Midterm 1 (Mod1-6) Flashcards
Initial assessment questions…
- is my patient sick?
- how sick?
(trauma)
- is my patient hurt?
- how hurt?
Mental status…
- prime indicators of how sick a patient is
- changes in state of consciousness
- establish a baseline as soon as you encounter a patient
AVPU process
-alert (person, place, day, event) (bottom 3 may be critical patients) -responsive to verbal stimuli -responsive to pain -unresponsive
Glasgow coma scale
- most reliable method of assessing mental status and neurological function
- assigns a point value for eye opening, verbal response, and motor response
- less then 10 serious dysfunction
- less then 8 airway control
- lowest score 3
- highest score 15
- in alert patients do it with ABC
- in non alert do it separate
Airway status focuses on these 2 questions…
- is the airway open and patent?
- is it likely to remain so?
- sonorous sounds (adjust)
- gurgling or bubbling sounds (suction)
Airway status simple to complex
- easiest problem to solve is position
- spine injury drives what decision to open airway
Airway status assessment is the same regardless of age
- talking or crying will give clues to airway adequacy
- for all unconscious patients establish responsiveness and look, listen and feel for breathing
Suctioning and mechanical means to keep the airway open
-oro or nasopharyngeal
Airway status order
- position
- suction
- adjuncts
Breathing questions
- is the patient breathing?
- if so adequate?
- supplemental O2 may not be needed if patient isn’t breathing enough then you would have to help them breathe
Minute volume
- RR x TV
- amount of air actually moved into and out of the lungs each minute
- note patients breathing rate, work of breathing and breath sounds, skin colour, and LOC or mental status
Techniques to assess breathing
- look, listen and feel
- look for rise and fall of the chest
- listen for breath sounds
- feel for air movement
- listen to patient breathe in and out
- striator in, wheezes out
- primary you can only listen to 2 places
Circulation pulse
- rapid check of cardiovascular status
- info about rate, strength and regularity
- force of pulse
- rhythm
- quality
- report findings
Circulation skin colour, temp, and moisture
-use back of hand to assess warmth
Identify priority patient
- will benefit from less time at the scene and rapid transport
- patients in need of interventions that cannot be performed in the prehospital setting except under extreme circumstances
OPQRST
- onset (how it came on)
- provocation/palilation
- quality
- region/radiation
- severity
- time
Responsive medical patient questions…
- dietary habits
- meds
- allergies
- exercise
- alcohol or tobacco
- recreational drug use
- sleep patterns and disorders
- immunizations (anyone over 50 flushots) (kids ask childhood ones)
Responsive medical patient questions focused physical examination
- driven by info gathered during initial
- most common complaints will involve the head, heart, lungs, or abdomen
- respiratory pain
focused physical exam unresponsive
- disadvantage
- next most reliable source of info
- position patient (recovery, neutral alignment)
- thorough assessment (head, neck, abdomen, pelvis, posterior body and extremities)
- unstable conditions get rapid transport and ongoing assessment
mechanisms that have the potential to produce life threatening injuries
- ejection from any vehicle
- death of another patient in the same compartment
- high speed (over 50) motor collision
- vehicle pedestrian collision
- motorcycle collision
- penetrating wounds to the head, chest or abdomen
