Chap 12 Flashcards
primary assessment and the 6 parts
the first element in a patient assessment; steps taken for the purpose of discovering and dealing with any life-threatening problems.
- Forming a general impression
- assessing mental status
- assessing airway
- assessing breathing
- assessing circulation
- determining the priority of the patient for treatment and transport to hospital
ABC
Airway
Breathing
Circulation
Also used to gather information of indications of severity/ priority, signs of illness or injury
Agonal breathing
ineffective breaths
Interventions
actions taken to correct or manage a patient’s problems
General impression
Helps you determine how serious the patient’s condition is and tp set priorities for care and transport
-Look, listen, Smell
“Look Test” to identify patients who may be critical
- Patients who appear lifeless
- Patients who have an obvious altered mental status
- Patients who appear unusually anxious and those who appear pale and sweaty
- Obvious trauma to the head, chest, abdomen, or pelvis
- Specific positions indicate distress
- Levine’s sign- chest pain
- Tripod
- Sniffing position
Chief Complaint
in emergency medicine, the reason EMS was called, usually in the patients own words
Clinical judgment
judgement based on experience in observing and treating patients
AVPU
Alert, Verbal, Pain, Unresponsiveness
Mental status
level of responsiveness
Alert and oriented time 4
Name
Day
Place
What happened
Primary assessment Airway procedures
- Look, Listen, Feel
- Does the patient have a patent airway? If not take measures such as Head-tilt, Chin-lift or Jaw thrust. Suctioning or insertion of an OPA or NPA airway if airway is blocked
Primary assessment Breathing procedures
- 4 general situations
- If the patient is in respiratory arrest with a pulse
- Perform rescue breathing
- If the patient is not alert and his breathing is inadequate
- Provide positive pressure ventilation with 100% O2
- If the patient has some level of alertness and his breathing is inadequate
- Assist his ventilations with 100% oxygen. Synchronize your ventilations with the patients own respirations so they are working together, not against each other
- If the patients breathing is adequate but there are signs or symptoms suggesting respiratory distress or hypoxia
- Provide oxygen based on the patients need as determined by your examination, patients oxygen and level of distress, and the pulse oximetry readings
Primary assessment Circulation procedures
Assess Pulse, Skin, and Bleeding
- Pulse- No need for exact rate but checking for rate, rhythm, and quality. - Skin- Diaphoretic (shock) or warm, pink and dry (good circulation) - Bleeding
Three types of pulse rates
within normal limits
unusually slow- Ex. chest pains
unusually fast- Trauma
Stable vs Unstable
Stable
- A patient needs to have vital signs that are in normal range or just slightly abnormal
Unstable
- Threat to airway, breathing, or circulation
- patients doesn’t have an immediate threat but due to NOI, they have possibility to deteriorate to unstable
High priority conditions
- Poor general impression
- Unresponsive
- Responsive, but not following commands
- Difficulty breathing
- Shock
- Complicated childbirth
- Chest pain consistent with cardiac problems
- Uncontrolled bleeding
- Sever pain anywhere
Healthy capillary refill time
Within 2 secs
-Cold weather will prolong refill time so it should be used as one factor and not the only factor deciding priority
Priority
The decision regarding the need for immediate transport of the patient versus further assessment and care at the scene
Conjunctiva
The tissue that lines the inside of the eyelids
- Usually used to check blood flow
PEARL
Pupils Equal and Reactive to Light
Levine’s sign
Chest pain or discomfort
Tracking
Visually locked on with eyes when EMT walks up to patient
