10. Patient Assessment

Question 1

The 5 Main parts of the assessment process

Answer 1

1. Scene size-up
2. Primary - assessment
3. History Taking
4. Secondary Assessment
5. Reassessment

Question 2

Symptom (Definition)

Answer 2

SUBJECTIVE condition that the patient feels and tells you about

Question 3

Sign (definition)

Answer 3

OBJECTIVE condition that you can observe or measure

Question 4

Field Impression (Definition)

Answer 4

conclusion about the cause of the patient’s condition after considering the situation, history, and examination findings.

Question 5

Scene Size-up

Answer 5

evaluation of the conditions in which you will be operating.
Must combine:
An understanding of your situation and conditions prior to responding
The information the dispatcher gave you
Observation of the scene itself to help you ensure safe and effective operations

Question 6

Situational Awareness

Answer 6

Paying attention to the conditions and people around you at all times and the potential risks those conditions or people pose.

Question 7

traumatic injuries are the result of:

Answer 7

physical forces applied to the outside of the body, usually from an object striking the body or a body striking an object.

Question 8

Mechanism of injury (MOI) is classified according to:

Answer 8

Type or amount of force
How long it was applied
Where it was applied to the body

Question 9

patient’s with medical problems, like an illness/ disease is the_____

Answer 9

Nature of illness (NOI)

Question 10

Chief Complaint

Answer 10

most serious thing the patient is concerned about and the reason EMS was called

Question 11

What is the goal of primary assessment?

Answer 11

Identify and begin treatment of immediate or imminent life threats.
You must physically examine the patient and assess:
Level of consciousness (LOC)
Airway, breathing, and circulation (ABCs)

Question 12

general impression is formed to determine the priority of care and is the first part of your primary assessment and includes noting:

Answer 12

The person’s age, sex, race
Level of distress
Overall appearance

Question 13

Uncontrolled External Bleeding:

Answer 13

Uncontrolled external bleeding takes priority over other assessments.
Uncontrolled bleeding is suggested by a large amount of bleeding that is squirting or gushing, has soaked through clothing, or is pooling under the patient.

Question 14

AVPU scale tests a patient’s responsiveness. What does AVPU stand for?

Answer 14

Awake and Alert
Responsive to verbal stimuli
Responsive to Pain
Unresponsive

Question 15

AVPU scale: A - awake and alert means

Answer 15

The patient’s eyes open spontaneously as you approach, and the patient appears to be aware of you and responsive to the environment.
The patient is awake, appears to follow commands, and the eyes visually track people and objects.

Question 16

AVPU Scale: V - Responsive to Verbal Stimuli means

Answer 16

The patient is not alert and awake.
The patient’s eyes do not open spontaneously. However, the patient’s eyes do open when you speak to him or her, or the patient is able to respond in some meaningful way when spoken to.
A patient who does not respond to your normal speaking voice but who responds when you speak loudly is responding to loud verbal stimuli

Question 17

AVPU Scale: P - Responsive to Pain means

Answer 17

The patient does not respond to your questions but moves or cries out in response to painful stimulus.
There are appropriate and inappropriate methods of applying a painful stimulus.
Some methods may not give an accurate result if a spinal cord injury is present.
To determine whether a patient will respond to a painful stimulus:
Gently but firmly pinch the patient’s skin.
Areas where this works best are on the patient’s ear, back of the upper arm (triceps), or the trapezius area (the muscle above the collar bone).
Apply upward pressure along the ridge of the orbital rim along the underside of the eyebrow.
Note the type and location of the stimulus and how the patient responded.
If the patient does not respond to a painful stimulus on one side, try to elicit a response on the other side.

Question 18

AVPU Scale: U - Unresponsive means

Answer 18

The patient does not respond spontaneously or to a verbal or painful stimulus.
Unresponsive patients usually have no cough or gag reflex and lack the ability to protect their airway.
If you are in doubt about whether a patient is truly unresponsive, assume the worst and treat appropriately.

