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EMT 1 > Module 4- Patient Assessment > Flashcards

Module 4- Patient Assessment Flashcards

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1
Q

What is the acronym for Patient assessment with Trauma patients?

A

“MARCH” OR “XABCDE”

M - massive hemorrhage
A - airway
R - respiration
C - circulation
H - hypothermia

-

X - eXsanguinating hemorrhage
A - airway
B - breathing
C - circulating
D - disability
E - expose/environment

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2
Q

Define OPQRST?

A

O - onset
P- provocation/palliation (what brings it on)
Q- quality (is it sharp, stabbing , dull)
R- region/radiation (does it radiate)
S - severity
T - time

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3
Q

Define SAMPLE:

A

S - signs and symptoms
A - allergies
M - medications
P - past medical history
L - last oral intake
E - Events prior to this event

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4
Q

What 2 acroynms are used for obtaining history from patient and what are they used for ?

A

SAMPLE : used for systematically obtaining Patients pertinent history

OPQRST: used to get more information about the pain/injury

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5
Q

Explain what pulse oximetry measures:

A

The amount of Oxygen in a persons blood

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6
Q

Describe factors and limitations in interpreting pulse oximetry findings

A

Factors:

  • Sufficient Perfusion
  • Body of normal tempature
  • No nail polish or anything that would obstruct reading

Limitations:

  • Low Perfusion to area where monitor attached
  • Lag time: Does not provide direct measurement of O2 in blood
  • Does not indicate the amount of oxygen being off-loaded to cells, the oxygenation status of the cells, or the ability of the cells to use the oxygen
  • Medical conditions such as shock, anemia, and CO2 poisioning can give inaccurate readings
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7
Q

How do you use pulse oximetry to help determine the need for supplemental oxygen?

A

It can tell how much oxygen is in the blood indirectly which can let you know if PT needs supplemental oxygen

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8
Q

What vital signs do you obtain that are a part of your BASELINE vital signs?

A
  • Respiration
  • Pulse rate
  • Skin
  • Capillary refill
  • Pupils
  • Blood pressure
  • Pulse Ox (SpO2)
  • Body temperature and blood - - glucose
  • Pain scale
  • Capnography
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9
Q

What is the normal range of “Heart rate” for Adults, elderly, children and infants?

A

Adults : 60-100

Adolescent (12-15): 60-100

School-age child (6-11): 75-118

Preschooler (3-5): 80-120

Toddler (1-2): 98-140

Infant (<1): 100-180

Birth-1 month: 100- 205

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10
Q

What is the normal range of “Respiration rate” for Adults, elderly, children and infants?

A

Adults : 12-20

Adolescent (12-15): 12-20

School-age child (6-11): 18-25

Preschooler (3-5): 20-28

Toddler (1-2): 22-37

Infant (<1): 30-53

Birth-1 month: 40-60

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11
Q

What is the normal range of “Blood pressure” for Adults, elderly, children and infants?

A

Adult: 120/80 or less

Adolescent (12-15 yo): 110-131/ 64-83

Preadolescent (10-12 yo): 102-120 / 61-80

School aged (6-9 yo): 97-115 / 57-76

Preschooler (3-5 yo): 89-112 / 46-72

Toddler (1-2 yo): 86-106 / 42-63

Infant: (1-12 yo): 72-104 / 37-56

Birth - 1 month: 67-84 / 35-53

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12
Q

What are the steps in Primary Patient Assessment?

A
  1. Form a general impression of the patient
  2. Assess level of consciousness (Mental Status/AVPU)
  3. Assess the airway
  4. Assess breathing
  5. Assess oxygenation
  6. Assess circulation
  7. Establish Patient Priorities
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13
Q

What 3 things do are assessed for respiration?

A
  • Rate
  • Quality
  • Rhythm
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14
Q

What 3 sounds are heard without a stethoscope?

A

Snoring
Gurgling
Stridor or crowing

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15
Q

What 3 sounds are heard with a stethoscope?

A

Wheezing
Crackles (Rales)
Rhonchi

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16
Q

What potentially causes Snoring?

A

Tongue partially blocking the upper airway at the level of the pharynx

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17
Q

What potentially causes Gurgling?

A

Fluid in the upper airway

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18
Q

What potentially causes Stridor/Crowing?

A

Partial obstruction of the upper airway at the level of the larynx

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19
Q

What potentially causes Wheezing?

A

Constriction (narrowing) and inflammation reducing the internal diameter of the bronchioles in the lungs

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20
Q

What potentially causes Crackles (Rales)?

A

Fluid surrounding and filling the alveoli

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21
Q

What potentially causes Rhonchi?

A

Mucus blocking the larger bronchioles

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22
Q

Define open ended questions and closed ended questions:

A

Open Ended Questions:

requires the patient to respond with a descriptive or more detailed answer

Closed Ended Questions:

Requires the patient to respond with a “Yes” or “no” answer

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23
Q

When assessing pulse rate and/or respirations, if the medic notes an irregularity, how long should that medic count to obtain an accurate reading?

