The systematic framework used on every patient. Never skip steps — scene safety to patient hand-off.
Steps by Cert Level
ALL: 1. Scene Safety — BSI, hazards, MOI/NOI, number of patients. 2. General Impression — sick or not sick? 3. Primary Survey (ABCDE): Airway, Breathing, Circulation, Disability (GCS), Expose. 4. Identify and treat life threats immediately.
EMT: Secondary Assessment: SAMPLE history (Signs/Symptoms, Allergies, Meds, Pertinent history, Last oral intake, Events). OPQRST for pain. Focused exam based on chief complaint. Baseline vitals.
AEMT: Expanded assessment: 12-lead ECG, BGL, SpO2, ETCO2 for appropriate patients. IV access on all serious patients. Reassess every 5 min (unstable) or 15 min (stable).
PARAMEDIC: Field impression with differential diagnosis. Targeted interventions. Comprehensive documentation including times, vitals, interventions, and patient response. Pre-alert hospital with MIVT: Mechanism, Injuries, Vital signs, Treatment.