Chapter 12 Primary Assessment

Question 1

Primary Assessment

Answer 1

The first element in a patient assessment; steps taken for the purpose of discovering and dealing with life threatening problems

1. General impression
2. C-Spine precaution if there an M.O.I.
3. Assessing mental status: AOX4, AVPU
4. Chief complaint/any life threats
5. Assessing ABC’s
6. Priority for treatment and transport

Question 2

When should you assess a person with C.A.B.’s

Answer 2

A person who appears lifeless and has no pulse

Question 3

What are the ABC’s

Answer 3

Assessment of

1. Airway
2. Breathing
3. Circulation

Question 4

General considerations you will take into account

Answer 4

1. Suctioning Vomit in airway - Vital component of PA
2. Exsanguinating (very Severe, life threatening) Bleeding must be stopped IMMEDIATELY
3. Breathing and circulation are obviously vital for life
   - make sure patient is breathing and breathing adequately
4. If Bleeding and CPR are not required you will administer O2 and evaluate for shock

Question 5

Agonal Breathing

Answer 5

occasional, ineffective breathing

Use CAB to assess

Question 6

Interventions

Answer 6

Actions taken to correct or manage a patients problems

Question 7

General Impression

Answer 7

Impression of the patients condition that is formed on first approach: Based on Patients environment, chief complaint, and appearance:

1. Look, Listen, Feel
2. age and sex, name
3. position
4. Sounds; abnormal breathing
5. smell; hazardous fumes

Question 8

Look Test To identify Critical patients are:

Answer 8

• Patients who Appear Lifeless - CAB Resuscitate by CPR if pulseless
• Patients with Altered mental status - may indicate Hypoxia, shock diabetes overdose or seizure
• Patient appears anxious, pale, sweaty
• obvious trauma to head, chest, abdomen or pelvis
  
  • Head injuries - brain is housed, bleeds a lot, airway attention and care
  • Chest - vital for breathing, houses lungs, heart
  • Abdomen - contains rich blood supply, and many organs
  • Pelvis - if injured can cause severe and fatal bleeding
• Specific positions indicate stress like:
  
  • Tripod position - indicates difficulty breathing
  • Levine’s position - indicates chest pain

Question 9

chief complaint

Answer 9

the reason EMS was called, Patients own words

Question 10

clinical judgement

Answer 10

judgment based on experience in observing and treating patient

Question 11

Two methods to determine mental status

Answer 11

• A.V.P.U

- A.O.X4

Question 12

AVPU

Answer 12

to asses level of responsiveness
 - Alert
 - Verbal
 - Pain
 - Unconscious 
Provide O2 if level is under Alert based on SaO2

Question 13

AOx4

Answer 13

Asses level of competence

1. Name
2. Place
3. Date
4. Event

Question 14

If a patients breathing is inadequate?

Answer 14

Assist with Breathing using BVM at 100% O2
- if person has some level of alertness but inadequate breathing sync with his breath using BVM helping not working against

Question 15

Flail Chest

Answer 15

Multiple Broken ribs

*And punctures chest

Question 16

Airway Assessment and treatment - unconscious patient

Answer 16

1. Open airway
2. suction if necessary
3. insert OPA or NPA

Question 17

Breathing Assessment and treatment - unconscious patient

Answer 17

1. evaluate breathing
2. apply positive ventilation; BVM
3. provide O2

Question 18

Circulation Assessment and treatment - unconscious patient

Answer 18

1. treat life threatening bleeding
2. check pulse
3. check skin temp, color
4. cap refill

Question 19

priority

Answer 19

the decision regarding the need for immediate transport of the patient versus further assessment and care at the scene