7 - Primary Assessment Flashcards
When an emergency occurs, one of the most essential aspects of your job is the
primary (initial) assessment
Process used to quickly identify those conditions that represent an immediate threat to the patient’s life, so that you may properly tram them as they are found.
Primary assessment
An effective primary assessment includes:
1) creating a general impression of the patient
2) checking for responsiveness
3) checking the airway, breathing & circulatory status
The four main components to consider during a scene size-up include:
1) Scene safety
2) The MOI or NOI
3) Number of patients involved
4) Resources needed
Determining the MOI and NOI:
1) look around the scene for clues to what caused the emergency and the extent of the damage
2) consider the force that may have been involved in creating an injury
3) if a patient is unconscious, determining the MOI or NOI may be the only way you can identify what occurred
When to summon more advanced medical personnel:
1) unconsciousness or altered LOC
2) Breathing problems
3) Chest pain, discomfort or pressure lasting more than a few minutes, that goes away and comes back or that radiates to the shoulder, arm, neck, jaw, stomach or back.
4) Persistent abdominal pain or pressure
5) No pulse
6) Severe external bleeding
7) Vomiting blood or passing blood
8) Severe burns
9) Suspected poisoning
10) Seizures
11) Stroke
12) Suspected or obvious injuries to the head, neck or spine
13) Painful, swollen, deformed areas or an open fracture
CRITICAL FACT
Primary assessment is essential to the job of an EMR to ensure proper care. However, a scene size-up to evaluate safety, MOI or NOI, number of patients and resources needed should always be done first.
CRITICAL FACT
To determine the MOI or NOI, check the scene for clues and consider the force that may have been involved.
CRITICAL FACT
Many conditions warrant summoning advanced medical personnel. These include breathing problems, prolonged chest pain, seizures and suspected head, next or spinal injures ect.
CRITICAL FACT
Always check for life-threatening conditions: lack of consciousness, abnormal breathing, blocked airway, no pulse or severe bleeding
CRITICAL FACT
To asses LOC, ask simple questions such as “What is your name?” LOC can range from being fully alert to unconsciousness. Always approach a patient from the front to avoid head turning.
Alert
Patients who are alert are aware of their surroundings, able to acknowledge your presence and able to respond to your questions.
Verbal
Sometimes the patient is only able to react to sounds, such as your voice. The patient’s eyes may be closed but they open when hearing your voice or when the patient is told to open them. The patient may appear to be lapsing into unconsciousness.A patient who has to be stimulated by sound to respond is described as responding to verbal stimuli.
Painful
A pat heir who does not respond to verbal stimuli or commands, but does respond when someone inflicts pain, is described as responding to painful stimuli. Pinching the earlobe or the skin above the collarbone are examples of painful stimuli used to try to get a response.
Unresponsive
Patients who do not respond to any stimuli are describes as being unconscious or unresponsive to stimuli.
The airway can become blocked by:
fluids, solid objects, the tongue or swollen tissue caused by trauma or severe allergic reaction
