ECare - Chapter 14 (The Secondary Assessment)

Question 1

three parts of the secondary assessment

Answer 1

physical examination, patient history, vital signs

Question 2

order of secondary assessment: medical patients

Answer 2

history, physical exam, vitals

Question 3

order of secondary assessment: trauma patients

Answer 3

physical exam first

Question 4

order of secondary assessment: unresponsive patients

Answer 4

get info from bystanders and start with physical exam

Question 5

reassessment

Answer 5

used to detect changes in patient’s condition; repeat primary assessment, vitals, physical exam, and checking interventions

Question 6

Medical Body Systems Exam: Respiratory

Answer 6

Work of breathing and position

Pedal and sacral edema, lung sounds, pulse oximetry

specific components: dyspnea on exertion, orthopnea, weight gain

Question 7

Medical Body Systems Exam: Cardiovascular

Answer 7

pulse, skin, blood pressure, osthostatic BP changes, JVD, many of respiratory will apply here

Question 8

Medical Body Systems Exam: Neurologic

Answer 8

Stroke scale, pupils, mental status over time

Question 9

Medical Body Systems Exam: Endocrine

Answer 9

Blood glucose, skin, breath odors, excessive hunger/thirst/urination, pupils, mental status over time

diabetic specific history oral intake, med history, recent illness

Question 10

popping/cracking sounds

Answer 10

this is rhonchi and rales; indicates fluid in airway

Question 11

crepitation

Answer 11

feeling of bone ends rubbing together

Question 12

secondary assessment for medical patient

Answer 12

history of present illness, past medical history, physical exam, and vitals

Question 13

Trauma Patient Assessment

Answer 13

Primary Assessment: ABC, priority determination, exam, transport, head to toe

Question 14

types of injuries to look for

Answer 14

DCAP-BTLS: deformities, contusions, abrasions, punctures, penetrations, burns, tenderness, lacerations, and swelling

Question 15

when to apply collar

Answer 15

after primary assessment and treating life-threatening problems

Question 16

sizing a cervical collar

Answer 16

measure the neck and collar. shin piece should not life the chin and hyperextend neck

Question 17

placing a cervical collar (patient is seated)

Answer 17

1. stabilize head and neck from behind
2. properly angle collar for placement
3. position it
4. secure collar
5. maintain manual stabilization

Question 18

placing a cervical collar (patient is supine)

Answer 18

1. kneel at head and stabilize head/neck
2. set collar in place
3. secure collar
4. maintain manual stabilization

Question 19

trauma patient with serious injuries

Answer 19

continue manual stabilization, consider ALS and transport decision, reassess mental status, rapid trauma assessment (head to tow), vitals, past medical history, interventions/transport

Question 20

rapid assessment of the head

Answer 20

palate cranium, face, ears,, eyes, nose, mouth

Question 21

rapid assessment of the neck

Answer 21

check with JVD and flat neck veins in flat patient (blood loss)

Question 22

rapid assessment of the chest

Answer 22

flail chest (floating ribs), paradoxical motion (movement of chest in opp direction to rest of chest when breathing), subQ emphysema

Question 23

rapid assessment of the abdomen

Answer 23

distention or firmness = bleeding

Question 24

rapid assessment of the pelvis

Answer 24

priapism: persistent erection due to spinal cord injury

Question 25

rapid assessment of the extremities

Answer 25

dont split extremity on scene if there is deformity, less function, etc

Question 26

rapid assessment of the posterior body/immobilization on backboard

Answer 26

roll patient on side and inspect posterior while sliding backboard

Question 27

when to perform detailed physical exam

Answer 27

on trauma patients with significant injuries and after all other interventions

Question 28

difference between rapid trauma assessment and detailed physical exam

Answer 28

location (ex. back of ambulance), and going around interventions (ex. cervical collar, backboards)

Question 29

when to perform reassessment

Answer 29

after interventions and detailed physical exams

Question 30

parts of reassessment

Answer 30

primary assessment (mental status, ABC, skin, reestablish patient priorities), vitals, important parts of second assessment, check interventions

Question 31

differential diagosis

Answer 31

list of potential diagnoses