Module 6: Patient Assessment

Question 1

What sort of diagnosis does an EMT provide a patient with?

Answer 1

A presumptive diagnosis

Question 2

Describe Scene Size Up script

Answer 2

1. BSI
2. Is my scene safe
3. How many patients are there
4. What is the MOI/NOI
   5 Additional Resources

Question 3

Describe the LISA process and where it goes in the patient assessment

Answer 3

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

Question 4

What are the three steps of airway?

Answer 4

1. Open (HTCL/Jaw thrust)
2. Suction (no > 15 seconds for adults)
3. Maintain (OPA/NPA)

Question 5

What is the most common airway obstruction?

Answer 5

The tongue

Question 6

Compare when you should use head-tilt chin-lift versus jaw thrust

Answer 6

HTCL: medical pts who haven’t fallen
Jaw thrust: Pts who have experienced trauma (ex. car crah) and are unresponsive. Suspected spinal injury

Question 7

What should be done when you hear gurgling in the airway? How long should it be done?

Answer 7

Suction. For adults, no more than 15 seconds.

Question 8

What kind of patients can you not use an OPA with?

Answer 8

Unresponsive patients with a gag reflex. Instead, use an NPA

Question 9

What kind of patients can you use an NPA with? What kind of pts should you not use them with?

Answer 9

DO use: semi-responsive patients, seizure patients, or those with gag reflex
Do NOT: If suspected facial or skull trauma (risk hitting the brain)

Question 10

What are the four steps of breathing assessment?

Answer 10

1. Look
   - symmetrical chest rise
   -impaled objects
   -punctures
2. Listen
   -both sides
3. Feel
   -entire chest wall
4. Give oxygen
   -BVM/NRB

Question 11

What sort of material should be used to pack a puncture wound?

Answer 11

Occlusive dressing (non-porous), taping all four sides

Question 12

If there is an impaled object in the chest, what should you do?

Answer 12

Stabilize the object

Question 13

What is the biggest difference between a non re breather (NRB) and a BVM?

Answer 13

BVM forces ventilation on pt and are used on unresponsive patients
NRB is for patients who are ventilating on their own

Question 14

How can you know the BVM is affective?

Answer 14

Look for chest rise

Question 15

Describe the steps of circulation during primary assessment?

Answer 15

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

Question 16

What does diaphoretic mean?

Answer 16

Sweaty/moist skin

Question 17

Describe the steps of decision in primary assessment?

Answer 17

1. High v Low priority
   2 give update to responding units

Question 18

Describe the steps of secondary assessment for trauma patients?

Answer 18

1. SAMPLE
2. Vitals
3. Physical Exam
4. Treatments

Question 19

Describe steps of secondary assessment for medical patients?

Answer 19

1. SAMPLE
2. OPQRSTI
3. Vitals
4. Physical Exam
5. Treatments

Question 20

The goal for assessment is to physically ___ and verbally ___

Answer 20

Physically assess and verbally treat

Question 21

What are the steps of reassessment

Answer 21

1. How often do you repeat assessment
2. Give verbal report (MIST report)

Question 22

What is the MIST report?

Answer 22

1. MOI or NOI
2. Injuries
3. Signs and Symptoms
4. Treatments

Question 23

The reading of SpO2 is a helpful in determining:
1. respiration
2. breathing
3 oxygenation
4 ventilation

Answer 23

3 oxygenation

Question 24

A 22-year-old male was stuck by a car he is laying in the prone position. You should first:

Answer 24

log roll patient as a unit into the supine positon

Question 25

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

Answer 25

3. count pulse for full minute to obtain an accurate reading

Question 26

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

Answer 26

4 suction oropharynx

Question 27

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

Answer 27

4 leave pt and call for back up in ambulance

Question 28

When reporting respirations as a vital sign, the EMT should document all except:
rate
resonance
quality
rhytm

Answer 28

resonance

Question 29

Give the general questions for SAMPLE as well as where it belongs in patient assessment

Answer 29

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

Question 30

Describe the general questions for OPQRSTI and where it belongs in patient assessment

Answer 30

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?”

Question 31

What is a pertinent negative?

Answer 31

negative finding that requires no further care or intervention