Chp 12 Performing a Scene Size-up and Primary Assessment

Question 1

AVPU Scale

Answer 1

a method for classifying a patient’s level of responsiveness, or mental status. The letters stand for Alert, Verbal, painful, and unresponsive

Question 2

Index of suspicion

Answer 2

an awareness or suspicion that there may be injuries based on the evaluation of the mechanism.

Question 3

Patient Assessment

Answer 3

overall evaluation of the patient for life-threatening and non-life-threatening conditions

Question 4

Chief Complaint

Answer 4

the patient’s perception of the problem in his own words

Question 5

Low-Angle Rescue

Answer 5

an off road rescue situation requiring specialized training and equipment.

Question 6

Primary Assessment

Answer 6

a component of the overall patient assessment. The Main objective of the primary assessment is to identify and treat any immediate life threats to the patient.

Question 7

Confined Space

Answer 7

a small, closed-in area with poor access and egress. Rescues involving confined spaces require specialized training and equipment

Question 8

Mechanism of Injury (MOI)

Answer 8

a force or forces that may have caused injury

Question 9

Scene Safety

Answer 9

an awareness that you must continually ensure your own and safety of your crew and your patient. This is done by teamwork, observation, and communication among members of a crew

Question 10

General Impression

Answer 10

an element of the patient assessment to how the patient appears as you approach

Question 11

Multiple Casualty Incident(MCI)

Answer 11

any incident involving multiple patients and first-in units/resources being overwhelmed

Question 12

Scene Size-up

Answer 12

the component of the patient assessment during which the following factors are assessed: safety, number of patients, need for resources, nature of illness or mechanism of injury, and need for spinal precautions.

Question 13

High-Angle Rescue

Answer 13

a vertical or above ground rescue situation requiring specialized training and equipment

Question 14

Nature of Illness (NOI)

Answer 14

what is medically wrong with a patient

Question 15

Secondary Assessment

Answer 15

the component of the patient assessment during which the medical history and physical exam are performed.

Question 16

12-2: Describe the 5 components of a scene size-up and the importance of each

Answer 16

A. Safety – Don appropriate PPE(BSI) and confirm scene is free of immediate hazards.
B. Nature of Illness (NOI) of Mechanism of Injury (MOI) – Determine the nature of the patient’s illness or the mechanism that may have caused the injury.
C. Number of Patients – Determine the number of patients at the scene of the emergency.
D. Additional Resources – Determine the need for resources such as law enforcement, additional transport units, advanced life support (ALS) units, specialty response teams and so on.
E. Spinal Precautions – make an initial determination on whether or not to take spinal precautions based on the mechanism of injury.

Question 17

12-3: Explain the importance of safety at the scene of an emergency.

Answer 17

One of the most important non-patient care skills as an EMT. If you disregard your own safety and become injured, you will require assistance that will divert available resources and could result in a delay in care for someone else. In short, stay safe for both your sake and your patient’s. This is done through teamwork, observation and communication among members of a crew.

Question 18

12-4: Describe Hazards commonly found at emergency scenes (medical and trauma).

Answer 18

Signs of downed powerlines (blackouts in areas normally lit) or pole missing or at odd angle
Tractor trailers or tankers. Look for placards or stuff spilling out.
Jagged metal at an MVA where you will be accessing patient
Agitated crowds, hostile crowds or weapons at crime scene
Signs of potential trouble, evidence of alcohol or drugs on scene, in use, pets, weapons, violent or agitated persons, unruly crowds, injuries that do not match the patient’s or bystander’s explanation of how they occurred

Question 19

12-5: Explain the role that the EMT plays in ensuring the safety of all people at the scene of an emergency.

Answer 19

In cases of potential violence do not enter until law enforcement has made it safe.
Retreat where there are weapons or violent persons or situations (use your equipment as a distraction to aid your retreat from the scene.
Take a position of cover or concealment (what is Cover and what is concealment)
Notify police immediately. (Dispatch could you send assistance Code 3 it is not Code 4 here)
MVA Hazards –
a. Wear appropriate PPE including turnout gear, gloves eye protection High visibility clothing (Manual of Uniform Traffic Control Devices-MUTCD) Exceptions for law enforcement doing law enforcement (traffic stops), Firefighters and Emergency Responders with direct exposure to flame, fire, heat, and/or hazardous materials if they are wearing full retro-reflective turn-out gear)
b. Be alert For traffic and always check both ways before stepping away from your vehicle
c. Be alert for leaking fluids, such as gasoline or hazardous materials.
d. Be alert for sharp surfaces, such as jagged metal
e. Notify fire depts and hazardous material units as needed
Scene of outdoor emergency
a. Be aware of extremes in weather that may harm you or your patients
b. Do not attempt rescues on or in slopes, heights, confined spaces or water unless you are trained to do so and have the proper equipment.
c. Notify the appropriate rescue teams for those situations.

Question 20

12-6: Diffierentiate between mechanism of injury and nature of illness.

Answer 20

Nature of Illness (NOI) is what is medically wrong with the patient and Mechanism of Injury (MOI) involve trauma and what caused the injury.
Trauma protocol
• Falls greater than 20 feet
• Falls greater than 10 feet or more than two or three times the height of the child in pediatrics
• High risk vehicle crash, which can be identified by the following:
o Intrusion of more than 12 inches on the occupant side of the crash vehicle or more than 18 inches on any side
o Death of a passenger within the same compartment of a vehicle
o Ejection (partial or complete) from a moving vehicle
o Vehicle telemetry data consistent with high-risk injury.
• Vehicle vs. pedestrian or bicyclist thrown, run over or with significant (more than 20 MPH) impact
• Motorcycle crash of more than 20 mph
• Penetrations of the head, chest, abdomnen or pelvis and extremities proximal to the knee or elbow.

Question 21

12-7: Differentiate between significant and non-significant mechanisms of injury.

Answer 21

Patients who appear to have experienced a significant mechanism of injury are considered to have a serious injury until proven otherwise-even if they appear fine. If the mechanism of injury appears to be non-significant, the patient still may have sustained life-threatening injuries.

Question 22

12-8: Explain the purpose of the primary assessment.

Answer 22

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Question 23

12-9: Describe the components of a primary assessment.

Answer 23

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Question 24

12-10: Explain how encountering patient in cardiac arrest alters the sequence of the primary assessment.

Answer 24

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Question 25

12-11: Describe how to evaluate each component of the primary assessment.

Answer 25

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Question 26

12-12: Describe how to prioritize and manage problems related to the primary assessment.

Answer 26

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Question 27

12-13: Differentiate patients who are high-priority and low-priority for transporters

Answer 27

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