A

Full Minute

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24
Q

What are the five components of SCENE-SIZE UP?

A
  1. Standard precautions
  2. Assess for safety hazards
  3. Determine MOI/NOI
  4. Number of patients
  5. Determine need for additional resources
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25
Q

Explain the purposes and goals of performing a scene size-up on every EMS call

A
  • allows to for the EMT and PT to remain safe
  • enables for max amount of resources to be available for the PT
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26
Q

How do you determine the pulse rate?

A

count for 30 seconds x 2

27
Q

What are the 4 types of Pulse Quality and their descriptions?

A

Thready - weak and rapid
Weak - as stated
Strong - Normal finding
Bounding - Usually Strong

28
Q

What 4 qualities do you assess skin for?

A

Color
Temperature
Condition
Capillary Refill

29
Q

What are the importance of taking accurate vital signs?

A
  • Accurate vital signs gives EMT a accurate picture of what is going on with the PT
30
Q

Explain the process of auscultating lung sounds?

A
31
Q

What are the different Pulse Points With patient’s age and level of responsiveness?

A

Birth -1 year: Brachial

> 1 year : Radial

32
Q

Explain systolic and diastolic blood pressure:

A

Systolic blood pressure :

Is the pressure in your arteries as your heart contracts and pumps blood

Diastolic Blood pressure:

Is the pressure in your arteries as your heart relaxes and fills with blood

32
Q

how do you perform orthostatic blood pressure?

A
  1. Place PT in supine position and take blood pressure and heart rate
  2. Stand PT up and after 2 minutes reassess BP and HR
  3. Positive finding:

If HR increases by 10-20 bpm and Systolic blood pressure decreases by 10-20 mmHg

33
Q

Why would performing orthostatic blood pressure be necessary?

A

It would be necessary to determine if there has been significant blood loss or fluid volume in PT

34
Q

What is a positive finding with orthostatic blood pressure and what does it indicate?

A

positive finding is

  • HR increases by 10-20 bpm
    Systolic BP decreases by 10-20 mmHg
  • Indicates that significant fluid loss has occurred
35
Q

Define and describe the mechanism of injury and nature of illness:

A

(MOI)- Mechanism of Injury : refers to PT how the patient was injured

(NOI) Nature of Illness:
Refers to PT who is not injured but suffering from a medical condition

36
Q

When should you have a high index suspicion for injuries?

A
  • Falls
  • Motor vehicle crashes (MVA)
  • Motorcycle crashes
  • Recreational vehicle crashes (for example, a snowmobile or all-terrain vehicle)
  • Contact sports involving intentional or unintentional collision
  • Recreational sports (such as skiing, diving, or basketball)
  • Pedestrian collision with a car, bus, truck, bike, or other force
  • Blast injuries from an explosion
  • Stabbings
  • Shootings
  • Burns
37
Q

What are the different types of skin colors and their causes?

A

Pallor (White) - Shock, blood loss

Cyanosis (Blue/gray) - inadequate of oxygenation

Flushing (Red)- Heat exposure/late CO2 poisoning

Jaundice (Yellow)- Liver disease

Mottling (Gray/blue blotching)- shock or blood pooling in extremities

38
Q

What are the 4 types of pupil reactive states and their causes?

A
  • Dilated:

Cardiac arrest (pupils will also be fixed), drug use such as LSD, amphetamines, or cocaine

  • Constricted:

Central nervous system disorder or narcotics use

  • Unequal:

Stroke, head injury, artificial eye (occasionally a normal finding), eye drops, or eye trauma

  • Nonreactive:

Cardiac arrest, brain injury, eye drops, or drug intoxication or overdose

39
Q

What is AVPU?

A

A - Alert
V - Verbal
P - Pain
U - Unresponsive

40
Q

What is GCS ?

A

The Glasgow Coma Scale (GCS) is used to rank the patient’s level of consciousness by assigning a numeric score from to 3-15

41
Q

How do you assess mental status?

A

AVPU

42
Q

What are the blood pressure rates that indicate HYPOtensive by age?

A

Adult: <90

Children (10-18): <90

Children (0-10 yo): <70

Infants - 1 yo: < 60

43
Q

what does DCAP-BTLS mean?

A

D - Deformities
C - Contusions
A - Abrasions
P- Punctures and Penetrations
B- Burns
T - Tenderness
L- Laceration
S- Swelling

44
Q

What are the 5 rights of medication administration?

A

the right patient
the right drug
the right dose
the right route
the right time

45
Q

What are the steps in a secondary exam?

A

Physical exam
Baseline Vital signs
History

46
Q

What is the pneumonic for Scene Size up?

A

PENMAN

P - PPE

E - Evaluate the scene for Hazards

N - Number of Patients
M - MOI/NOI
A - Additional Resources
N - Need for C-Spine Resources

47
Q

What are the steps in Patient assessment?

