*(Chapter 9) Patient Assessment Flashcards
What are baseline vitals?
The first set of vitals.
What is flail chest?
Two or more contiguous rib fractures with two or more breaks per rib.
What is the mechanism of injury (MOI)?
The type of injury that occurred.
What is the nature of illness (NOI)?
The nature of the medical complaint.
What is a sucking chest wound?
A penetrating thoracic wound that allows air into the pleural space.
What are the five components of patient assessment for EMTs?
- Scene size-up
- Primary assessment
- Patient history
- Secondary assessment
- Reassessment
When does scene size-up begin and end?
Begins as soon as the call is received and ends when the call is over.
What is the first priority in scene safety?
Your safety.
What should rescuers wear at accident scenes near traffic?
Approved high-visibility safety vests.
Why should you carry a flashlight at all times?
For portability, impact resistance, and high intensity.
Where should an ambulance not be positioned at the scene?
In the path of oncoming traffic.
What are standard precautions for EMTs?
- Take standard precautions and utilize appropriate PPE.
- The level of PPE required depends on the nature of the call.
How should the number of patients and additional resources be assessed?
- Determine the number of patients.
- Request additional resources as needed (e.g., ambulances, advanced life support, law enforcement).
Who can provide the best information about the mechanism of injury or nature of illness?
The patient; family members or bystanders may also help if needed.
What is the purpose of understanding the mechanism of injury (MOI)?
To help predict injury patterns, influence treatment decisions, and determine the hospital destination.
How is the nature of illness (NOI) related to the chief complaint?
NOI relates to the chief complaint but is not the same thing.
For example, chest pain could result from a respiratory issue or a traumatic injury.
What should be considered for spinal precautions?
- Determine the need based on the information obtained.
- Follow local protocols.
- Use ‘spinal motion restriction’ instead of ‘spinal immobilization’ per updated guidelines.
When does the primary assessment begin?
As soon as you reach the patient.
What is the purpose of the primary assessment?
To identify and manage life-threatening conditions.
What is a general impression in patient assessment?
It is based on information gathered immediately upon arrival at the patient, including approximate age, gender, level of distress, and overall appearance.
What is the AVPU scale for assessing responsiveness?
A: Awake (e.g., patient’s eyes are open and tracking).
V: Responsive to voice (e.g., ‘Are you okay?’).
P: Responsive to pain.
U: Unconscious/unresponsive.
What does ‘A&Ox4’ mean?
The patient is oriented to person, place, time, and event.
How do you assess unresponsive patients using the CAB approach?
- Circulation: Check pulse and manage bleeding.
- Airway: Ensure it is open and clear.
- Breathing: Check for adequate breathing and provide ventilations if necessary.
What should you assume about a patient’s airway if their LOC is decreased?
Do not assume they can adequately protect their own airway.
What are the three key steps for airway management?
- Manual airway maneuvers (head-tilt, chin-lift, or jaw thrust).
- Suction the airway if needed.
- Use mechanical airway adjuncts (OPA or NPA) if appropriate.
What is the role of BVM ventilation in breathing management?
To provide ventilation for patients with inadequate breathing or respiratory failure.
How do you manage life-threatening bleeding?
Stop bleeding immediately and initiate CPR if needed.
What is a rapid scan?
A head-to-toe assessment to identify life-threatening conditions, including internal bleeding, fractures, or brain injuries.
How long should a rapid scan take?
No longer than 90 seconds.
What is the difference between high and low transport priority?
- High priority: Patients with unstable conditions, including decreased LOC, shock, or severe pain, requiring immediate transport.
- Low priority: Stable patients who can continue care on the scene before transport.
What is the SAMPLE history?
A method for gathering patient history:
- S: Signs and symptoms
- A: Allergies
- M: Medications
- P: Past medical history
- L: Last oral intake
- E: Events leading to the illness/injury
What is the purpose of the secondary assessment?
To identify any remaining signs, symptoms, conditions, or injuries not previously discovered and managed.
Should the secondary assessment delay the transport of a high-priority patient?
No, it should not delay transport.
What are the two types of secondary assessments?
- Detailed head-to-toe assessment
- Focused exam for relevant areas
When is a detailed secondary assessment indicated?
For unresponsive patients or multi-system trauma patients.
What is assessed in a detailed head-to-toe exam?
Head, neck, chest, abdomen, pelvis, extremities, and posterior using DCAP-BTLS (Deformities, Contusions, Abrasions, Penetrating wounds, Burns, Tenderness, Lacerations, Swelling).
What does PMS stand for in extremity checks?
Pulse, Motor response, Sensation.
How often should baseline vitals be reassessed for stable and unstable patients?
- Stable patients: Every 15 minutes.
- Unstable patients: Every 5 minutes.
What is the purpose of the reassessment phase?
To continuously monitor the patient’s condition for signs of deterioration or improvement.
What should always be reassessed during the reassessment phase?
- Primary assessment for any changes.
- The patient’s chief complaint.
- Interventions performed.
- Vitals (every 5-15 minutes depending on condition).
What considerations are there for pediatric patients?
- Perform a toe-to-head assessment to reduce anxiety.
- Communicate carefully to avoid misunderstanding terms (e.g., ‘take your blood’ could scare a child).
What considerations are there for elderly patients?
- Assessments may take more time.
- Use honorifics unless directed otherwise.
What is the SAMPLE history in patient assessment?
- S: Signs and symptoms
- A: Allergies
- M: Medications
- P: Past medical history
- L: Last oral intake
- E: Events leading to the illness or injury
What are the main steps of a patient assessment?
- Scene size-up: Scene safety, BSI precautions, MOI/NOI, number of patients, additional resources, spinal precautions.
- Primary assessment: General impression, LOC, ABC/CAB, rapid scan, transport priority.
- Secondary assessment: Detailed head-to-toe or focused exam, baseline vitals.
- Patient history: SAMPLE history.
- Reassessment: Reassess ABCs, chief complaint, interventions, and vitals.
