Patient Assessment Flashcards
What is a primary survey?
A rapid assessment of the patient, looking for immediate threats to life and providing treatment as required.
Should take 30-60 seconds.
List the elements of a primary survey.
- Airway
- Breathing
- Circulation
- Disability
- Exposure, examination and environmental control
How do you assess the airway in a primary survey?
Look and listen for signs of airway obstruction. Open the airway manually using head tilt/chin lift or jaw thrust if required. Use airway adjuncts such as an OPA or NPA if required.
Consider the possibility of c-spine injury if the patient has trauma.
How do you assess breathing in a primary survey?
Look and feel for adequate chest rise and fall. Look for obvious signs of respiratory distress. Ventilate using a manual ventilation bag and mask if required.
How do you assess circulation in a primary survey?
Look for and compress significant external bleeding. Start CPR if required. Feel the pulse rate and strength. Look and feel for abnormal (slow) peripheral perfusion/capillary refill time.
How do you assess disability in a primary survey?
Check the level of consciousness using the AVPU scale.
What steps are taken for exposure, examination and environmental control in a primary survey?
Appropriately expose and examine the patient, while keeping them warm.
What is a secondary survey?
A ‘top to toe’ examination of the patient following a primary survey.
Should take 2-3 minutes.
When should a secondary survey not be conducted?
If there are significant abnormalities in the primary survey.
How do you assess the central nervous system (CNS) in a secondary survey?
Check the patient can move their face and all limbs normally. Check the patient can feel soft touch on all limbs.
How do you assess the head, neck and face in a secondary survey?
Look and feel for abnormalities such as wounds, deformity, bleeding or signs of infection. Feel the cervical spine for tenderness if appropriate.
Looking at the pupils does not usually provide useful information.
How do you assess the chest in a secondary survey?
Look and feel for abnormalities such as wounds, deformity or bleeding. Look and feel for symmetry of chest movement and/or abnormal chest wall movement.
How do you assess the abdomen and pelvis in a secondary survey?
Look and feel for abnormalities such as wounds, deformity or bleeding. Ask the patient if they have pain in their abdomen or pelvis/hips.
How do you assess the extremities in a secondary survey?
Look and feel for abnormalities such as wounds, deformity, bleeding or signs of infection. Look at colour, feel warmth and assess perfusion/capillary refill time.
How do you assess the back and spine in a secondary survey?
Look at feel for abnormalities such as wounds, deformity or bleeding. Feel the spine for tenderness if appropriate.
Define what a vital sign is.
A vital sign is both a sign of life and an indication of a patient’s physical condition.
How often should vital signs be recorded for a status one or two patient?
Every 10-15 minutes.
When should vital signs be recorded?
In all patients unless there is a specific reason not to.
When they are a pre-requisite to treatment.
What is level of consciousness (LOC)?
A measure of how responsive a patient is to stimuli from their environment.
How can you assess level of consciousness (LOC)?
Using the AVPU scale or Glasgow coma scale (GCS).
FRs are not required to use the GCS but need to know how to assess using AVPU.
What is respiratory rate (RR)?
The number of breaths per minute.
How do you assess respiratory rate (RR)?
Count the number of breaths over 30 seconds and multiply by two.
What is heart rate (HR)?
The number of times the heart beats and generates a pulse that you are able to feel during one full minute.
How can you obtain heart rate (HR)?
By an ECG monitor or by feeling the pulse rate.
