Article by DAN Staff
Being able to quickly and correctly perform emergency care skills can be the difference between life and death for a student diver or buddy. Regardless of your level of personal experience with emergency management and response, providing the utmost in care requires regular refreshers on even the most basic skills, such as the measurement of vital signs. Through your training, you received an introduction to vital sign monitoring, but likely haven’t had much need to practice those skills. Accurate measurements of an individual’s condition not only provide EMS personnel with a good baseline for care, but can also expedite needed medical interventions and provide a valuable timeline of a patient’s condition. How prepared are you to use your basic life support skills to monitor a patient?
Time
Time is the fundamental metric in emergency response. Regularly recording the patient’s condition and the corresponding time is vital to creating an accurate timeline of patient symptoms. Timelines can be used to determine whether a patient’s condition is worsening, and can dictate medical interventions. Seriously ill patients should have their vital signs reassessed every few minutes, while patients who are stable may have their vitals checked hourly.
Level of Responsiveness
A patient’s level of responsiveness (LOR) can be one of the most revealing indicators of wellbeing. LOR is generally measured with four basic questions:
What is your name?
Where are we?
What time is it?
What happened?
If an individual can answer all of these questions with reasonable accuracy, you can quantify the LOR as “Alert and Oriented to Person, Place, Time and Event.” If a patient can’t respond to these, or is unconscious, you can further measure LOR by determining responsiveness to verbal or painful stimuli. However, while this may provide useful information to professional responders, it’s not likely to change the care you provide as a dive professional.
Pulse
Pulse can be a very effective indicator of an individual’s wellness, especially if more than just heartbeats are measured. To assess a pulse, place two fingers gently on either the carotid artery (lateral to the trachea on the neck) or on a patient’s wrist just beneath the base of the thumb (radial pulse). If you can’t find a pulse, first confirm the location of your fingers and then make sure you aren’t pressing too hard or too gently. Note not just the speed of heartbeats, but also the strength and regularity of the beat because these can be important factors when determining injury severity.
Respiration
A body can’t survive for more than a few minutes without oxygen, so you must constantly monitor a patient’s respirations. Because many people will alter their breathing if they know you’re trying to count their breaths, begin counting respirations immediately after measuring the patient’s pulse. Pay close attention to the sound of the breaths and listen for wheezing, gasping, or labored breathing – these can indicate the existence of specific conditions for healthcare personnel.
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