Page 9 - 2026 SMOG

GENERAL
UNIVERSAL PATIENT CARE
Patient History Key Concepts
• Age of the patient • Use MARCHES for trauma patients
• Chief complaint ˚ Massive bleeding control
• Timing of events/event factors ˚ Airway
• Other symptoms or complaints ˚ Respiratory
• Patient’s past medical history ˚ Circulation
• Other pertinent SAMPLE, OPQRST ˚ Hypothermia care
questions ˚ Eye injuries
Spinal motion restriction
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• Focused primary exam for non-traumatic
illness/injury
Treatment/Actions
• Scene safety
˚ Maintain situational awareness
Utilize appropriate PPE
˚
• Initial assessment
˚ Treat obvious and emergent life threats
˚ MARCHES or Focused Primary Exam
Utilize BLS, ALS, and/or PALS guides as necessary
˚
• Consider spinal immobilization
˚ Dangerous MOI
˚ Low-risk MOI but unable to rotate neck 45°
Does not apply to situations where imminent danger exists
˚
• Record vital signs and make an appropriate transport decision
• Initial interventions
˚ Supplemental O 2
˚ IV/IO (saline lock) as applicable
˚
Medication/fluid administration (as indicated)
• Secondary assessment
˚ 12-lead EKG (as applicable)
˚ EtCO (as applicable)
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˚ Secondary interventions
˚ Pain management
Notes, Cautions, Warnings
• Record all patient encounters on appropriate care documentation sheets per theater policies,
unit SOPs, and/or in accordance with JTS Documentation CPG at the end of a patient encounter
• Bring any mishaps/errors to the attention of the medical control ASAP
• Contact medical control for any necessary assistance when feasible
• Consider spinal immobilization if:
˚ Fall from height (versus fall from standing)
˚ Axial load to the head
˚ High-speed collision, rollover, or ejection from any motorized vehicle
˚ Explosion or blast injury
˚ Trauma resulting in temporary amnesia/loss of consciousness

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