Chapter 12 Primary Assessment Flashcards
Key Terms
airway, breathing, and circulation
ABCs
Key Terms
a memory aid for classifying a patient’s level of responsiveness or mental status. The letters stand for alert, verbal response, painful response, unresponsive
AVPU
Key Terms
in emergency medicine, the reason EMS was called, usually in the patient’s own words
Chief Complaint
Key Terms
impression of the patient’s condition that is formed on first approaching the patient, based on the patient’s environment, chief complaint, and appearance
General Impression
Key Terms
actions taken to correct or manage a patient’s problems
Interventions
Key Terms
level of responsiveness
Mental Status
Key Terms
the first element in a patient assessment; steps taken for the purpose of discovering and dealing with any life-threatening problems. The six parts of _______ __________ are: (1) forming a general impression, (2) assessing mental status, (3) assessing airway, (4) assessing breathing, (5) assessing circulation, and (6) determining the priority of the patient for treatment and transport to the hospital.
Primary Asessment
Key Terms
the decision regarding the need for immediate transport of the patient versus further assessment and care at the scene
Priority
Short Answer
List factors you will take into account in forming a general impression of a patient.
When forming a general impression, look at the patient’s environment, whether the patient is medical or trauma, whether there are any mechanisms of injury, and the patient’s age and sex. Overall, you should form the general impression by looking, listening, and smelling. It is gathered through direct observation and through your feelings and intuition.
Short Answer
Explain how to assess a patient’s mental status with regard to the AVPU levels of responsiveness.
Assess the patient’s mental status using AVPU as follows:
- Alert—The patient is awake if he can answer your questions. The patient is oriented to person if he can tell you his name. The patient is oriented to place if he can tell where he is. The patient is oriented to time if he can tell you the day, date, and time.
- Verbal—If the patient appears to have a depressed level of consciousness, determine if the patient responds to verbal stimuli such as talking or shouting.
- Painful—If the patient does not respond to verbal stimuli by rubbing your knuckles across his sternum or by pinching his toe.
- Unresponsive—The patient will not respond to verbal or painful stimuli.
Short Answer
Explain how to assess airway, breathing, and circulation during the primary assessment. Explain the interventions you will take for possible problems with airway, breathing, and circulation.
Assess airway breathing and circulation as follows:
- Airway—If the patient is talking or crying, the airway is open. If the airway is not open , the patient is not alert, or the patient is breathing noisily, open the airway by using the jaw-thrust maneuver for trauma patients and the head-tilt, chin-lift maneuver for medical patients. Suction the airway and insert an airway adjunct. If the airway is blocked, perform the Heimlich maneuver or back blows and chest thrusts as appropriate.
- Breathing—If the patient is not alert, use the technique you learned in CPR class to listen, look, and feel for breath. Perform rescue breathing if necessary. If the patient is breathing, count the breathing rate. If a conscious patient is breathing at a rate of less than 8 breaths per minute or more than 24 breaths per minute, administer oxygen using a nonrebreather mask.
- Circulation—Take the patient’s pulse. Start with the radial pulse in adults and the brachial pulse in infants. If you cannot feel these peripheral pulses, check the carotid pulse. If the pulse is absent, administer CPR and apply an automated external defibrillator. Check for bleeding and control any major bleeding. Check the skin for temperature, moisture, and color. Warm, pink, dry skin indicates good circulation. Pale, cool, and moist skin indicates poor circulation.
Short Answer
Explain the C-A-B approach to the primary assessment, and explain the circumstances in which the C-A-B approach would be appropriate.
The CAB approach puts the “C” (Circulation/compressions) step of primary assessment before the “A” and “B” (airway and breathing) steps. The CAB approach is performed only on apparently lifeless patients with no breathing or agonal breathing and involves an immediate pulse check and initial compressions when the pulse is absent.
Short Answer
Explain the A-B-C approach to the primary assessment, and explain the circumstances in which the A-B-C approach would be appropriate.
ABC is the traditional approach to the patient in the primary assessment. It is performed on most patients you encounter in this sequence: airway, breathing, circulation.
Short Answer
Explain what is meant by this statement in the chapter: “The order in which these interventions [airway, breathing, circulation] are performed depends on the patient’s specific condition and the number and priority of urgent conditions…that you are presented with.”
The statement that the order of interventions depends on the patient’s condition and number and priority of conditions means that “ABC” is a mnemonic to remind you of the three main things you must assess and treat, as necessary, during the primary assessment. However, “ABC” does not indicate the order in which you must do these steps. For example, a patient with vomit in the airway would be suctioned first. A patient with arterial bleeding would get bleeding control first. You will consider the ABCs on every call, but the order may differ depending on the patient’s needs.
Short Answer
Explain what is meant by this statement in the chapter: “Multiple EMTs can accomplish multiple priorities simultaneously.”
The statement “Multiple EMTs can accomplish multiple priorities simultaneously” means that when there are two or more EMTs or other trained personnel on scene, many tasks can be carried out at the same time. This is often the case. For example, one EMT could stabilize the patient’s c-spine while another suctions bleeding while the other EMT opens the airway.
