Medical Assessment

Question 1

BSI/PENMAN/Need for c-spine:

Answer 1

Determines environment is safe (scene, situation)
Determines number of patients
Determines Nature of Illness (NOI)
Requests additional resources if necessary
Determines need for extrication
Considers stabilization of the spine

Question 2

Patient Assessment/Management-Medical

Section Order

Answer 2

1. BSI/PENMAN/Need for c-spine
2. PRIMARY SURVEY/INITIAL ASSESSMENT
3. PERFORMS FOCUSED HISTORY AND PHYSICAL EXAM OR RAPID ASSESSMENT
4. SECONDARY ASSESSMENT
5. ONGOING ASSESSMENT

Question 3

PRIMARY SURVEY/INITIAL ASSESSMENT steps 2-4

Answer 3

2.Verbalizes general impression of the patient
3.Determines responsiveness/level of consciousness (AVPU)
Alert / Verbal / Painful / Unresponsive
4.Determines chief complaint/Apparent life threats
Crew introduction:
Introduce yourself

Question 4

PRIMARY SURVEY/INITIAL ASSESSMENT step 5 Airway

Answer 4

Open 
Clear 
Maintainable 
Need for suction 
Initiates appropriate airway control/adjuncts/suctioning

Question 5

PRIMARY SURVEY/INITIAL ASSESSMENT step 6: Breathing

Answer 5

Rate 
Depth 
Ease (effort) 
Assess Lung Sounds 
Initiates appropriate oxygen therapy (high flow 02)

Question 6

PRIMARY SURVEY/INITIAL ASSESSMENT step 7: CIRCULATION, and. STEP 8

Answer 6

Check for life threatening hemorrhage 
Rate 
Quality 
Rhythm 
Skin signs: Color, moisture and temperature 
Cap refill

8. Identifies patient priority and makes treatment/transport decision

Question 7

PERFORMS FOCUSED HISTORY AND PHYSICAL EXAM OR RAPID ASSESSMENT STEPS 9 AND 10

Answer 7

9.Determine patient’s level of orientation (A&O questions) 
Person 
Place 
Time 
Event

10.Determines history of present illness (This is the “S” in SAMPLE Hx)
Onset: Sudden or gradual
Provocation: What makes it better or worse
Quality: Describe the C/C
Radiation: Does C/C go anywhere
Severity: 0 - 10
Time: When did C/C start
Asks clarifying questions of associated signs/symptoms and pertinent negatives

Question 8

PERFORMS FOCUSED HISTORY AND PHYSICAL EXAM OR RAPID ASSESSMENT
Step 11

Answer 8

Past medical history

Signs and symptoms

Allergies

Medications

Past pertinent history

Last oral intake

Events leading to present illness

Question 9

SECONDARY ASSESSMENT STEPS 12, 13

Answer 9

12.Obtains a full set of vital signs
Blood pressure

Pupils (PERRL)

Pulse (obtained in primary assessment)

Respirations (obtained in primary assessment)

Skin signs (obtained in primary assessment)

13. States field impression of patient (What is wrong with the patient

Question 10

SECONDARY ASSESSMENT 14,15

Answer 10

14.Interventions (obtains medical direction or verbalizes standing order for
medication interventions)
15.Transport (re-evaluate transport decision)

Question 11

ONGOING ASSESSMENT: 16,17

Answer 11

16.Repeats primary/initial assessment
Level of consciousness (AVPU)

ABC’s

17.Repeats full set of vital signs

Question 12

ONGOING ASSESSMENT, 18, 19

Answer 12

18.Repeats focused assessment regarding patient complaint

Onset and time remain the same

PQRS and compare to original findings

19.Provides accurate verbal report