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Bachelor of Paramedicine > Patient Assessment > Flashcards

Patient Assessment Flashcards

1
Q

A patient is not opening their eyes at all. Making grunting sounds and their joints flex when painful stimulus is applied to the nail bed. What is their GCS?

A

6

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2
Q

A patient has cool, pale, clammy skin. A blood pressure of 75/60. A pulse of 125 and are GCS 14. What is their perfusion status?

A

Inadequate

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3
Q

What are the components of a neurovascular assessment for a limb threatening injury?

A

Colour, temperature, distal pulse, swelling distal to site, capillary refill, pain distal to site, sensation.

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4
Q

What method is used to detect facial droop in a MASS assessment?

A

Pt asked to smile or show teeth

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5
Q

What method is used to test for slurred speech in MASS assessment?

A

Pt to repeat “you can’t teach an old dog new tricks”

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6
Q

The Pt has a respiratory rate of 7 bpm, has obviously increased WOB, both insp and exp wheezes present, is unable to speak and is pale and sweaty. what is their respiratory status?

A

Severe

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7
Q

Trauma Pt Vital signs: SBP 92, HR 130, sPO2 97%, respiratory rate 24, GCS 13. Is the patient time critical? If so, why?

A

Yes - abnormal vital sign pulse rate

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8
Q

Trauma pt vital signs: HR 90, RR 16, BP 100, GCS 15, sPO2 96%. The pt is aged 67 and has an obvious femur fracture but no spinal concerns, a few minor abrasions. You ask the patient what happened and they tell you they were struck by a car whilst crossing a pedestrian crossing. Is the patient time critical? If so, why?

A

Yes - pedestrian impact (mechanism of injury) and high risk patient (age_

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9
Q

The pt is complaining of pain in the abdomen. What type of assessment would you use to investigate the pain and what are the components?

A

DOLORS - describe the pain, when did it start (onset) and has it got worse or better, where exactly is the pain (location) and does it radiate at all. Other symptoms - have you had any other issues associated with the pain. Relief/aggravation - does anything make the pain better or worse. Severity (pain score)

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10
Q

Your patient is in an altered conscious state. What assessment will you use to help determine the cause and what are its components?

A

AEIOUTIPS - alcohol, epilepsy, insulin (hypo/hyper), oxygen/overdose, uremia, trauma/temperature, infection, poisoning/psychiatric, stroke/seizure/syncope

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11
Q

You are called to pt complaining of SOB. The patient appears anxious, they are able to speak in sentences, they have an expiratory wheeze, their RR is 20, they have a prolonged exp phase, they have increased WOB, their pulse is 98, their skin is normal, they have a GCS of 15. What is this patient’s respiratory status?

A

Mild distress.

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12
Q

You are called to a patient who has fainted at a music festival. The patient is GCS 15 on arrival but appears cool, pale and clammy. You carry out a VSS and their blood pressure is 85/40. Does this patient have a clinical flag, what colour and why?

A

Yes - red (abnormal vital sign blood pressure <90 mmHg)

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13
Q

You attend a patient who has been in a car accident. You would like to clear the patient of spinal concerns for extrication. What assessment will you carry out and how?

A

Neurological exam (spinal clearance): assess motor function of arms (push, pull, grab), assess motor function of legs (push and plantar flex, pull and Dorsiflex). Assess sensory function of arms (light touch to palms, backs of hands), assess sensory function of legs (light touch lateral calcaneus), suprasternal notch light touch. Ask patient if they have any numbness, tingling or other altered sensations anywhere.

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14
Q

What four components are required to be assessed to determine if a patient has the capacity to consent to treatment?

A

Ability to understand the information given, ability to retain the information to extent necessary to make decision, ability to weigh information to make decision, ability to communicate their decision

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15
Q

You arrive on scene and the patient appears unwell and is complaining of SOB. You are considering giving O2 so assess the patients sPO2, the result is 92%. What other question must you ask before starting the patient on O2?

A

Do you have a history of COPD?

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16
Q

You are assessing your pt, their vitals are: pulse 62, BP 85, their skin is c,p,c and they are alert and oriented to time, place and person. What is their perfusion status?

A

Borderline

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17
Q

During the Pt assessment you complete a set of adjuncts, list these.

A

SPO2, pain, BGL, ECG, pupils, temp

18
Q

You approach your pt, what three components will help you determine if they are well or unwell as part of your rapid assessment?

A

Work of breathing, skin (appearance), conscious state

19
Q

You are taking a past Hx from your patient, what format may assist you and what are its components?

