The Paramedic Trauma Exam


This is a quick summary of the minimum physical exam that is appropriate for a traumatic patient. For full details of the exam items listed below, and for links to other focused physical exams, go here.

Head and Neck Exam

  1. Assess for facial and cranial lesions (DCAP-BTLS)

  2. Assess if pupils are equal and reactive to light (PEARL)

  3. Assess pupils for midline, conjugate gaze

  4. Assess pupils for nystagmus

  5. Assess for Ottorrhea/Rhinorrhea & Ottorrhagia/Rhinorrhagia

  6. Asses for speech deficits or abnormalities

  7. Assess for oral trauma (bitten lips, cheeks or tongue)

  8. Assess for ptosis and other facial asymmetry

  9. Assess for JVD

  10. Assess for tracheal deviation

  11. Assess for cervical vertebral body deviation & tenderness

  12. Assess for cervical muscle spasm & tenderness

Chest Exam

  1. Assess for lesions (DCAP-BTLS)

  2. Assess chest wall respiratory movement

  3. Assess Anterior/Posterior ratio

Respiratory Exam

  1. A   Assess for Accessory muscle use

  2. B   Assess Breath sounds

  3. C   Assess Colour and condition of skin

  4. D   Assess word Dyspnea

  5. E   Assess for Extending position

  6. F   Assess SpO2 using Finger probe

  7. G   Assess end tidal CO2 Gas values and waveforms

  8. H   Heart Rate

  9. I   Assess the inspiratory/expiratory ratio (“i/e ratio”)

Abdominal Exam

  1. Assess for lesions (DCAP-BTLS)

  2. Assess for shape

  3. Assess for abdominal cough tenderness

  4. Assess for softness / guarding

  5. Assess for colour and temperature

  6. Assess for ascities/obesity

  7. Assess for appliances

  8. Bowel sounds

Pelvic Exam

  1. Assess for lesions (DCAP-BTLS)

  2. Assess for stability in 3 planes (in up, and down)

  3. Assess for priaprism

  4. Assess for urinary and fecal incontinence

Extremity Exam

  1. Assess for lesions (DCAP-BTLS)

  2. Assess for PMS (pulse, motor, sensory) 

  3. Assess for ROM (range of motion)

  4. Assess for ambulation if appropriate (ability, posture and gate)

  5. Assess for bilaterally equal BPs in arms

  6. Assess for orthostatic hypotension

  7. Assess for edema

  8. Assess for Plantar- Babinski reflex

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