AEMT 14 Flashcards
Patient Assessment
What are the 4 components of the patient assessment process?
1- Scene Size-Up
2- Primary assessment
3- Secondary Assessment
4- Reassessment
What is done during Scene Size-Up?
Determine the scene is safe.
Formulate a general impression of the nature of the situation.
When do you formulate your general impression?
During Scene size-up
What are the operational aspects of the scene size up
Identify hazards, number of patients, and need for additional resources.
What are the clinical aspects of the scene size up?
Determine NOI/MOI, get general impression including age, sex and responsiveness.
What is included in the general impression?
Approximate age, sex, responsiveness, sick or well.
What do you do if your scene is unsafe.
Correct hazard, control scene until deemed safe.
BSI comes before?
My scene is safe.
Primary Assessment includes?
Look for and manage life threats, establish priorites for treatment and transport.
What do you do when the patient appears to be unresponsive?
Confirm level of responsiveness, determine if patient is breathing.
What do you do if patient is unresponsive and not breathing?
Check for pulse.
What do you do if patient is responsive in primary assessment?
Check ABC’s and determine chief complaint.
After checking ABC’s and determining chief complaint what is the last step in primary assessment?
Interventions for life threats (ABC’s), determine if patient is critical or non critical. Priority of treatment and transport.
If patient is unresponsive and has no pulse what do you do next?
Start chest compressions.
If patient is unresponsive and has a pulse, what do you do?
Check for problems with ABC’s
What is done during secondary assessment?
Vitals, obtain medical history, and look for additional signs of injury or illness.
When you have a critical medical patient, what steps do you take in your secondary assessment?
Obtain history, rapid medical exam, baseline vitals and use monitoring devices, and preform head to toe exam as needed.
When you have a critical trauma patient, what steps do you take in your secendary assessment?
Rapid trauma exam, baseline vitals and monitoring devices, head to toe exam, and obtain history.
Non critical medical patient, what do you do in your secondary assessment?
Obtain history, focused physical exam, baseline vitals and monitoring devices.
If you have a non critical trauma patient, what steps do you take in your secondary assessment?
Preform focused physical exam, baseline vitals and monitoring devices, and obtain history.
What questions do you use to obtain history?
SAMPLE
How do you obtain history if your patient is unable to give it to you.
Ask a bistandard, or family for any information they can give you.
What do you do after you have finished your secondary assessment?
Reassess
What is the first step you take in your reassessment?
Reassess primary assessment; LOC, ABC’s
After reassesing your primary assessment, what steps do you take next?
Vital signs and monitoring devices. (start trending)
What are the steps taken in the Reassesment?
Reassess: Primary assessment, vitals, aspects of physical exam, changes in complaints, and sepcific effects of treatment.
What are all the critical components of the scene size up?
Establishing a safe scene, identifying the number of patients, and determining the need for additional resources.
What are you checking when you reassess the primary assessment?
LOC and ABC’s
How often do you reassess a critial patient?
Every 5 minutes
What is one of the first clinical goals of assessing a patient?
To detemine if the patients problem is medical or trauma.
What does the general impression help you determine?
The urgency of the situation.
What do you have to determine before before you know how to approach your primary assessment?
If the patient is responsive/unresponsive.
You would check a pulse in your primary assessment if your patient was?
Unresponsive and not breathing.
If your patient is in cardiac arrest you?
Immediatley start compressions and attatch him to an AED
How do you determine the patients level of distress?
By preforming a systematic primary assessment.
When would you first assess the ABC’s
If the patient is awake, responds to voice or painful stimuli, or is uncontious and breathing.
What is Agonal?
Ineffective breathing.
What quickly follows after absent or agonal breathing?
Cardiac Arrest.
How do you verify an assumed cardiac arrest if patient is unresponsive and not breathing?
Check for carotid pulse
What happens when circulation is stopped?
The patient becomes unresponsive and stops or has ineffective breathing.
When do you look for and correct immediate life threats during the primary assessment?
After confirming the level or responsiveness.
Circulation is required for both?
Responsiveness and breathing.
When do you decide the priority for patient care and transport?
After correcting any immediate life threats.
