Visual walkthroughs of a few core decision sequences, for a different way to review than reading text.
Primary Assessment Sequence
Scene size-up: BSI, scene safety, MOI/NOI, number of patients
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Form general impression (age, sex, distress level, obvious life threats)
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Airway patent?
No
Open airway (manual maneuver, suction, adjunct as needed)
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Breathing adequate? (rate, depth, effort)
No
Assist ventilations, high-flow oxygen
Yes
Proceed to circulation
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Circulation: pulse, major bleeding, skin signs
Major bleeding present
Control bleeding immediately
No major bleeding
Proceed to priority decision
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Significant MOI, unstable finding, or altered mental status?
Yes
Rapid trauma exam or detailed exam, high transport priority
No
Focused exam on chief complaint, history, vitals
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Ongoing reassessment (more frequent if unstable)
Adult Foreign Body Airway Obstruction
Signs of choking — can the patient cough or speak?
Mild / partial obstruction
Encourage forceful coughing, monitor closely, do not intervene further unless it worsens
Severe / complete obstruction
Deliver abdominal thrusts repeatedly (chest thrusts if pregnant or significantly obese)
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Result of thrusts?
Object expelled
Reassess airway and breathing, monitor
Patient becomes unresponsive
Lower to ground, begin CPR — check mouth for a visible object before each set of breaths
Anaphylaxis Recognition & Management
Signs of an allergic reaction after exposure — severity?
Mild / localized
Rash or itching only, no airway/breathing/circulation involvement — supportive care, monitor for progression
Severe / anaphylaxis
Stridor, wheezing, widespread hives, or hypotension — systemic involvement
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Assist with the patient's prescribed epinephrine auto-injector (or administer per local protocol), lateral thigh
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High-flow oxygen, position for comfort/perfusion, reassess
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Improving?
No
Repeat epinephrine per protocol/timing if authorized, continue support
Yes
Continue monitoring — reaction can still recur
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Immediate, high-priority transport
Stroke Assessment & Transport Decision
Sudden neurological symptoms — perform a stroke screen (FAST / Cincinnati)
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Screen positive? (facial droop, arm drift, or speech abnormality)
No, but suspicion remains
Still transport and monitor — symptoms can evolve
Yes
Note the time last known well, check blood glucose
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Blood glucose result?
Low
Treat hypoglycemia per protocol, reassess — it can mimic a stroke
Normal
Treat as a stroke — high-priority transport to a stroke-capable facility, avoid on-scene delay
Spinal Motion Restriction Decision
Trauma with a mechanism that could involve the spine
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Is the patient reliable? (alert, not intoxicated, no distracting injury)
No
Spinal motion restriction indicated
Yes
Midline spinal tenderness or deformity?
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Present
Spinal motion restriction indicated
Absent
Numbness, tingling, or weakness in the extremities?
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Present
Spinal motion restriction indicated
Absent
Spinal motion restriction generally not required — continue monitoring
Adult BLS / CPR Sequence (no advanced airway)
Scene safe, BSI taken
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Check responsiveness
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Check breathing & pulse (≤10 sec)
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No pulse
Begin CPR
30:2, 100-120/min, ≥2 in. depth
Pulse, no breathing
Rescue breaths
1 every 6 sec
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Attach AED as soon as available, analyze, shock if advised
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Resume CPR immediately after shock/no-shock advised
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Continue until ROSC, AED re-analysis prompts, or handoff to higher care
Shock Recognition & General Management
Assess perfusion: skin color/temp/moisture, pulse rate/quality, mental status, cap refill
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Compensated
Tachycardia, normal or slightly low BP, still mentating
Decompensated
Hypotension, altered mental status, weak/absent peripheral pulses
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Manage identifiable cause (e.g. control severe bleeding)
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High-concentration oxygen as indicated
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Position appropriately, prevent heat loss
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Indicate need for immediate transport
START Triage (general concept)
Can the patient walk?
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Breathing present? Rate very high/low?
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Absent, no response to reposition
Deceased / Expectant
Present, abnormal rate
Immediate
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If breathing rate normal: check perfusion (pulse/cap refill) and mental status
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Poor perfusion or can't follow commands → Immediate. Otherwise → Delayed.