Clinical Approach Flashcards
What is the purpose of a Clinical Approach?
To ensure all patients receive a structured and comprehensive assessment of their health status that leads to their healthcare needs being met
What are biases and human factors?
Cognitive bias and human factors have a significant impact on decision making and should be considered frequently throughout the entire process of patient care.
Human factors and their potential impact on patient care should be considered and acknowledged prior to arrival and throughout patient assessment.
HALTS
- Hungry
- Angry
- Late
- Tired
- Stressed
What should you do if the patient deteriorates?
Return to the primary survey for reassessment
What is a rapid assessment?
Immediate impression based on the presence of
- Altered conscious state
- Increased work of breathing
- Obvious skin signs (diaphoresis/cyanosis)
This informs
- The need for a formal primary survey
- The urgency with which the patient should be assessed and the need for simultaneous collection of information
Should you interrupt the well patient during initial history taking?
No
History taking in a patient that appears well/non-serious complaint
Avoid concurrent vital signs and other assessment elements where possible to allow for uninterrupted, thorough history taking
History taking in a patient that appears unwell/serious complaint
Concurrent assessment as required
E.g. 12 lead ECG in chest pain or SpO2 in acute SOB
What is the role of P1 during initial assessment
Assess the patient directly, taking the lead in history taking and physical examination
What is the role of P2 in initial assessment
Observes assessment and scene with minimal cognitive load, collects information and identifies missed information, errors or opportunities
When should a BSL be measured?
In patients with
- Altered conscious state
- History of Diabetes
- Medical patients with undifferentiated acute illness
What is a focussed examination?
It is found in specific CPGs indicated for particular complaints
- E.g. ACT-FAST/MASS, AEIOUTIPS,
When should you escalate care?
As soon as possible after recognition of deterioration.
Care can be escalated at any stage and for any reason at the judgement of the paramedic.
What is the minimum standard of VSS?
Minimum 15 minutely.
Where impossible or clinically unnecessary a rationale MUST be documented.
Where a patient deteriorates or is considered unwell, reassessment should be performed more frequently and care escalated as appropriate
On reassessment of VSS what should be included?
- SpO2, HR, BP, RR, GCS and any other observation that was initially found to be abnormal (e.g. Haemorrhage, pain, SOB).
- The efficacy and safety of any treatments (e.g. tourniquets, CPAP, splint, ETT)
Recite the flow chart for the Clinical Approach.
