PATIENT ASSESSMENT MODEL (PAM )

PATIENT ASSESSMENT MODEL

Scope
Introduction The SEVEN Components of PAM Rescue Scene Evaluation Primary Survey Secondary Survey Conclusion

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PAM1-1

PATIENT ASSESSMENT MODEL

Objectives At the end of the lesson, trainees should be able to List the SEVEN COMPONENTS of PAM correctly Explain the steps in rescue scene evaluation correctly Explain the steps in Primary Survey correctly Explain the steps in Secondary Survey correctly
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PAM1-2

SEVEN COMPONENTS OF PAM

1. RSE 2. Primary Survey 3. Secondary Survey 4. Protocol 5. Treatment 6. Load & Transport 7. Record & Report
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RESCUE SCENE EVALUATION (RSE)

Environmental Conditions
Hazards Mechanism of Injury

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PAM1-4

Environmental Conditions
detrimental to patient? - too hot or too cold - dangerous traffic conditions look for important clues about patients condition check for other victims look for witnesses or family members who can provide information
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PAM1-5

Hazards
any potential hazards to you, crew or patient

- gasoline, fumes, electrical wires, smoke,

fire - unstable vehicles police presence (at the scene of an assault)
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PAM1-6

Mechanism of Injury
event or agent which caused the patients injury or injuries

Mechanisms of injury indicating a

probable unstable patient
- pedestrian struck by a vehicle
- fall from a height > 15 feet - severe deceleration accident - ejection from vehicle
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PAM1-7

IMPORTANT
AN UNSTABLE PATIENT

needs to be transported

IMMEDIATELY
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Primary Survey
Aim : To discover and treat life or limb-threatening conditions

LOC - Level of Consciousness - use AVPU Alert Verbal Pain Unresponsive D - Delicate spine - stabilize as required A - Airway - tongue jaw lift - modified jaw thrust B - Breathing - ventilate as required - check for adequacy
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Primary Survey
C - Circulation - check for rate and character

- NO radial pulse, check carotid pulse

- NO carotid pulse, perform CPR - control hemorrhage RBS - Rapid Body Survey (max. 30secs) - check for external bleeding and deformities - expose and examine injury site - provide appropriate emergency treatment
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Primary Survey
Skin - check for colour and condition Oxygen - administer appropriate volume Decision point - UNSTABLE > transport IMMEDIATELY - STABLE > provide necessary treatment

before transportation
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SECONDARY SURVEY
AIM : To identify problems that do not pose an immediate threat to survival. However, it may threaten survival if undetected Consists of
History Vital Signs Head to Toe Examination

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 History
chief complaint history of chief complaint medical history - past and present medications allergies identifying data

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PAM1-10

Vital Signs level of consciousness - GCS pulse, respiration, blood pressure skin color & condition temperature (if appropriate)

NOTE : if UNSTABLE transport IMMEDIATELY

( Complete secondary survey enroute
to hospital )
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PAM1-11

 Head to Toe Examination (inspection & palpation) head neck chest abdomen pelvis lower extremities upper extremities back

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PAM1-12

SEVEN COMPONENTS OF PAM

RSE
LOC D A B C RBS SKIN OXYGEN DECISION POINT

HISTORY

VITAL SIGNS

HEAD TO TOE

PROTOCOLS TREATMENT LOAD & TRANSPORT RECORD & REPORT

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The End
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