1-3. ESTABLISH PATIENT CONTACT

a. After assessing the scene for safety and determining the need for additional help, the number of patients, the mechanism of injury or nature of illness, and considering the need for cervical spine immobilization, the combat medic must make contact with the patient. The patient is assessed for ABC’s and his level of consciousness; then you can begin questioning your patient for vital information about the current medical problem with which you are concerned. This is the "chief complaint."

b. The chief complaint is the major signs, symptoms, or events that caused the illness or injury. Symptoms are conditions that the patient feels and tells you about, such as dizziness or particular pain. Symptoms are the subjective information you obtain from you patients. Signs can be seen, heard, felt, smelled, or measured, such as wounds, external bleeding, deformities, breathing rate, and pulse. You must be able to record and report how and when the signs and symptoms began.

c. Initial assessment is a rapid evaluation of the patient’s general condition to identify any potentially life-threatening injuries or conditions.

(1) Repeated vital signs will be compared to the baseline set.

(2) Vital signs are key indicators used to evaluate and determine the patient’s overall condition. Because key indicators include quantitative (numeric) measurement, vital signs always include breathing, pulse, and the blood pressure.

(a) The first vital sign is breathing. Breathing is discussed in Lesson 4.

(b) The second vital sign is the pulse. The pulse is discussed in Lesson 3.

(c) The third vital sign is the blood pressure. Blood presser is discussed in Lesson 5.

(d) Other key indicators include:

1 Skin temperature and condition in adults.

2 Capillary refill time (in children).

3 Pupillary response.

4 Level of consciousness (LOC).