ch10 (patient assessment) Flashcards

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1
Q

what are the 5 parts of safety assessment?

A
  1. scene size-up
  2. primary assessment
  3. history taking
  4. secondary assessment
  5. reassessment
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2
Q

symptom

A

a subjective condition that the patient feels and tells you about (can be identified only by the patient)

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3
Q

sign

A

an objective condition that you can observe or measure (can be seen, heard, smelled or measured)

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4
Q

field impression

A

conclusion about the cause of the patient’s condition after considering the situation that will help you determine your priorities of care

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5
Q

scene-size up

A

quick assessment of the scene and the surroundings (MOI and NOI) before you enter and begin patient care

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6
Q

situational awareness

A

knowledge and understanding of one’s surroundings and the ability to recognize potential risks (to the patient or EMS team)

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7
Q

mechanism of injury (MOI)

A

the forces, or energy transmission, applied to the body that cause injury

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8
Q

nature of illness (NOI)

A

the general type of illness the patient is experiencing

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9
Q

chief complaint

A

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

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10
Q

personal protective equipment (PPE)

A

clothing or specialized equipment that protects the wearer

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11
Q

standard precautions

A

protective measures developed by the CDC when dealing with blood/bodily fluids and risks of communicable disease

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12
Q

incident command system

A

a system to manage disasters+mass casualty incidents in which responders report to the incident commander

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13
Q

triage

A

the process of sorting patients based on the severity of their condition

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14
Q

primary assessment

A

to identify and begin treatment of immediate or imminent life threats

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15
Q

general impression

A

rapid identification of potentially life-threatening problems (LOC and ABCs)

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16
Q

what is the general impression formed to do?

A

determine the priority of care

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17
Q

what is the first part of the primary assessment

A

the general assessment

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18
Q

what should you make a note of during the general impression?

A
  1. age, sex, race
  2. level of distress
  3. overall appearance
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19
Q

during the general impression how can you define your patient’s condition as?

A
  1. stable
  2. potentially unstable
  3. unstable (to direct further assessment and treatment)
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20
Q

what does the AVPU test?

A

the patient’s responsiveness

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21
Q

what does AVPU stand for?

A

Awake and alert
Verbal (responsive to verbal stimuli)
Pain (responsive to pain)
Unresponsive

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22
Q

orientation

A

tests a patient’s mental status by checking their memory and thinking ability
-ask person, place, time and event (MOI or NOI)

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23
Q

altered mental status

A

a change in the way a person thinks or behaves to or from a patient’s normal baseline

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24
Q

responsiveness

A

the way in which a patient responds to external stimuli including verbal stimuli (sound and touch)

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25
Q

in certain cases, ___________ takes priority over airway and breathing concerns

A

life-threatening bleeding

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26
Q

perfusion

A

circulation of blood throughout the body

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27
Q

spontaneous respirations

A

spontaneous breathing that occurs without assistance

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28
Q

patient’s should have an oxygen saturation greater than…

A

94%

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29
Q

what questions should you ask when you assess a patient’s breathing?

A
  1. is the PT breathing
  2. is the PT breathing adequately
  3. is the patient hypoxic?
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30
Q

shallow respirations

A

little movement of the chest wall

31
Q

deep respirations

A

significant rise and fall of the chest

32
Q

retractions

A

indentations about the clavicles and in the spaces between the ribs

33
Q

accessory muscles

A

neck, chest, abdominal muscles
-secondary muscles of respiration

34
Q

nasal flaring

A

widening of the nostrils (indicates an airway obstruction)

35
Q

two-to-three word dyspnea

A

PT can only speak 2-3 words at a time without pausing to take a breath

36
Q

tripod position

A

PT is sitting and leaning forward on outstretches arms with the head and chin thrust slightly forward

37
Q

sniffing position

A

PT sitting upright with the head and chin thrust slightly forward and seems to be singing (common in pediatrics)

38
Q

labored breathing

A

breathing that requires greater than normal effort (grunting, stride, accessory muscles)