A

SAMPLE - signs and symptoms, allergies, medications, past Hx of similar episodes, last meal/last bathroom, events leading up to calling ambulance

20
Q

You are attempting to determine if your patient has any risk factors for a cardiac episode. What are these?

A

Diabetes, obesity, family Hx, hypertension, smoker

21
Q

What are the abnormal vital signs that would indicate a trauma pt is time critical?

A

HR <60 or > 120
RR <10 or > 30
SPO2 <90%
SBP < 90
If > 16 yrs GCS < 13
If < 16 yrs GCS < 15

22
Q

Your patient opens their eyes in response to your voice, they answer your questions with nonsense phrases and when you perform a trap squeeze they push your hand away. What is their GCS?

A

11

23
Q

What are the components of the respiratory status assessment?

A

Appearance, speech, breath sounds, rhythm, rate, effort, skin, pulse, conscious state

24
Q

You suspect your patient may have a fracture. What assessment will you carry out and what are its components?

A

PILSDUCT - pain, irregularity, loss of function, swelling, deformity, unnatural movement, crepitus, bony tenderness

25
Q

Your pt is MASS positive. What other assessment might you carry out to determine the significance of their stroke and what does it include?

A

ACT-FAST: ask patient to hold arms up at 45 degrees. If only one arm unable or one arm falls: RIGHT check speech again as per MASS. LEFT tap patient opposite shoulder and call name

26
Q

What are the components of the medical secondary survey?

A

Neurological, cardiovascular, respiratory, gastrointestinal, genitourinary, reproductive, skin, musculoskeletal

27
Q

During your trauma secondary survey what might you be checking the head for?

A

Battle’s sign (bruising under the ears), Halo sign (CSF in ears), raccoon eyes, boggy man, abrasions, lacerations

28
Q

What are the clinical signs of a pneumothorax?

A
  1. Subcutaneous emphysema
  2. Reduced breath sounds
  3. SpO2 less than 92% on RA
29
Q

What is the high risk head injury criteria?

A
  1. Vomiting more than once
  2. Unconscious longer than 5 minutes
  3. Suspected skull fracture
  4. Neurological deficit
  5. Seizures
  6. Worsening signs and symptoms
30
Q

What are the clinical signs of a pelvic fracture?

A

Haemodynamic instability, blunt force trauma, altered conscious state, unable to straight leg raise

31
Q

The espiratory rate in severe distress is?

A

< 20 or > 8

32
Q

What are the component of the mental status assessment?

A

Safety, Appearance, Behaviour, Affect, Speech, Cognitions, Thought process, Perceptions, Thought content, Self-harm, Environment

33
Q

The time critical trauma triage pertaining to penetrating/blunt injury involves?

A
  1. Any penetrating injury
  2. Blunt injury to a single body area such that specialised intervention may be required to prevent risk to life or permanent damage
  3. Blunt injury to two or more body regions
34
Q

What are the components of the paediatric pain assessment?

A

Face, Legs, Activity, Consolability, Cry/Speech

35
Q

What are the components of the APGAR score?

A

Appearance, Pulse, Grimace, Activity, Rest Rate

36
Q

What is the RASH criteria?

A

Any two of: Respiratory distress, Abdominal symptoms, Skin symptoms, Hypotension with/without a known allergen OR isolated hypotension with a known allergen OR isolated respiratory distress with a known allergen

37
Q

What is the nexus criteria?

A

High risk patients: age > 65 or previous bone density issue

Difficult to assess: intoxicated, altered conscious state or significant distracting injury

Central c-spine tenderness on palpation

Unable to move head right to left without pain

38
Q

What are the clinical signs of a NoF fracture?

A
  1. External rotation of affected limb
  2. Limb shortening
  3. Bruising or swelling to area
  4. Pain in hip/groin
39
Q

A pt is given a SAT score of +3, what is the criteria for this?

A

Pt is showing continual loud outbursts and is violent and uncontrollable

40
Q

What is the criteria for status epileptics?

A

Greater than 5 minutes continual seizure activity or greater than 2 seizures without return to baseline

41
Q

What is the criteria for tension pneumothorax?

A

Signs of pneumothorax AND worsening respiratory distress, SpO2 < 92% despite oxygen, inadequate perfusion, increasing peak inspiratory pressures/stiff bag, decreased EtCo2

42
Q

What is the SIRS criteria?

A

Temp > 38
Pulse > 90
Respiratory rate > 20

Bachelor of Paramedicine (6 decks)

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