Wilderness and Rescue Medicine 7th Edition Jeffrey Isaac, PA-C and David E. Johnson, MD

Chapter 3: Patient Assessment and the SOAP Format

The patient assessment system (PAS) is a tool for organizing your response to any situation involv- ing an ill or injured person. The more complicated and difficult the situation is, the more valuable a well-rehearsed PAS will be. Properly applied, the PAS will lead you to a concise description of the problems you are facing and what you are going to do about them.

but it is one of the best tools that you have avail- able for reducing risk and improving outcome. Gathering Information The Scene Size-Up For Search and Rescue (SAR) teams the scene size up begins with the call out. While the team is getting organized, the team leader will usually delegate a member to collect further data from dispatch, the reporting party, and people on scene if possible. By adding a weather report and local knowledge, it is sometimes possible to form a near complete picture of the situation and the associ- ated risks. More often, however, it is the rescuer on scene that performs this vital function. The scene size-up is designed to keep you alive and effective. It also serves to protect other rescu- ers, bystanders, and the patient from further harm. If you are among the first on scene, a complete scene size-up is your first responsibility. It is also your first opportunity to assess the number of people affected and the forces and factors involved. Stabilize the Scene It can take tremendous discipline to overcome the urge to rush to the aid of a person in trouble,

General Principles

Patient Assessment System

1

SCENE SIZE-UP

Stabilize the Scene

PRIMARY ASSESSMENT

Stabilize the Patient

SECONDARY ASSESSMENT

Complete then Treat

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The PAS consists of three important steps: gath- ering information, creating a problem list, and planning treatment and evacuation. Information is collected in a series of surveys, which is sum- marized as three triangles. These steps allow you to gather the necessary information systematically, act on what is urgent and important, and organize your ongoing response. Becoming competent and comfortable with the PAS requires lots of practice,