39
Q

circulation is evaluated by…

A

checking the patient’s mental status, pulse, and skin condition

40
Q

pulse

A

pressure wave that occurs as each heartbeat causes a surge in the blood circulating through the arteries

41
Q

palpate

A

to examine by touch

42
Q

conjunctiva

A

lines the eyelids and covers the exposed surface both e eye

43
Q

cyanosis

A

skin turns blue

44
Q

jaundice

A

liver disease that results in PT’s skin turning yellow

45
Q

sclera

A

white portion of the eye

46
Q

diaphoretic

A

when the skin in bathed in sweat

47
Q

capillary refill

A

evaluated in pediatric patients to asses the ability of the circulatory system to perfuse in the fingers/toes

48
Q

how do you perform a capillary test?

A
  1. compress the fingertip until it turns white
  2. release the fingertip and count until it goes back to pink (should take no more than 2 seconds)
49
Q

hypothermia

A

cold environment

50
Q

frostbite

A

frozen tissue

51
Q

vasoconstriction

A

narrowing of a blood vessel

52
Q

rapid head-to-toe exam

A

-after primary assessment, used to find additional injuries
-should take less than 90 seconds
DCAP-BTLS

53
Q

DCAP-BTLS

A

Deformities (misshapen body part)
Contusions (bruising)
Abrasions (loss or damage to the surface of the skin)
Punctures (penetration through the skin)
Burns
Tenderness (pain when an area is palpated)
Lacerations (deep cut in the skin)
Swelling

54
Q

what are the steps to perform a rapid exam?

A

asses:
1. head
2. neck
3. chest
4. abdoment
5. pelvis
6. all extremities
7. back and buttocks
and pupils

55
Q

crepitus

A

grating sensation caused by fractures bone ends rubbing together

56
Q

Golden Hour

A

time from injury to definitive care, during which treatment must occur to increase the patient’s chance of survival

57
Q

breakdown of the golden hour

A

20 mins: discovery of incident+activation of EMS
10 minutes: initial assessment, intervention, packaging
30 minutes: EMS transport and initial hospital stabilization

58
Q

history taking

A

provides details about the patient’s chief complaint+an account of the patient’s signs and symptoms

59
Q

OPQRST

A

Onset (what were you doing when the symptoms began?)
Provocation/palliation (Does anything make the symptoms better or worse? How are you most comfortable)
Quality (What does the symptom feel like? Is it sharp, dull, crushing, tearing?)
Region/radiation (Where do you feel the symptom? Does it move anywhere?)
Severity (On a scale of 0-10 how would you rate your symptom?)
Timing (How long have you had the symptom, when did it start?)

60
Q

pertinent negatives

A

signs and symptoms the patient does not have
-helpful in identifying a patient’s problem and choosing an appropriate treatment

61
Q

SAMPLE

A

Signs and symptoms
Allergies
Medications
Pertinent past medical history
Last oral intake
Events leading up to the injury or illness

62
Q

secondary assessment

A

a systematic physical examination
-can be a head-to-toe assessment or examine a certain area/system

63
Q

auscultation

A

to listen with a stethoscope

64
Q

focused assessment

A

based on the chief complaint, focused on the body part system
done on nonsignificant MOIs or responsive patients

65
Q

stridor

A

harsh high-pitched respiratory sound

66
Q

breath sounds

A

indication of air movement in the lungs, assessed with a stethoscope

67
Q

what is the avg respiratory rate for adults?

A

12 to 20 breaths/min

68
Q

tidal volume

A

the amount of air moved into or out of the lungs during one breath

69
Q

wheezing

A

high pitches whistling sound

70
Q

crackles

A

wet crackling breath sounds (may indicate fluid in the lungs)

71
Q

rhonchi

A

congested breath sounds, low pitched (may suggest mucus or fluid in the lungs)

72
Q

what is the normal pulse rate for adults?

A

60 to 100 beats/min

73
Q

tachycardia

A

above 100 beats/min in adults