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Emergency Medical Responder (EMR) > Patient Assesment Model > Flashcards

Patient Assesment Model Flashcards

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Royal College: Emergency Medicine flashcards USMLE® Step 1 flashcards
1
Q

What is the first acronym considered when responding to a call according to the patient assessment model?

A

HEMP. Hazards, Environment, Mechanism, Patients.

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2
Q

What does HEMP stand for in terms of the patient assessment model? When during a call is it used?

A
  • Hazards
  • Environment
  • Mechanism
  • Patients
    Used first when following the patient assessment model.
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3
Q

What two acronyms, along with the RBS, indicate the actions that should be performed during the primary survey?

A

DABC and SOAPI.

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4
Q

What does DABC stand for in terms of the patient assessment model? At what stage of a call is it used?

A
  • D(elicate)-spine
  • Airway
  • Breathing
  • Circulation
    Used first during the primary survey.
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5
Q

What does SOAPI stand for in terms of the patient assessment model? At what stage of a call is it considered? What is its purpose?

A
  • Skin
  • Oxygen
  • Airway
  • Package (prep)
  • Interventions
    Used towards the end of the primary survey to ensure you haven’t forgotten any of these things.
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6
Q

What are the 2 transport decisions you can make once you’ve responded to a call? What differentiates the two?

A
  1. Routine (speed limit, no lights)

2. Code 3 (speeding, sirens, hospital notification)

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7
Q

What must you remember to do if you find that a patient has no radial pulse?

A

Check their carotid pulse!

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8
Q

During the primary survey, how does your breathing assessment change for a conscious vs an unconscious patient?

A

Conscious: observe the patient, speak to them
Unconscious: Look-Listen-Feel

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9
Q

What 3 main components comprise the secondary survey?

A
  1. History
  2. Vital signs
  3. Head-to-toe/functional inquiry
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10
Q

During the secondary survey, what 2 acronyms are used to remember the steps of history-taking?

A

CHAMPLE and OPQRRST.

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11
Q

What does CHAMPLE stand for? When during your response for a call is this acronym employed? Why?

A
  • Chief complaint
  • History (of the injury)
  • Allergies
  • Medications
  • Past medical history
  • Last oral intake
  • Events leading up
    used first during the secondary survey to determine the patient’s medical history.
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12
Q

When using CHAMPLE for history-taking during the secondary survey, what is an example of a question that might help you determine the chief complaint?

A

“What’s bothering you the most right now?”

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13
Q

When using CHAMPLE for history-taking during the secondary survey, what is an example of a question that might help you determine the history of the chief complaint?

A

“Has this ever happened before? What could have caused this?”

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14
Q

When using CHAMPLE for history-taking during the secondary survey, what is an example of a question that might help you determine if the patient has allergies, as well as their severity?

A

“Do you have any allergies I should know about? What happens when you have an allergic reaction?”

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15
Q

When using CHAMPLE for history-taking during the secondary survey, what is an example of a question that might help you determine the patient’s medication use?

A

“Are you currently taking any medications? Are you compliant? Do you ever miss days or take extra to make up for missing one?”

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16
Q

When using CHAMPLE for history-taking during the secondary survey, what is an example of a question that might help you determine the patient’s last oral intake?

A

“What was the last thing you ate or drank? When was this?”

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17
Q

When using CHAMPLE for history-taking during the secondary survey, what is an example of a question that might help you determine the events leading up to the chief complaint?

A

“What were you doing before this happened?”

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18
Q

What does OPQRRST stand for? When during your response for a call is this acronym employed? Why?

A
  • Onset
  • Provoke
  • Quality
  • Radiate
  • Relief
  • Severity
  • Timing
    Used after CHAMPLE during the secondary survey to gather details about the chief complaint.
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19
Q

When using OPQRRST for history-taking during the secondary survey, what is an example of a question that might help you determine the onset of symptoms for the chief complaint?

A

“How long ago did these symptoms start?”

20
Q

When using OPQRRST for history-taking during the secondary survey, what is an example of a question that might help you determine what provokes the pain associated with the chief complaint?

A

“What makes your pain worse? Any specific actions?”

21
Q

When using OPQRRST for history-taking during the secondary survey, what is an example of a question that might help you determine the quality of the pain associated with the chief complaint?

A

“If you could describe your pain in one word, how would you describe it? Sharp? Constant? Crushing?”

22
Q

When using OPQRRST for history-taking during the secondary survey, what is an example of a question that might help you determine the localization of the patient’s pain?

A

“Does your pain radiate to somewhere else in your body, or is it localized?”

23
Q

When using OPQRRST for history-taking during the secondary survey, what is an example of a question that might help you determine what relieves the pain associated with the chief complaint?

A

“Have you found that anything offers relief from your pain? What’s helping you right now?”

24
Q

When using OPQRRST for history-taking during the secondary survey, what is an example of a question that might help you determine the severity of the patient’s pain?

A

“On a scale of 1-10, 10 being the worst pain you’ve ever experience in your entire life, how would you rate your pain right now?”

25
Q

When using OPQRRST for history-taking during the secondary survey, what is an example of a question that might help you determine the timing associated with your patient’s pain?

