Patient Assessment System (PAS) (HB)

A patient assessment system is simply an organizational tool for determining the problems with a patient. Because of the chaotic nature of emergencies and the potential for anxiety (even with experienced rescuers), it is important to have a standard system to learn and follow. Like a mechanic trying to repair a car, we need to know what is wrong before fixing it. A PAS is a simple, organized set of guidelines that, when completed, will give you a good idea of what might be wrong and how bad it might be. Remember, we are trying to fix things–what you don’t find, you don’t fix. And what you don’t fix will cause more problems.

The PAS is divided into three “triangles” with specific components and subcomponents unique to each triangle.

The first triangle is called the Scene Size-up, and it focuses on:

• the safety of the scene, rescuers, and patient(s),
• what the mechanism that is causing the problem(s), and
• what equipment and resources we may need.

The second triangle is called the Primary Assessment, and its main focus is to identify and correct any potentially life-threatening Critical System problem(s).

The third triangle is to gather more information about the incident history and patients’ medical history and assess non-life-threatening injuries.

You may encounter different systems in different training programs, and you may develop your preferred system. The important thing is to remember the concepts.

Once you become comfortable with our system, you will understand that you can do many of the Scene Size-up and Primary Assessment components in parallel. You can assess many things about the core stability of your patient as you are observing the scene.

What we need to know at the end of the PAS is one of our core concepts:

• Right now, my patient is “NOT SICK,” “KIND OF SICK,” “REALLY SICK.”
• Over time the patient is “GETTING BETTER,” “NO CHANGES,” “GETTING WORSE.”