DCAP-BTLS & Trauma Assessment
DCAP-BTLS is the mnemonic every EMS student learns and every NREMT trauma scenario tests. It's the structured way to find life threats fast during the rapid trauma exam.
EMT · AEMT · Paramedic
What DCAP-BTLS stands for
Palpate and inspect every body region for these eight findings during the rapid trauma exam.
- Deformities
- Contusions
- Abrasions
- Punctures / penetrations
- Burns
- Tenderness
- Lacerations
- Swelling
Primary vs secondary survey
Primary (XABCDE): stop massive hemorrhage, then airway, breathing, circulation, disability, expose. Secondary: head-to-toe DCAP-BTLS + SAMPLE + vitals. Significant MOI → rapid trauma exam; no significant MOI → focused exam on the chief complaint.
Significant mechanism of injury (MOI)
High-energy MOI triggers full spinal precautions, rapid transport, and trauma-center consideration.
- Ejection from vehicle
- Death in same passenger compartment
- Falls > 20 ft adult / > 10 ft or 2–3x height for peds
- Vehicle rollover with unrestrained occupant
- High-speed collision, motorcycle > 20 mph
- Pedestrian struck, penetrating trauma to head/neck/torso
Reassess every 5 minutes
Unstable trauma patients get reassessment every 5 minutes; stable every 15. Re-check the primary survey, vitals, and interventions — a tension pneumothorax can develop between the scene and the ED.
Frequently asked
- When do I do a rapid trauma exam vs focused exam?
- Rapid trauma exam for any significant MOI or unresponsive trauma patient. Focused exam for isolated injury with no significant MOI.
- Does massive hemorrhage really come before airway?
- Yes in modern TCCC/MARCH protocols — a bleeding femoral kills faster than an obstructed airway. Tourniquet or direct pressure first, then airway.
Test yourself
Practice on this topic.
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