Patient Assessment

Question 1

What are the five components of patient assessment?

Answer 1

1. Scene size-up
2. Primary assessment
3. Patient history
4. Secondary assessment
5. Reassessment

Question 2

What are the components of scene size-up?

Answer 2

1. Scene safety
2. Standard precautions
3. Number of patients/additional resources
4. Mechanism of injury (MOI)/nature of illness (NOI)

Question 3

How can you ensure scene safety?

Answer 3

• Your safety is the first priority. If the scene is safe, continue with your assessment.
• EMS personnel are required to wear a National Standards Institute 207 certified safety vest at all accident scenes or anytime working near traffic.
• A portable, durable, high-intensity flashlight should be carried at all times.
• Keep a portable radio and cell phone with you when possible.
• Position emergency vehicle for easy access, and use as a traffic barrier when needed.
• When told to “stage,” crew will respond to the call but remain a safe distance away until cleared by law enforcement.

Answer 4

Request additional resources as needed, such as advanced life support, transport, or extrication.

Question 5

What is blunt trauma?

Answer 5

Blunt trauma is an injury that does not penetrate the skin.

Question 6

What is penetrating trauma?

Answer 6

Penetrating trauma is an injury that penetrates the skin.

Question 7

What is the purpose of the primary assessment?

Answer 7

The purpose of the primary assessment is to identify and treat immediately life-threatening conditions.

Question 8

How soon should you stabilize a cervical spine (c-spine) injury?

Answer 8

If cervical spine (c-spine) injury is suspected, manual c-spine precautions should be taken immediately according to local protocol.

Question 9

What is the general impression?

Answer 9

The general impression is the information you are able to immediately determine upon arriving at the patient, such as the patient’s age, sex, level of distress, and overall appearance.

Question 10

How should you position the patient during the primary assessment?

Answer 10

If the patient is prone, log roll the patient to the supine position. Move the patient with manual c-spine precautions if indicated.

Question 11

What is the AVPU scale?

Answer 11

The AVPU scale can be used to rapidly determine the patient’s general responsiveness.

Question 12

What does the accronym AVPU stand for?

Answer 12

• A = awake and alert
• V = responsive to voice
• P = responsive to pain
• U = unresponsive

Question 13

What is the recommended CAB approach to assessment for unresponsive patients?

Answer 13

• Circulation. If the patient is unresponsive, with no signs of breathing, or agonal breaths, and no confirmed pulse within 10 seconds, initiate CPR and incorporate the automated external defibrillator (AED) as soon as it is available. CPR should begin with compressions, not ventilations.
• Airway. Check airway and intervene as needed. Opening the airway in unresponsive patients should be done after determining the need for chest compressions.
• Breathing. Assessing for breathing and artificial ventilations are performed after determining the need for chest compressions.

Question 14

What are the components of the assessing LOC?

Answer 14

• The patient knows his or her name.
• The patient knows where he or she is.
• The patient knows the month, year, and approximate date and time.

Question 15

What is the order of airway assessments and interventions?

Answer 15

• Manual airway maneuvers as needed
• Suction as needed
• Mechanical airway adjuncts as needed

Answer 16

Manage life-threatening conditions associated with breathing. For example, if the patient has a flial chest, initiate artificial ventilations. If the patient has a sucking chest wound, apply an occlusive dressing.