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Emergency Care and Transportation of the Sick and Injured, 12th Edition > Chapter 10: Patient Assessment > Flashcards

Chapter 10: Patient Assessment Flashcards

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1
Q

What is the mnemonic for scene size up?

A

PENMAN
P – personal, partner, patient safety
E – environmental hazards
N – number of patients
M – mechanism of injury or nature of illness
A – additional resources if needed
N – need for spinal motion restriction

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2
Q

What does AVPU stand for?

A

A - Awake and alert
V - Responsive to verbal stimuli
P - Responsive to painful stimuli
U - Unresponsive

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3
Q

What is the difference between MOI and NOI?

A

MOI - The forces, or energy transmission, applied to the body that cause injury.

NOI - The general type of illness a patient is experiencing.

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4
Q

What makes up our general impression?

A

General Impression
- What do we see as we approach our patient?
- age, gender, level of distress, response to us

Level of Consciousness
* AVPU
* oriented to time, place, self & event (A/O x #)

Chief Complaint
- From what is the patient suffering? Narrow it down to the top complaint.

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5
Q

What elements make up Primary assessment?

A

Primary Assessment
A – airway
* open & patent
B – breathing
* rate, rhythm & quality
* auscultate lung sounds based on chief complaint
C – circulation
* pulse – rate, rhythm & quality
* skin parameters – color, temperature & moisture

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6
Q

What does S.A.M.P.L.E stand for and why do we use it?

A

SAMPLE
S – signs & symptoms
A – allergies & what happens
M – medications & compliance
P – past medical history
L – last oral intake
E – events leading up

Medical Secondary Assessment

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7
Q

During a Medical Secondary Assessment in what order should you approach patient assessment?

A

SAMPLE
S – signs & symptoms
A – allergies & what happens
M – medications & compliance
P – past medical history
L – last oral intake
E – events leading up

Focused Assessment
O – onset
P – provocation & palliation
Q – quality
R – radiation
S – severity
T – time
Chief Complaint based questions

Vital Signs
P – pulse rate
R – respiration rate
B – blood pressure
E – eyes
L – lung sounds
L – level of consciousness
S – oxygen saturation
S – blood sugar
S – skin parameters
G – Glasgow Coma Scale

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8
Q

What is the difference between a sign and a symptom?

A

A sign is what you can hear, feel, see, smell. Verifiable information that can be observed.

A symptom is something only the patient can tell you.
- I feel dizzy
- I feel weak
etc

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9
Q

What is DCAP-BTLS stand for?

A
  • Deformity
  • Contusion
  • Abrasion
  • Puncture
  • Burns
  • Tenderness
  • Lacerations
  • Swelling
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10
Q

What does CMS stand for?

A

Circulation, motor, sensation

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11
Q

What are the 5 main parts of patient assessment?

A
  • scene size-up
  • primary assessment
  • history taking
  • secondary assessment
  • Reassessment
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12
Q

What are standard precautions as recommended by the CDC?

A
  • Consistent handwashing before and after care
  • Gloves
  • Eye Protection
  • Mask
  • Gown
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13
Q

You have finished your scene size up, what is the next phase of assessment called and what are the steps?

A

Primary Assessment
- Form a general impression
- Assess level of consciousness
- Assess the airway: identify and treat life threats
- Assess breathing: identify and treat life threats
- Assess circulation: identify and treat life threats
- Perform primary assessment
- Determine priority of patient care and transport

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14
Q

What are the 7 steps of primary assessment?

A
  • Form a general impression
  • Assess level of consciousness
  • Assess the airway: identify and treat life threats
  • Assess breathing: identify and treat life threats
  • Assess circulation: identify and treat life threats
  • Perform primary assessment
  • Determine priority of patient care and transport
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15
Q

You arrive on scene, what is the first phase of assessment and what are you doing?

A

Scene Size Up
- Ensure scene safety (me, us, them)
- Determine mechanism of injury (MOI) / nature of illness (NOI)
- Take standard precautions
- Determine number of patients
- Consider additional specialized resources

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16
Q

What are the 5 steps of scene size up?

A

Scene Size Up
- Ensure scene safety (me, us, them)
- Determine mechanism of injury (MOI) / nature of illness (NOI)
- Take standard precautions
- Determine number of patients
- Consider additional specialized resources

17
Q

What does LOC stand for?

A

Level of Consciousness

18
Q

How do we determine a patient’s level of consciousness (LOC)?

