*(Chapter 9) Patient Assessment

Question 1

What are baseline vitals?

Answer 1

The first set of vitals.

Question 2

What is flail chest?

Answer 2

Two or more contiguous rib fractures with two or more breaks per rib.

Question 3

What is the mechanism of injury (MOI)?

Answer 3

The type of injury that occurred.

Question 4

What is the nature of illness (NOI)?

Answer 4

The nature of the medical complaint.

Question 5

What is a sucking chest wound?

Answer 5

A penetrating thoracic wound that allows air into the pleural space.

Question 6

What are the five components of patient assessment for EMTs?

Answer 6

1. Scene size-up
2. Primary assessment
3. Patient history
4. Secondary assessment
5. Reassessment

Question 7

When does scene size-up begin and end?

Answer 7

Begins as soon as the call is received and ends when the call is over.

Question 8

What is the first priority in scene safety?

Answer 8

Your safety.

Question 9

What should rescuers wear at accident scenes near traffic?

Answer 9

Approved high-visibility safety vests.

Question 10

Why should you carry a flashlight at all times?

Answer 10

For portability, impact resistance, and high intensity.

Question 11

Where should an ambulance not be positioned at the scene?

Answer 11

In the path of oncoming traffic.

Question 12

What are standard precautions for EMTs?

Answer 12

1. Take standard precautions and utilize appropriate PPE.
2. The level of PPE required depends on the nature of the call.

Question 13

How should the number of patients and additional resources be assessed?

Answer 13

1. Determine the number of patients.
2. Request additional resources as needed (e.g., ambulances, advanced life support, law enforcement).

Question 14

Who can provide the best information about the mechanism of injury or nature of illness?

Answer 14

The patient; family members or bystanders may also help if needed.

Question 15

What is the purpose of understanding the mechanism of injury (MOI)?

Answer 15

To help predict injury patterns, influence treatment decisions, and determine the hospital destination.

Question 16

How is the nature of illness (NOI) related to the chief complaint?

Answer 16

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.

Question 17

What should be considered for spinal precautions?

Answer 17

1. Determine the need based on the information obtained.
2. Follow local protocols.
3. Use ‘spinal motion restriction’ instead of ‘spinal immobilization’ per updated guidelines.

Question 18

When does the primary assessment begin?

Answer 18

As soon as you reach the patient.

Question 19

What is the purpose of the primary assessment?

Answer 19

To identify and manage life-threatening conditions.

Question 20

What is a general impression in patient assessment?

Answer 20

It is based on information gathered immediately upon arrival at the patient, including approximate age, gender, level of distress, and overall appearance.

Question 21

What is the AVPU scale for assessing responsiveness?

Answer 21

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.

Question 22

What does ‘A&Ox4’ mean?

Answer 22

The patient is oriented to person, place, time, and event.

Question 23

How do you assess unresponsive patients using the CAB approach?

Answer 23

1. Circulation: Check pulse and manage bleeding.
2. Airway: Ensure it is open and clear.
3. Breathing: Check for adequate breathing and provide ventilations if necessary.

Question 24

What should you assume about a patient’s airway if their LOC is decreased?

Answer 24

Do not assume they can adequately protect their own airway.

Question 25

What are the three key steps for airway management?

Answer 25

1. Manual airway maneuvers (head-tilt, chin-lift, or jaw thrust). 2. Suction the airway if needed. 3. Use mechanical airway adjuncts (OPA or NPA) if appropriate.

Question 26

What is the role of BVM ventilation in breathing management?

Answer 26

To provide ventilation for patients with inadequate breathing or respiratory failure.

Question 27

How do you manage life-threatening bleeding?

Answer 27

Stop bleeding immediately and initiate CPR if needed.

Question 28

What is a rapid scan?

Answer 28

A head-to-toe assessment to identify life-threatening conditions, including internal bleeding, fractures, or brain injuries.

Question 29

How long should a rapid scan take?

Answer 29

No longer than 90 seconds.

Question 30

What is the difference between high and low transport priority?

Answer 30

1. High priority: Patients with unstable conditions, including decreased LOC, shock, or severe pain, requiring immediate transport. 2. Low priority: Stable patients who can continue care on the scene before transport.

Question 31

What is the SAMPLE history?

Answer 31

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

Question 32

What is the purpose of the secondary assessment?

Answer 32

To identify any remaining signs, symptoms, conditions, or injuries not previously discovered and managed.

Question 33

Should the secondary assessment delay the transport of a high-priority patient?

Answer 33

No, it should not delay transport.

Question 34

What are the two types of secondary assessments?

Answer 34

1. Detailed head-to-toe assessment 2. Focused exam for relevant areas

Question 35

When is a detailed secondary assessment indicated?

Answer 35

For unresponsive patients or multi-system trauma patients.

Question 36

What is assessed in a detailed head-to-toe exam?

Answer 36

Head, neck, chest, abdomen, pelvis, extremities, and posterior using DCAP-BTLS (Deformities, Contusions, Abrasions, Penetrating wounds, Burns, Tenderness, Lacerations, Swelling).

Question 37

What does PMS stand for in extremity checks?

Answer 37

Pulse, Motor response, Sensation.

Question 38

How often should baseline vitals be reassessed for stable and unstable patients?

Answer 38

1. Stable patients: Every 15 minutes. 2. Unstable patients: Every 5 minutes.

Question 39

What is the purpose of the reassessment phase?

Answer 39

To continuously monitor the patient’s condition for signs of deterioration or improvement.

Question 40

What should always be reassessed during the reassessment phase?

Answer 40

1. Primary assessment for any changes. 2. The patient’s chief complaint. 3. Interventions performed. 4. Vitals (every 5-15 minutes depending on condition).

Question 41

What considerations are there for pediatric patients?

Answer 41

1. Perform a toe-to-head assessment to reduce anxiety. 2. Communicate carefully to avoid misunderstanding terms (e.g., 'take your blood' could scare a child).

Question 42

What considerations are there for elderly patients?

Answer 42

1. Assessments may take more time. 2. Use honorifics unless directed otherwise.

Question 43

What is the SAMPLE history in patient assessment?

Answer 43

1. S: Signs and symptoms 2. A: Allergies 3. M: Medications 4. P: Past medical history 5. L: Last oral intake 6. E: Events leading to the illness or injury

Question 44

What are the main steps of a patient assessment?

Answer 44

1. **Scene size-up:** Scene safety, BSI precautions, MOI/NOI, number of patients, additional resources, spinal precautions. 2. **Primary assessment:** General impression, LOC, ABC/CAB, rapid scan, transport priority. 3. **Secondary assessment:** Detailed head-to-toe or focused exam, baseline vitals. 4. **Patient history:** SAMPLE history. 5. **Reassessment:** Reassess ABCs, chief complaint, interventions, and vitals.