Assessment Protocol 2

- Call to Dispatch: Radio Number, On Scene, Descriptive Location

- Scene safety & cross skis uphill

- Introduce self & gain consent

- General impression & ABCs

- Chief complaint

- LOC

- Head, neck, back (always) questions

- Rapid body survey

- Assess chief complaint, including CMS

- Call to Standby: Radio Number, Equipment, Descriptive Location

- Ambulance call or doctor request, if needed

- Prepare platform for equipment arrival

- SAMPLE

- OPQRST (if needed)

- Vitals

- Bandage & splint (if materials already available)

- Final packaging once equipment arrives - injury uphill in sled

- Depart for first aid

- Complete incident forms in first aid

Assessment Protocol 1

		Sub-steps		General
The scene is safe. I’m crossing my skis uphill. I see one patient, no witnesses. The scene shows that … may be the MOI. I have BSI on.				Size-Up Scene
“Hi, my name is Piotr, I’m with Ski Patrol, may I help you?”		Introduction & Permission		First Contact
“Please don’t move your head” Qualitative assessment of: Pulse is… (strong and steady) Skin is… (warm, dry, and pink)		2 Pt Landing
“Tell me what happened. Tell me what hurts” "Does it feel like it’s bleeding?" [Go to skin] >>“Please don’t move your head. Just answer me verbally".      (If they move their head) >>“Can you point to where it hurts?”     (If they can't clearly identify injury)		Chief Complaint
Patient is speaking and has Airway		A		ABCs (<5 min to death)
Patient is Breathing		B
Patient has pulse and is not bleeding - Circulation		C
"I have my ABCs"
LOC Questions:  “What is your name?” “Where are you?” “What day is it?” “What happened just before the accident?” >> Patroller will note: "Patient is A&O by 3, not responsive to time".		D1/ Mental Status (LOR/LOA) PPTE		Four D’s & Decision (<1 hr to death)
(Pause to) Review for signs of shock: Head – (LOC) - from above LOC questions Heart – Pulse is… (pulse & type) - from 2-point landing check Lungs – Respiration is… (respiration & type) - from 2 point landing check Skin – Skin is… (color, temp, wet) - from 2 point landing check		D2/ Shock Signs (Head, Heart, Lungs, Skin)
Always Questions: “Did you hit your head?” “Did you hit your back?” “Does your neck hurt?” “Does your back hurt?” “Did you ever lose consciousness?”		D3/ Always Questions
Important Medical Issues Questions: “Do you have any medical issues that I should be aware of, such as Heart Disease, Hemophilia, Epilepsy, Asthma, Allergies or Diabetes?”		D4/ Medical Issues HHEADD
>>Is the situation urgent and thus requires Emergency Transport?		Decision
“I’m going to do a body survey” Checking head Checking cervical spine Checking anterior neck and trachea Checking clavicles and shoulders Checking chest Checking abdominal quadrants Checking pelvis by squeezing not pressing Checking legs (including CSM & pedal test) Checking arms (including CSM & squeeze test) Roll patient over & check back & palpate spine		Head C-Spine Neck Clavicles / Shoulders Chest / Sternum Abdominal Quadrants Pelvis Squeeze Legs Arms Back Spine		Rapid Survey  (>1 hr to death)
Check CSM (can/usually is done during arm & leg test above) “Does this feel numb or tingly?” “Can you tell me which finger/toe I’m holding?” “Can you move your… “		C – circulation S – sensation M – motion
For medical chief complaints or if you reason to believe a sign/symptom may be medical:  “When did this start?” “Does anything make it worse?  Does anything make it better?” “Can you describe the pain?” “Does the pain radiate anywhere?” “On a scale from 1 to 10, 10 being the worst pain in your life, how much pain are you feeling?” “Is it getting better? Is it getting worse?”		O – onset P – provoke Q – quality R – radiate S – severity T – time *for medical issue not trauma
"Pulse is X Respiration rate is Y"		15 pulse x 4 15 breathing x4 *after every body survey and in severe situations on regular basis		Vitals
“Dispatch, I have a… male, 25 years old, with a shoulder injury with compromised CMS. Patient is A&O by 3. We are skiers right on Big Dipper near tower 10. I need a sled and sled bag Requesting emergency transportation.”		S – sex A – age I – injury L – LOC & location E – equipment needed R – resources		Radio Call
“Do you have any allergies?” “Do take medications - prescription, recreational, OTC ?" “Prior medical conditions/seeing a doctor for anything?” “When was the last time you ate or drank anything?  What was it?" "One more time, tell me what happened"		A – allergies M – medication P – prior medical cond. L – last oral intake E – events		SAMPLE
MOI – Mechanism of Injury BSI – Body Safe Isolation	DO: Tell the patient that “We are getting you the best help we can” DON’T: Tell the patient that “Everything is going to be alright.”		15 second count x2 x2 * final count divisible by  4

Radio Protocol 1

- Calls to Dispatch include: Reporting a 10-50, On Scene of a 10-50, Ambulance call, requesting Doc/105 to First Aid, 10-60/AITs

- Calls to Standby include: Any equipment request (either first aid or set up related), Statement of location to respond to or back a 10-50

- Any call to a person: <Their Radio Number>, <Their Name>, <Your Radio Number>. Wait for response

- Any call to a standby: <Complex> Standby, <Your Radio Number>. Wait for response

- Any call to dispatch: Mountain Dispatch, <Your Radio Number>. Wait for response

- If you think you missed a radio call to you: Traffic for <Your Radio Number>?

- Reporting a 10-50 you see, but that you cannot reach: Possible 10-50 at Descriptive Location

- Reporting a 10-50 reported to you by a customer but that you cannot reach: Customer report of a possible 10-50 at Descriptive Location

- Reporting a 10-50 reported to you by an employee but that you cannot reach: Possible 10-50 at Descriptive Location, reported by Employee's Role & Location

- Reporting a 10-50 that you are able to reach: Append "Responding to a" before any of the above 3 calls.

- On Scene: Radio Number, On Scene, Descriptive Location

- Equipment Request: Radio Number, Equipment, Descriptive Location

- Doctor Request: Can I get a 105 to First Aid?

- Ambulance Request: Age, Gender, Injury/Chief Complaint, LOC, ETA to First Aid, Breathing?, Bleeding?

- 10-4 = OK

- 10-7 = Not working

- 10-8 = Working

- 10-9 = Please repeat

- 10-19 = Return to standby

- 10-20/Your 20 = Location/Your location

- 10-50 = Wreck

- 10-60/AIT = Wreck involving anything placed by humans (including lifts, race courses, snowmaking, terrain park features, etc.). Will result in an Accident Investigation Team documentation session that will need your help.