A

“Is your pain constant? Does it come and go? How long has it been as bad as it is? Is it getting better? Is it getting worse?”

26
Q

Why might we ask the patient to rate the severity of their pain during the secondary survey?

A

One rating is almost meaningless, but we ask multiple times to get a sense of the progression of their pain. Is it getting better? Is it getting worse?

27
Q

What are the 6 main vital signs that we take on patients after the secondary survey? What 7th vital sign might we add if necessary?

A
  1. Respirations
  2. Pulse
  3. SPO2
  4. Blood Pressure
  5. Pupils
  6. Temperature
    (7) . Blood glucose levels (only if mechanism or history suggests)
28
Q

When taking vital signs, what is the respiration range that indicates a healthy individual?

A

12-20 breaths per minute at rest.

29
Q

When taking vital signs, what is the pulse rate that indicates a healthy individual?

A

60-90 beats per minute is generally accepted as a healthy standard.

30
Q

When taking vital signs, what is the SPO2 that indicates a healthy individual? What are some exceptions to this?

A

95-100% is a healthy standard. Smokers may have a lower SPO2 due to their poor oxygenation.

31
Q

When taking vital signs, what is the blood pressure readings that indicate a healthy individual?

A

120/80 mmHg is the accepted healthy blood pressure range, though smaller individuals and those with high cardiovascular fitness may have a lower BP.

32
Q

When taking vital signs, what pupillary observations indicate a healthy individual? What acronym is used to describe this?

A
  • Pupils are
  • Equal (usually 3-4 mm dilated),
  • Reactive to
  • Light, and
  • Accomodating
33
Q

When taking vital signs, what range should a healthy individual’s core temperature fall between?

A

36.5-37.5 degrees C.

34
Q

What differentiates the Head-to-toe/functional inquiry from the rapid body survey (RBS)?

A

Head-to-toe/FI: thorough, palpate while asking questions and assessing function.
RBS: Palpate quickly but thoroughly, looking for obvious life-threatening symptoms.

35
Q

What are 3 questions you can ask while focusing on the head during the head-to-toe/FI?

A
  1. Any history of migraines?
  2. Any history of strokes?
  3. Any visual disturbances? Issues with vision?
36
Q

What is a good way to test for visual disturbances during the head-to-toe/FI?

A

Use a pen light/object/finger to assess visual tracking. Look for jerking or flicking motions of the eyes.

37
Q

How may you want to test for head trauma during the head-to-toe/FI?

A

Visually inspect the ears for CSF leak.

38
Q

What are 2 questions you can ask yourself or the patient while focusing on the neck during the head-to-toe/FI?

A
  1. Is there any jugular vein distension (JVD) (backfilling in the veins indicates tension pneumothorax).
  2. Does the patient have any history of thyroid issues? Does anyone in their family?
39
Q

What are 5 questions you can ask when focusing on the chest during the head-to-toe/FI?

A
  1. Do you have any history of an irregular heartbeat?
  2. Do you have any history of hypertension?
  3. Have you ever had any fainting episodes?
  4. Are you ever short of breath at night?
  5. Do you have any history of asthma? Even as a child?
40
Q

When using the patient assessment model during a call, at what point would you auscultate the lungs?

A

During the head-to-toe/FI when you’re focusing on the chest.

41
Q

During the head-to-toe/FI, what is it important to remember if you want to auscultate the abdomen?

A

To do so before palpating the 4 quadrants (apparently).

42
Q

What are 3 questions you may want to ask when focusing on the abdomen during the head-to-toe/FI?

A
  1. Have your bowel movements been normal? Have you been urinating normally?
  2. Do you have a history of abnormal bowel movements/urination?
  3. *Any chance you may be pregnant? Has your menstrual cycle been normal?
43
Q

What are 3 questions you may want to ask when focusing on the arms and legs during the head-to-toe/FI?

A
  1. Do you have any history of fractures or broken bones?
  2. Do you have any history of dislocations?
  3. Have you ever experienced rashes or skin abnormalities?
44
Q

When using the patient assessment model, at what stage should you do the circulation/motor/sensory assessment for the hands and feet? What else is important to ask at this time?

A

After your primary and secondary surveys, at the end of the head-to-toe/FI. If there are any unusual findings, are these normal for the patient (known issues, not an immediate concern)?

45
Q

What acronym is used as a checklist when transitioning from the scene to the ambulance?

A
  • House O2: switch to it from the portable
  • ABCs: reassess once you’re in the ambulance
  • Meds/mother/muscle: are you forgetting any of these that you’ll need?
  • Pen/paper: Have you completed documentation?
  • Suction: turn on the main house suction
  • Time: record time of departure from the scene
  • Egress: tell the driver to go to the hospital
  • Radio: notify the hospital
46
Q

What 4 components make up a professional and concise hospital notification?

A
  1. Introduce yourself
  2. Describe patient (age, gender, chief complaint, GCS)
  3. Give ETA to care facility
  4. Ask if there are any questions for you
47
Q

What does SBAR stand for? When should we use it?

A
  • Situation: what happened
  • Background: what led up to the event
  • Assessment: findings and interventions
  • Recommendations: we don’t recommend

Emergency Medical Responder (EMR) (2 decks)

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