Chapter 12 | Primary Assessment Flashcards
• Deciding on the approach to the primary assessment • Manual stabilization of the head and neck when necessary • The general impression • Assessment of mental status using the AVPU scale
List (in order):
primary assessment steps
7 points (and explain)
- general impression: information gathered right away
- mental status: determining LOC by assessing with AVPU
- chief complaint: why EMS was called to scene
- airway: manually open and consider adjunct or suctioning if necessary
- breathing: check ventilation and consider oxygen therapy
- circulation: pulses, skin condition, blood sweep, and shock treatment
- patient priority: consider life threats to make transport decision
clarifications:
- italics means necessary point for explanation
- general impression and chief complaint are pretty self-explanatory
- LOC means level of consciousness
- AVPU is scale of LOC (alert, verbal, pain, unresponsive)
Explain:
A-B-C vs. C-A-B
- A-B-C: For conscious patients, check airway, breathing, and then circulation
- C-A-B: For unconscious patients, check circulation, airway, and then breathing
Fill in the blank:
When approaching primary assessment, always focus on [BLANK].
always focus on life threats.
List:
signs indicating critical patient
5 points (patient’s behavior/appearance/condition)
- AMS
- pale/diaphoretic skin
- obvious trauma to head/chest/abdomen/pelvis
- positions of stress
- anxiety (people know when they gonna die)
List:
appropriate assessments of painful stimuli
3 points
- sternum rub
- shoulder squeeze
- pen on fingernail
List:
qualities of alert mental status
4 points (knowledge of…)
- person
- place
- time
- event
patient who is conscious, alert, and oriented is documented as CAOx4
Explain:
qualities of verbal mental status
patient that is only responsive to verbal stimuli
Explain:
qualities of painful mental status
patient that is only responsive to painful stimuli
Explain:
qualities of unresponsive mental status
patient does not respond spontaneously, to verbal stimuli, or to painful stimuli
(when nothing in AVPU test works)
List:
questions asked in breathing assessment
4 points
- is patient breathing?
- is breathing adequate?
- is patient hypoxic?
- is breathing affected by injuries?
Define:
stable patient priority
patient exhibits no threats to ABCs
benign general impression
Define:
potentially unstable patient priority
patient exhibits potential for ABCs to deteriorate
concerning general impression
Define:
unstable patient priority
patient is facing immediate threats to ABCs
begin treating life-threats right away
Define:
ABC
(acronym)
- Airway
- Breathing
- Circulation
primary assessment tool focusing on 3 key life necessities
Define:
syncope
(“sink-o-pee”)
a loss of consciousness for a short period of time
List:
targets for formulating general impression
2 points (primary assessment)
- environment (odors/sounds)
- patient appearance (age/race/expression/hygiene/position)
Define:
general impression
EMT’s initial sense of the patient’s condition, based on immediate assessment of the patient’s environment, appearance, and chief complaint
“view from the door” or “big sick vs. little sick”
Answer:
Which of the following is the most reliable means of determining whether a patient has any immediately life-threatening conditions?
A: use of intuition
B: through scene size-up
C: systematic approach to assessment
D: obtaining a detailed medical history
C
Choose:
Which of the following differences should be expected when assessing a pediatric patient, as compared to an adult patient?
A: capillary refill is not as reliable an indicator of circulatory status
B: the normal respiratory rate is faster
C: the normal pulse rate is slower
D: an adult’s tongue is proportionally larger than that of a child and should always be considered as a potential airway obstruction
B
A is false and irrelevant
C is false becausee the pediatric pulse is typically faster than adults
D is backwards because a child’s tongue is proportionally larger than that of an adult
Choose:
Which of the following presentations would be considered normal during the breathing phase of the primary assessment?
A: respiratory rate of 12 with adequate depth
B: respiratory rate of 16 with altered mental status
C: respiratory rate of 6 with shallow depth
D: respiratory rate of 28 with adequate depth
A
although on the lower end of the acceptable range for RR, 12 bpm would be considered normal if the patient is breathing adequately
B is wrong because, although an RR of 16 is within the acceptable range, an altered mental status would be a cause for concern during the breathing phase of the primary assessment
Choose:
Which of the following is NOT part of the general impression?
A: patient’s facial expression
B: patient’s age and race
C: position in which the patient is found
D: patient’s past medical history
D
although potentially important, the patient’s past medical history does not directly relate to the formation of a general impression
Choose:
In EMS, what does mental status refer to?
A: patient’s level of awareness of his surroundings
B: any history of mental illness that the patient may have
C: patient’s general level of intelligence
D: none of the above
A
Define:
CAOx4
patient who is conscious, alert, and oriented and knows person, place, time, and event
(also expressed as “AOx4”)
Fill in the blank:
The purpose of the primary assessment is to [BLANK].
The purpose of the primary assessment is to detect and treat immediately life-threatening problems.