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Adult Protocols > Initial Assessment and Management > Flashcards

Initial Assessment and Management Flashcards

1
Q

8 components of a scene size up?

A
  1. Review dispatch info
  2. Assess need for BSI
  3. Assess need for scene safety
  4. Determine MOI
  5. Determine NOI
  6. Determine number and location of patients
  7. Determine need for additional resources
  8. Consider C-spine immobilization
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2
Q

8 components of a initial assessment

A
  1. Poor general impression
  2. Assess mental status and maintain spinal immobilization as needed
  3. Assess circulation
  4. Assess airway
  5. Assess breathing
  6. Assess disability; movement of extremities
  7. Expose and examine
  8. Identify priority patients
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3
Q

When assessing circulation in initial assessment you should be rapidly evaluating for?

A

Pulse, major bleeding, skin color and temperature. Assess need for defibrillation.

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4
Q

What does AVPU stand for?

A

Alert
Alert to verbal
Responds to pain
Unconcious

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5
Q

What do you look for while assessing circulation?

A

Pulse
Bleeding
Skin color
Skin temp

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6
Q

What patients are considered priority?(10)

A 
Poor general impression
Unresponsive
Responsive but does not follow commands
Difficulty breathing
Hypoperfusion or shock
Complicated child birth
Chest pain with systolic BP less than 100
Uncontrolled bleeding
Severe pain anywhere
Multiple injuries
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7
Q

A patient with chest pain and a BP less ______ is considered priority?

A

100

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8
Q

What does a secondary assessment consist of?

A

Head to toe survey
Neurological assessment
Vital signs
Medical history

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9
Q

What does a neurological assessment consist of?

A

Pupillary response

GCS

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10
Q

What vital signs are checked in a secondary assessment?

A 
Respirations
Pulse
BP
Cap refill
Skin condition
Lung sounds
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11
Q

What do you look for when assessing skin conditions?

A

Color
Temperature
Moisture

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12
Q

What does SAMPLE stand for?

A 
Symptoms-assessment of chief complaint
Allergies
Medications
Past medical HX
Last oral intake
Events leading up to illness or injury
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13
Q

What does OPQRRRST stand for?

A 
Onset
Provocation
Quality
Radiation
Referred
Relief
Severity
Time
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14
Q

Other assessment techniques?

A 
Cardiac monitoring
Pulse oximetry
Glucose determination
Monitor temp
Capnography
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15
Q

When would you administer oxygen when spontaneous breathing is present without compromise?

A

Oxygen saturation below 94%

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16
Q

How should you administer oxygen when spontaneous breathing is present with compromise?

A

Non-rebreather

10-15 LPM

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17
Q

What airway device should be considered for a Unconcious patient with compromise?

A

OPA or NPA

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18
Q

What should be considered for a Unconcious patient accepts a OPA?

A

Supraglottic device

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19
Q

When can a EMT insert a supraglottic device?

A

When authorized by the medical director

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20
Q

When should you use assisted ventilations with a BVM?

A

As needed

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21
Q

What LPM of oxygen should you use when assisting ventilations with a BVM?

A

15-25 LPM

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22
Q

When do you suction?

A

As needed

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23
Q

When do you use a pulse oximeter and Capnography is a patient with respiratory compromise?

A

As soon as possible

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24
Q

What O2 level do you want to try and maintain in a patient with absent or markedly compromised spontaneous breathing when assisting ventilations?

A

94%

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25
Q

What do you wan tot try and avoid when assisting ventilations?

A

Over oxygenation

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26
Q

Who may place a advanced airway?

A

Paramedic only

27
Q

What method of advanced airway placement must be used to confirm placement?

A

End tidal CO2 monitoring

28
Q

What 3 ways can be used to confirm advanced airway placement in addition to end tidal CO2 monitoring?

A

Visualization of tube passing through the cords
Negative epigastric sounds
Positive Bi lateral breath sounds

29
Q

What may be useful in preventing an advanced airway from becoming dislodged?

A

C-collar

30
Q

What should you secure a advanced airway with?

A

Commercially available device

31
Q

What type of immobilization should be used for trauma patients with head/neck injuries?

A

Full spinal immobilization

32
Q

What procedure should be performed on patient where a advanced airway cannot be inserted and patient cannot be adequately ventilated?

A

Cricothryroidotomy

33
Q

Where should you transport patients whom you have performed Cricothryroidotomy on?

A

Nearest appropriate facility rapidly

34
Q

When would you not establish an IV of NS with a regular infusion set?

A

When it is overridden by the specific protocol

35
Q

What are authorized IV routes?

A

All peripheral venous sites

36
Q

When may external jugular veins be used?

A

When other peripheral sites have been unsuccessful or would be inappropriate

37
Q

What size catheter to unstable patients get?

A

Large bore

38
Q

What IV access sites should be avoided?

A

Ones below the diaphragm

39
Q

When can intraosseous line be used?

A

When unable to establish IV in an adult patient

40
Q

Who is authorized to use a IO?

A

Paramedic only

41
Q

When may an EMT establish an IV?

A

When authorized by the individual medical director

42
Q

How do you correct any open/sucking chest wound?

A

Occlusive dressing

43
Q

What medications must be determined if patient is taking in trauma supportive care?

A

Anticoagulants

Antiplatlets

44
Q

Warfin(Coumadin) is what type of drug?

A

Anticoagulant

45
Q

Dabugatran(Pradaxa) is what type of drug?

A

Anitplatlet

46
Q

When should you consider correction of a massive flail segment and possible advanced airway?

A

When is causes respiratory compromise

47
Q

When should you initiate 2 large bore IV’s in trauma patients?

A

When they are unstable

48
Q

What must be ruled out to manage pain associated with isolated extremity fractures?

A

Multi system trauma

Hemodynamic instability

49
Q

What must be ruled out to manage pain of an isolated back strain?

A

Acute abdominal process

50
Q

To manage flank pain associated with kidney stones what must be ruled out?

A

Acute abdominal process

51
Q

To manage pain associated with soft tissue injuries, burns, bites, and stings it must not associated with?

A

Multi system trauma

Hemodynamic instability

52
Q

How should extremity fractures be positioned?

A

Elevated if possible and cold applied

53
Q

What should be noted and recorded in the injured extremity?

A

Distal circulation
Sensation
Movement

54
Q

What scale should patients be asked to quantify their pain on?

A

Analog scale

1 least severe - 10 most severe

55
Q

What is the analog scale used for?

A

Measure the effectiveness of of analgesia

56
Q

What medication can be give for pain Managment?

A

Morphine

57
Q

What must systolic BP be above to administer morphine for pain?

A

90

58
Q

How should morphine be administered for pain?

A

2 mg increments
Slow IV
Every 3-5 minutes
Titrated to pain and BP above 90

59
Q

What is the max dose of morphine?

A

10mg

60
Q

Extreme caution should be used when administering narcotic analgesics to patients with a SP02 below what?

A

92%

61
Q

What should be closely monitored when administering morphine?

A

Pt’s respiratory status

62
Q

What should be done is a patient respirations/oxygenation is suppressed(less than 92%) due to narcotic analgesics?

A

Basic airway maneuvers(open airway)

Administer oxygen

63
Q

If oxygen and basic airway maneuvers don’t improve oxygen saturation suppressed from narcotic analgesics(less than 92%) what should can be considered?

A

Narcan

Adult Protocols (2 decks)

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