Initial examination of the casualty of an accident or an illness before emergency services arrive is vital. Once you have established that the casualty is conscious and breathing, you should carry out a quick head-to-toe examination. First take a look at the face of the casualty to see if it is pale, but don’t move the body or it may aggravate any injury that they may have suffered. You need to make sure the airway is clear before you attempt a physical examination. The information you gather can be extremely useful to the paramedics when they arrive for emergency services.
Examine the casualty from head to toe in a gentle and soothing way, but be purposeful and methodical. If you think there may be a spinal injury, you have to be extremely careful, as protecting the spine during the examination is of top priority. Follow the procedure outlined below:
First check the casualty’s head for any wound, swelling or bleeding. Examine the nose and ears also for any traces of blood or clear fluids. People who are experienced in giving first aid also examine the eyes to check the size of the pupil, because if they are of varying sizes, the person may be suffering from internal bleeding in the brain. If the pupils are tiny as pinpoints, the casualty may have taken drugs or some strong medication.
First, without moving the head, feel the back of the neck very gently for signs of swelling or tenderness. People who have undergone a tracheotomy have a surgical opening on the front side of the neck which serves as an airway; make sure nothing is blocking it.
Gently examine the chest to see if there are any tender areas which might indicate a rib fracture. If you find an object sticking out, leave it there. Then feel the collarbones to see if there is any swelling. If the emergency services are taking too long, it may be necessary to remove clothing to examine the casualty for any bruises or lacerations on the chest, but be very sensitive if this is necessary.
Feel the abdomen area to check if there is any swelling. While you do this, if the victim is conscious and feels some pain in the abdomen, they will flinch, moan or yell in agony.
Examine the hips for any tenderness. Make sure you keep your touch very light because a pelvic injury can be unbearably painful.
Arms and legs
Examine the limbs for signs of injury. Slowly bend the limbs to see if they are functioning normally. Ask the casualty if they can sense you touching their limbs. Ask them if they can tense and relax their limb muscles voluntarily.
If from the circumstances of the accident you think there may be a spinal injury, don’t try to examine the back, because even the slightest of movements can aggravate a spine injury. However, if you do not suspect injury to the spine, gently examine the back for tender areas.