A
  1. Scene size up
  2. Consider SMR (Spine Mobile restriction)
  3. Primary assessment
  4. Decide to “Load and Go” or “Stay and play”
  5. Perform secondary assessment
48
Q

How often should you reassess vitals in high priority and low-priority patients?

A

High Priority: Every 5 minutes

low-Priority: Every 15 minutes

49
Q

Explain the four ways in which primary assessment can go:

A

Non-threatening life Injuries

  1. Modified Medical:
  2. Modified Trauma

Life threatening Injuries:

  1. Rapid Trauma:
  2. Rapid Medical
50
Q

What are the different locations of the pulses?

A

Central pulses:

  • Carotid artery
  • Femoral artery

Peripheral Pulses:

  • Radial artery
  • Brachial Artery
  • Popliteal Artery
  • Posterior Tibial Artery
  • Dorsalis Pedis Artery
51
Q

Where can each of the 7 pulse locations be felt at

A

Central pulses:

  • Carotid artery: On neck between trachea and muscle mass
  • Femoral artery: Groin

Peripheral Pulses:

  • Radial artery : Proximal to thumb and palmar surface of wrist
  • Brachial Artery: Middle of inside of the army between bicep and tricep
  • Popliteal Artery: Crease behind the knee
  • Posterior Tibial Artery: behind the ankle bone
  • Dorsalis Pedis Artery : on the top of the foot on the great-toe side.
52
Q

What is normal range for blood sugar?

A

70-140

53
Q

What are the components of the Secondary Assessment?

A
  • Physical exam
  • Baseline vitals signs
  • History
54
Q

What is the 4 ANO?

A

Place: address/city/state

Time: date/year/month

Person: what is your name

Events: current events in the world or day

55
Q

What are the two types of electrodes in a 12-lead?

A

Limb Electrodes (4):

-RA, LA, RL, LL

Precordial Electrodes (6):

  • V1,V2,V3,V4,V5,V6
56
Q

How to do a 4 lead?

A

(Salt and pepper)
RA, LA

(Christmas tree) “Presents go underneath”
LL,RL

57
Q

Where do the leads go on a 12 - lead?

A

RA - Right arm or wrist
LA - Left arm or wrist
LL - Left lower leg
RL - Right lower leg
V1 - 4th intercostal space Right sternal
V2 - 4th intercostal space Left sternal
V3 - Midway between V2 and V4
V4 - 5th intercostal space, Midclavicular line (Nipple line)
V5- Midway between V4 and V6
V6 - Mid axillary line (armpit)

58
Q

What is the following for Nitroglycerin:

Indications:
Contraindications:
Medication form:
Dosage:
Action:
Side effects:

A

Indications:
- To increase coronary perfusion in angina and acute myocardial infarction

Contraindications:
- BP systolic is less then 90 mmHg or has gone up by 30 points
- HR is less then 50 bpm
- Suspected head injury
- Suspected head injury
- PT is child or infant
- Max dose of 3 have been administered
- ED meds taken with 12-48 hours

Medication form:
-Tablet or sublingual spray

Dosage:
0.3-0.4 mg sublingual or 400 mcg SL per dose (can be repeated within 3-5 max dose 3)

Action:
- Potent vasodilation
- Nitroglycerin causes blood vessels to relax, or dilate, which will decrease workload on the heart

Side effects:
- Headache
- Decrease in BP
- Burning at the site of administration

59
Q

Define the following terms in regards to medication:

Indication
Contraindication
Dose
Administration
Action

A
  • Indication:
    Most common use(s) for medication when treating a specific Condition
  • Contraindication:
    Situations in which a medication should not be given to a patient due to a potentially harmful outcome
  • Dose
    The amount of medication that is to be given to PT
  • Administration
    Refers to the way the medication is given
  • Action
    The effect the medication has on the body
60
Q

Describe the difference between the objective and subjective signs and symptoms?

A

Objective information:
is measurable or verifiable in some way

Subjective information:
is based on an individual’s perceptions or interpretations

61
Q

What is DCAP-BTLS ?

A

is an acronym used by first responders to assess a patient’s soft tissue injuries and conditions

62
Q

what does DCAP-BTLS stand for ?

A

D- Deformities
C- Contusions
A- Abrasions
P- Punctures/Penetrations

B- Burns
T- Tenderness
L- Lacerations
S- Swelling

63
Q

Define the following terms in regards to medication Oxygen:

Indication
Contraindication
Dose
Administration
Action

A

Indication:
- S/S of hypoxia
- asst. ventilations with PPV
- SpO2 reading <94%
- S/S of heart failure and shock
- unresponsive PT

Contraindication:
- None in emergency situations

Dose:
- 1-6 lpm via nasal cannula
- 6-10 lpm face mask
- 10-15 lpm non-rebreather mask

Action:
- Reverse hypoxia
- increase tissue oxygenation and hemoglobin saturation

EMT 1 (13 decks)

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