Assessment Flashcards
What are the steps of the Scene Size Up
BSI
MOI/NOI
C-Spine
A,B, C
What are the steps of the Primary Assessment
LOC-AVPU
A - Airway - Open Talking
B - Breathing - Fast/Slow Deep/Shallow
C - Circ - Bound/Thready Reg/Irr Fast/Slow
Skin - MTC Blood Loss
D - Disposition ALS/BLS
E - Expose - As appropriate
Decision - Load & G - Stay & Play
A&Ox3 FBO OPA/NPA Listen O2/BVM CPR (CAB) Call ALS
What are the steps of the Secondary Assessment for an Unconscious / Unresponsive Medical Patient
Focused Exam - CPR - as needed - AED - BVM Suction -OPA/NPA Combitube O2
To Ambulance
DETAILED EXAM Vitals as needed Hx Family / Friends Check "Med Tag" Assessment / Tx as possible
What are the steps of the Secondary Assessment for an Conscious / Responsive Medical Patient
Focused Exam OPQRST SAMPLE Exam - Fast Vitals - BP, Pulse, Resp, Skin, Pupils POx Blood Sugar O2 Suction Lung Sounds
Call - Hospital - Medication
To Ambulance - Where is ALS
Detailed Exam - orafices
In Ambulance "Head to Toe" -dizzy -headache -ringing -hearing -vision -lightheaded -throat -cough -neck JVD -lung Sounds -Nausea -Vomiting -BM/Urine -LMP
What are the steps in the Secondary Assessment of the Trauma Patient with Multi-Trauma or Significant Mechanism of Injury
Focused Exam
Rapid Trauma Assessment 60-90 Sec
DCAP-BTLS or WTD
PMS
Tx - CPR, OPA, NPA, BVM, O2, Suction Combi
To Ambulance or Helicopter
Continue Resus
Detailed Exam, VS & Tx
As possible while en route to hospital or trauma center
What are the steps in the Secondary Assessment of the Trauma Patient with Single Injury
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What are the vital signs
Pupils Respiration (Lung Sounds as needed) Blood Pressure Pulse SpO2 Blood Glucose Skin Color and Temp Temp
Administering Medication
P atient T ime M edication D dose R oute L ast taken A wake / allergies C ontraindications
Stroke Questions
Headache onset - worst headache of your life? (aneurysm) Cardiac Arrhythmias Weakness/Numbness/Dizziness Visual Disturbance Headache, Nausea/Vomiting, Neck Pain Pregnancy DNR Head Trauma at Onset Coumadin Seizure at Onset Bleeding / Clotting Disorders Recent Surgery
Destination:
Onset <2-3 1/2 hr, transport IV thrombolytic within 3-4 1/2 hr
Onset 2-6 hr, intra-cerebral interventional
Stroke Tx
O2 if SaO2 <94 - avoid hyperventilation
Neurological Assessment
Positions pt to facilitate comfort
OPQRST
Stroke Assessment
Completes stroke assessment
Calls stroke alert in needed
Calls ALS if needed
Transports to stroke center
After interventions
Reassesses S/S Identifies any side effects continues with focused assessment continues with reassessment continues to assess pt in route contact medical control if needed
Treatments
O2 Therapy
- Correct L/M
- Correct Device
Airway Therapy
- Correct use of adjuncts
- Correct procedure
Drug Administration
- Correct Drug
- Correct Route
- Correct Dose
- Correct Time
PCR
correctly documents scenario
Acute Abdomen
Location of Pain Bleeding or Disccharge Orthostatic Vital Signs Last Menstrual Period Blood in feces, urine, or vomit Nausea and Vomiting
Ulcers
Location of Pain Does Pain Diminish ager eating then return Blood in stool Orthostatic Vital Signs Blood in feces, urine, or vomit Nausea and Vomiting
Appendicitis
Location of Pain Nausea and Vomiting Blood in Stool Orthostatic Vital Signs Rebound Tenderness
Orthostatic Vital Signs
Orthostatic vital signs are a series of vital signs of a patient taken while the patient is supine, then repeated sitting up, then again while standing. A variation is to check blood pressure and heart rate in supine and then standing positions only. The results are only meaningful if performed in the correct order (starting with supine position)[1][2][3] Used to identify orthostatic hypotension,[4] orthostatic vital signs are commonly taken in triage medicine when a patient presents with vomiting, diarrhea or abdominal pain; with fever; with bleeding; or with syncope, dizziness or weakness.[1] Orthostatic vital signs are not collected where spinal injury seems likely or where the patient is displaying an altered level of consciousness. Additionally, it is omitted when the patient is demonstrating hemodynamic instability,[1] which term is generally used to indicate abnormal or unstable blood pressure but which can also suggest inadequate arterial supply to organs.[5] Orthostatic vital signs are also taken after surgery.[6]
A patient is considered to have orthostatic hypotension when the systolic blood pressure falls by more than 20 mm Hg, the diastolic blood pressure falls by more than 10 mm Hg, or the pulse rises by more than 20 beats per minute within 3 minutes of standing[4][6
Gastroenteritis
Location of Pain Nausea and Vomiting Diarrhea Orthostatic Vital Signs Rebound Tenderness Dehydration
Kidney Stones
Location of Pain
Nausea and Vomiting
Blood in Urine
Inability to pass urine
Pancreatitis
Location of Pain
Orthostatic Vital Signs
Nausea and Vomiting
Critical Criteria
Failure To:
Take or verbalize infection control procedures
Determine Scene Safety
Provide appropriate O2 therapy
Evaluate & manage conditions of A, B & C (shock)
Differentiate stay and play vs. load and go
Does other detailed PE before assessing and tx ABC
Determine the primary problem
Performs any management or procedure that would harm
Allergic Reaction
Hx of allergies Exposed to what How exposed What effects are present Progression of S/S Interventions Assesses for use of EpiPen
Auto EpiPen
Contacts Medical Control Obtains proper dose EpiPen Pulls off safety cap Places black tip on outer thigh Holds in place for several seconds Discards in approved Biohazard container
Drug Administration
- Correct Patient
- Correct Drug
- Correct Route
- Correct Dose
- Correct Time
- Not expired
- Contraindications
% of O2 by Device & Flow Rate - Nasal Cannula
Nasal Canula: 2-6 lpm O2 conc: 24-44%
