3: Primary, secondary and focused assessment Flashcards
What are the three types of assessments and what are their general aims?
Primary= rapid assessment to triage and plan further care
Secondary= health history, physical examination and vital signs
Focoused= specific to body system
Explain a purpose primary assessment
= a rapid assessment to identify life-threatening conditions, allowing for prompt management.
- performed promptly after admission/on entry
- poor primary assessment= medical failures
enables care to be prioritised - can be done in 2 minutes
Identify- correct- re-assess
Primary assessment criteria
DRSABCD
Danger
Response
Send for help
Airways and c-spin Breathing Circulation Disability Exposure and environment
Air way and C-spine assessment
- ensure the airway is patent
- perform head tilt and chin lift manoeuvre to open airways
- assess for airway compromise
- think about potential spinal cord injury and manage as required (use jaw thrust if spinal cord injury is suspeced)
Breathing assessment
assess for effective
- air entry to lungs
- skin and mucosal membrane - chest wall movement
Circulation assessment
Check for and assess - central pulse - pulse rate and quality - skin colour and warmth - capillary refill - internal and external hemorrhage auscultate to hear S1 and S2 heart sounds
Disability assessment
To assess CNS function AVPU - alert - Verbal stimulated response - Painful stimulus-response - Unconscious or unresponsive
- test pupillary response
- assess limb strength and sensation (same on both sides)
- ask about pain
Check for reversible causes of reduced consciousness
- medication
- blood glucose level
- hemorrhagic shock and hypotension
- overdose
- anaphylaxis
Exposure and environment assessment
- remove clothing to expose patient but maintain body temp, assess signs of trauma, injury or illness (anaphylaxis)
- assessment of clues to the cause of condition
- ensure emergency equipment is available at bedspace (air, forcepts)
What are the three major components of a secondary assessment?
1- health history interview
2- physical examination
3- vital signs assessment
What are the 6 components of a health history interview?
1- biographical data
- name, age, gender, address
2- Reason for seeking care
- why you here today?
3- Perception of the present state of health
- what happened leading up to the issue?
4- past health + medical history
- family history
5- General overall health and wellbeing
6- health and lifestyle management
- do you see GP, STI check, pap smear
Physical assessment
Generally, assess structure and function via appearance and motion.
head-to-toe or system assessment of body system
- general survey
- head and neck
- neurological
- cardiovascular
- respiratory
- Gastrointestional
- Skin and extremities
- endocrine
- Posterior
Focused assessment
assessment of particular clinical manifestations related to a particular body system.
completed often (throughout shift and at handover)
Using skills of
- inspection
- auscultation
- palpation
- percussion