Question 19

Orientation means

Answer 19

tests a patient’s mental status by checking his or her memory and thinking ability

Question 20

An orientation test evaluates a patient’s ability to remember four things:

Answer 20

Person. The patient is able to remember his or her name.
Evaluates long-term memory
Place. The patient is able to identify his or her current location.
Evaluates intermediate memory
Time. The patient is able to tell you the current year, month, and approximate date.
Evaluates intermediate memory when asking year or month
Evaluates short-term memory when asking approximate date and event
Event. The patient is able to describe what happened (the MOI or NOI)

Question 21

Distracting Injury (Definition)

Answer 21

Any injury that distracts the patient’s attention from other injuries he or she may have, even severe injuries.
Ex is a painful femur/ tibia fracture that prevents the patient from noticing back of neck pain.

Question 22

There are only a few general conditions that cause sudden death, they are:

Answer 22

Airway obstruction
Respiratory failure
Respiratory arrest
Shock
Severe bleeding
Primary cardiac arrest

Question 23

while assessing the airway, responsive patients

Answer 23

A conscious patient who cannot speak or cry most likely has a severe airway obstruction.
If you identify an airway problem, stop the assessment process and work to clear the patient’s airway.
If your patient has signs of difficulty breathing or is not breathing, take corrective actions using appropriate airway management techniques.

Question 24

while assessing the airway, unresponsive patients:

Answer 24

With an unresponsive patient or a patient with a decreased LOC, immediately assess the patency of the airway.
If there is a potential for trauma, use the jaw-thrust maneuver to open the airway.
If you cannot obtain a patent airway using the jaw-thrust maneuver, or if it can be confirmed that the patient did not experience a traumatic event, use the head tilt–chin lift maneuver.
Another cause of airway obstruction in an unconscious patient could be relaxation of the tongue muscles.
Address this first by positioning the airway, followed by placing an oral or nasal airway.
Dentures, blood clots, vomitus, mucus, food, and other foreign objects may also create an obstruction. These can be cleared with manual techniques and suctioning.
Signs of airway obstruction in an unconscious patient include:
Obvious trauma, blood, or other obstruction
Noisy breathing, such as snoring, bubbling, gurgling, crowing, stridor, or other abnormal sounds (normal breathing is quiet)
Extremely shallow or absent breathing (airway obstructions may impair breathing)
If any of these conditions exist, the airway is considered inadequate and you should:
Open the airway using the head tilt–chin lift maneuver
Suction as necessary
Use an airway adjunct as necessary

Question 25

A patient who is breathing without assistance is said to have

Answer 25

Spontaneous respirations or spontaneous breathing.

Question 26

When respirations exceed 28 breaths/min or are fewer than 8 breaths/min, or are too shallow to provide adequate air exchange, consider providing ______ with an airway adjunct.

Answer 26

positive pressure ventilations

Question 27

Shallow Respirations

Answer 27

can be identified by little movement of the chest wall (reduced tidal volume) or poor chest excursion.

Question 28

Deep Respirations

Answer 28

cause a significant rise and fall of the chest

Question 29

Accessory Muscles are:

Answer 29

include the neck muscles, chest pectoralis major muscles, and abdominal muscles.

Question 30

Nasal flaring and seesaw breathing in pediatric patients indicate _____

Answer 30

inadequate breathing

Question 31

A patient who can speak only two or three words without pausing to take a breath, a condition known as ______________, has a serious breathing problem.

Answer 31

two- to three-word dyspnea

Question 32

Increased air flow sitting position: Tripod -

Answer 32

where a patient is sitting and leaning forward on outstretched arms with the head and chin thrust slightly forward.

Question 33

Increased air flow sitting position: Sniffing -

Answer 33

most commonly seen in children.
The patient sits upright with the head and chin thrust slightly forward, and the patient appears to be sniffing.