Module 6: Patient Assessment Flashcards
What sort of diagnosis does an EMT provide a patient with?
A presumptive diagnosis
Describe Scene Size Up script
- BSI
- Is my scene safe
- How many patients are there
- What is the MOI/NOI
5 Additional Resources
Describe the LISA process and where it goes in the patient assessment
In the scene size up w Aura, In Primary Assessment with textbook
1. Obvious Life threats
2. Impression (sentence about what the pt looks like)
3. Spine
4. AVPU
What are the three steps of airway?
- Open (HTCL/Jaw thrust)
- Suction (no > 15 seconds for adults)
- Maintain (OPA/NPA)
What is the most common airway obstruction?
The tongue
Compare when you should use head-tilt chin-lift versus jaw thrust
HTCL: medical pts who haven’t fallen
Jaw thrust: Pts who have experienced trauma (ex. car crah) and are unresponsive. Suspected spinal injury
What should be done when you hear gurgling in the airway? How long should it be done?
Suction. For adults, no more than 15 seconds.
What kind of patients can you not use an OPA with?
Unresponsive patients with a gag reflex. Instead, use an NPA
What kind of patients can you use an NPA with? What kind of pts should you not use them with?
DO use: semi-responsive patients, seizure patients, or those with gag reflex
Do NOT: If suspected facial or skull trauma (risk hitting the brain)
What are the four steps of breathing assessment?
- Look
- symmetrical chest rise
-impaled objects
-punctures - Listen
-both sides - Feel
-entire chest wall - Give oxygen
-BVM/NRB
What sort of material should be used to pack a puncture wound?
Occlusive dressing (non-porous), taping all four sides
If there is an impaled object in the chest, what should you do?
Stabilize the object
What is the biggest difference between a non re breather (NRB) and a BVM?
BVM forces ventilation on pt and are used on unresponsive patients
NRB is for patients who are ventilating on their own
How can you know the BVM is affective?
Look for chest rise
Describe the steps of circulation during primary assessment?
VCRS
1. Voids (for medical patients ask, for trauma, check)
2. Check a pulse (don’t count that’s a vital sign, just check and make sure it’s there)
-carotid for unconscious
-radial for conscious
3. Skin
-color, temperature, condition
What does diaphoretic mean?
Sweaty/moist skin
Describe the steps of decision in primary assessment?
- High v Low priority
2 give update to responding units
Describe the steps of secondary assessment for trauma patients?
- SAMPLE
- Vitals
- Physical Exam
- Treatments
Describe steps of secondary assessment for medical patients?
- SAMPLE
- OPQRSTI
- Vitals
- Physical Exam
- Treatments
The goal for assessment is to physically ___ and verbally ___
Physically assess and verbally treat
What are the steps of reassessment
- How often do you repeat assessment
- Give verbal report (MIST report)
What is the MIST report?
- MOI or NOI
- Injuries
- Signs and Symptoms
- Treatments
The reading of SpO2 is a helpful in determining:
1. respiration
2. breathing
3 oxygenation
4 ventilation
3 oxygenation
A 22-year-old male was stuck by a car he is laying in the prone position. You should first:
log roll patient as a unit into the supine positon
When palpating a patient’s pulse, you note that it is grossly irregular. You should:
1. count pulse for thirty seconds to ensure accuracy
2. count pulse for fifteen seconds and multiple by four
3. count pulse for full minute to obtain an accurate reading
4. count number of pulsations in thirty seconds and multiply by two
- count pulse for full minute to obtain an accurate reading
You respond to a call for a female pedestrian who has been struck by a car. As your partner maintains manual stabilization of her head, you perform a primary assessment. She is unconscious, has ineffective breathing, and has bloody secretions and vomit in her mouth. You should FIRST:
1. assist breathing with BVM
2 splint
3 assess rate and quality of pulse
4 suction oropharynx
4 suction oropharynx
You are your partner are called for a 17-year-old male having a seizure. Upon arrival you are greeted by the patient’s mother who states her son sometimes acts strange after he has seizure. When you enter the home, the patient is sitting on the edge of his bed holding a knife. You should:
1. attempt to disarm pt
2 attempt to calm patient
3 ask his mother to help
4 leave pt and call for back up in ambulance
4 leave pt and call for back up in ambulance
When reporting respirations as a vital sign, the EMT should document all except:
rate
resonance
quality
rhytm
resonance
Give the general questions for SAMPLE as well as where it belongs in patient assessment
S: Signs and symptoms: “do you have any additional signs and symptoms?”
A: Allergies “Are you allergic to anything?”
M: Medications “what sort of medications do you take?”
P: Past Medical history “Do you have any relevant past medical history?”
L: Last oral intake “What was the last thing you ate/drank?”
E: Events leading up to the injury “What were you doing BEFORE your symptoms began?”
This occurs during secondary assessment
Describe the general questions for OPQRSTI and where it belongs in patient assessment
O: Onset “what were you doing while your symptoms began?”
P: Provocation “Does anything make it better/worse?”
Q: Quality “What does the pain feel like?”
R: Region “Where is the pain felt the most?”
S: Severity “Scale of 0 to 10”
T: Timing “How long have you experienced this pain?”
I: Intervention “Did you do anything to make the pain better/worse?”
What is a pertinent negative?
negative finding that requires no further care or intervention