In ABCD, what does D represent?
Disability
In ABCD, Disability refers to patients?
Level or responsiveness or mental status.
Determining the Disability is important early in the stage of assessment to help determine?
The seriousness of the situation.
Mental status is also refered to as?
Disability
It is important to comfirm your the level of consciousness when a patient appears to be unresponsive because?
They may be sleeping or obtunded
If your patient is not alert and does not respond to your voice you would?
Use painful stimuli such as a sternum rub.
A in AVPU represents
Awake and aware of surroundings
V in AVPU represents
Responds to verbal stimuli
During scene size up from an operational standpoint you determine what three things?
If the scene is safe, how many patients, and if additional resources are needed.
What is your highest priority on an unresponsive patient?
checking for the absence of breathing and circulation.
If oxygen does not reach the lungs to oxygenate the red blood cells what wil happen?
No oxygen will be delivered to the cells and the patient will axphyxiate and die.
If inadiquate breathing is not corrected and the lungs are not being ventilated your patient will become?
Hypoxic
If patient is pulseless you?
Start CPR
When checking a pulse you are concerned with what three things?
If the pulse rate is within normal range, and its strength and reularity.
Two considerations when assessing circulation?
1-Overall quality of the patient’s perfusion.
2- Control ongoing hemorrhage.
What will uncontrolled hemorrhage lead to?
Shock and death.
Patients with poor perfusion and significant bleeding are critical and require?
Rapid intervention and immediate transport.
All other tasks and interventions are planned around what major intervention?
Getting your patient to the hospital.
What kind of patients need you to quickly implement interventions to suport ABC’s and get them to the hospital without delay?
Critial patients
In a critical patient where would you continue the assessment and treatments after Primary assessment?
En route to the hospital
Non critical patients need to be evaluated and treated at the hospital but do not require what?
Immediate intervention
The airway is a concern in what assessment?
Primary
Unresponsive ptients have threatened?
Airways
Secondary assessment consists of what steps?
Medical history, base line virals, and physical examination
An unresponsive patient should always be considered what?
Critical
For a responsive medical patient you should start the secondary assessment with?
Obtaining medical history
Medical history should be focused on what?
Patients cheif complaint
Basing your physical exam on the information given about the patients condiciton is called
A focused physical exam
For an unresponsive medical patient the first thing you do in the secondary assessment is?
Rapid physical exam to detect any serious problems that were not found in the primary assessment.
While you are obtaining vitals on an unresponsive patient your partner should be doing what?
Getting history from family or bistanders
En route if you did not determine a cause of the patients condition in an unresponsive medical patient through rapid physical exam, vital signs or history you should?
Do a complete head to toe exam
How do you judge the severity of the patient’s condition in a trauma patient?
Mechanism of injury and Primary assessment findings.
Critical trauma patients means they have
life or limb threatening injuries
For critical trauma patients it is important to do what while preparing them for transport?
Preform rapid trauma exam
Time is of the essence in stabilizing what in critical trauma patients?
Life threats
What is the purpose of the rapid trauma exam?
Further check vital areas fo the body for indications of potential life threatening injuries
On a non critical trauma patient do you have to preform a detailed physical exam?
No you can do a focused physical exam focusing on the isolated injury.
What continues throughout the call
assessments
You will reassess a patient any time there is what?
A change in his condition.
hypothetico-deductive approach to problem solving is what?
Collecting information, forming several hypotheses then proving or disproving each hypothesis to to narrow down the list.
Heuristics: rule of thumb refers to what kind of critical thinking?
Assuming the most common cause.
Seach satisficing is what?
Focusing on the first injury found when the patient might have a much more significant injury.
Failure to pay sufficient attention to the possibvility that a patient has a medical problem because he has a history of psychiatric illness is known as what?
Fundamental attribution error or (Psych out)
when something should be done but the provider hesites to do it is called
Omission error.
Overtreating patients because it makes them feel better to do something is called?
Commision Bias
Taking a piece of infomation revealed early in the assessment and making it more significant than it is is considered?
Anchoring
The process in which experts typically identify a patients problem?
Recognizing patterns of patient presentations made familiar through experiance.