A

The AVPU scale
- Awake and alert - The patient is awake, appears to follow commands, and the eyes visually track people and objects

  • Responsive to Verbal stimuli - The patient is not alert and awake.
    The patient’s eyes do not open spontaneously. However, the patient’s eyes do open when you speak to him or her, or the patient is able to respond in some meaningful way when spoken to.
    A patient who does not respond to your normal speaking voice but who responds when you speak loudly is responding to loud verbal stimuli.
  • Responsive to Painful stimuli - The patient does not respond to your questions but moves or cries out in response to painful stimulus.
  • Unresponsive - The patient does not respond spontaneously or to a verbal or painful stimulus.
    Unresponsive patients usually have no cough or gag reflex and lack the ability to protect their airway.
    If you are in doubt about whether a patient is truly unresponsive, assume the worst and treat appropriately.
19
Q

What are the 4 things that we are reporting when we say someone is A/Ox4?

A

Orientation

**Person**. The patient is able to remember his or her name.
    Evaluates long-term memory

**Place**. The patient is able to identify his or her current location.
    Evaluates intermediate memory

**Time**. The patient is able to tell you the current year, month, and approximate date.
    Evaluates intermediate memory when asking year or month
    Evaluates short-term memory when asking approximate date and event

**Event**. The patient is able to describe what happened (the MOI or NOI).
20
Q

What are the indications for spinal immobilization?

A
21
Q

What are the 6 general conditions that cause sudden death?

A

There are only a few general conditions that cause sudden death:

Airway obstruction
Respiratory failure
Respiratory arrest
Shock
Severe bleeding
Primary cardiac arrest
22
Q

When should we use an AED or start CPR on a conscious patient?

A

Never

The apparent absence of a palpable pulse in a responsive patient is not caused by cardiac arrest. Therefore, never begin CPR or use an AED on a responsive patient.

23
Q

What might lead to a patient’s skin feeling cool?

A

The skin will feel cool when the patient is in early shock, has mild hypothermia, or has inadequate perfusion.

24
Q

What is CRT?

A

Capillary Refill Test

25
Q

What is a normal time when performing a CRT?

A

2 seconds

Anything more report it as “delayed” or CR>2

26
Q

When performing a rapid exam what are we looking for and what is the Mnemonic that helps us remember?

A

D - deformity
C - Contusions
A - Abrasions
P - Punctures
|
B - Burns
T - Tenderness
L - Lacerations
S - Swelling

27
Q

List the steps for a proper rapid exam.

A
  1. Assess the head feeling for DCAPBTLS
  2. Assess the neck
  3. Assess the chest and listen bilaterally for chest sounds
  4. Assess the abdomen
  5. Assess the pelvis. If there is no pain, gently compress the pelvis downward and inward to look for tenderness and instability.
  6. Assess all 4 extremities
  7. Assess the patients back. If spinal immobilization is indicated, do so with minimal spinal movement by having your partner stabilize
28
Q

List a few examples of high priority patients needing IMMEDIATE transport

A

Unresponsive
Poor general impression
Difficulty breathing
Uncontrolled bleeding
Responsive but unable to follow commands
Severe chest pain
Pale skin or other signs of poor perfusion
Complicated childbirth
Severe pain in any area of the body

29
Q

If the patient’s condition is stable, reassess vitals every _____ minutes. IF the patient’s is unstable, reassess vitals every ______ minutes looking for trends.

A

15 and 5

30
Q

What do we use the OPQRST mnemonic for?

A

Patient history:
O - onset, HOW did the symptoms begin?
P - Provocation/Palliation - what makes it better or worse?
Q - Quality - the patients description of the pain
R - Region/radiation - where is the pain and does it go anywhere?
S - Severity - on a scale of 1 -10 how bad is it. While objective, it gives you a baseline to follow up against as you are transporting
T - Timing - when did the pain start?

31
Q

What is a pertinent negative?

A

Important negative findings

Often conditions go together, chest pain with shortness of breathe etc. The lack of a common related complaint is noteworthy and should be documented.

32
Q

What does the mnemonic SAMPLE help us with?

A

Medical history
S Signs and symptoms
A Allergies
M Medications
P Pertinent past medical history
L Last oral intake
E Events leading up to injury or illness

33
Q
A

Emergency Care and Transportation of the Sick and Injured, 12th Edition (30 decks)

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