody else can help take over the care of the patient.
Now when we talk about approach to the scene, you’ll hear different terms such as windscreen report, scene survey, global overview, a whole range of different words and terms. They all generally mean the same thing. So if you’re going to look at this image here, usually I would ask you what you’re seeing, but you can tell that there’s a house here with a garden that looks pretty rundown. You could make an assumption from this image that the person who lives here either cannot get out to do the gardening or they don’t have the time or the finances to be able to look after the garden. Yes, you can also assume that maybe they like it like that and that’s also a good assumption. The reality is, all of these are assumptions until we actually get inside and meet the patient. But looking at this image, you can make an assumption that the person who lives here doesn’t have either the time or the willingness or the ability to actually take care of this garden. When we talk about ability, that could be that there’s a mobility problem or that they just hate gardening.
Let’s take a look at another scene. So here’s another scene that you may find yourself in. There’s a big crowd of people. There’s people laying on the floor. There’s some kind of responder on scene already, and again, it’s not uncommon for you guys to arrive on scene to find some kind of first aid or maybe a neighbor or somebody who’s a nurse on scene helping people. But again, you are reading the scene for danger, but you’re also reading the scene to try and help work out what the mechanisms of injury are. Now, when you get to the patient, you can use something called the pediatric or the patient assessment triangle, they’re both the same thing. What you do is as you approach the patient, you look at the patient’s general appearance, how heavy or normal the work of breathing is, and whether or not the patient looks pale. That’s part of the circulation. That’s something that’s well established now within medicine. Okay, so that’s a snapshot of approaching the scene.