Patient Assessment

Question 1

Five steps of scene size up

Answer 1

1. Scene safety (I am #1)
2. Mech of Injury / Spine (What happened to you?)
3. Body substance isolation (Don’t get it on me!)
4. Other patients? (Are there more?)
5. General impression (Dead or alive?)

Question 2

Normal range of O2 saturation

Answer 2

95-100%

Question 3

Normal respiratory rate

Answer 3

12-20 per minute (+- 4, faster for kids)

Question 4

How to categorize / describe symptoms such as pain

Answer 4

Onset
Provokes/palliates
Quality (dull, sharp, aching, throbbing, intermittent)
Radiate/refer
Severity (1-10, 10 is worst pain ever felt)
Time/trend

Question 5

SOAP note includes

Answer 5

Subjective: chief complaint, age, MOI or illness, position found, time arrived.
Objective: patient assessment findings, vitals, history.
Assessment: list of possible problems.
Plan: Treatment plan for each problem.

Question 6

Normal blood pressure

Answer 6

Adults: 120/80
or
100+patient age / 60 to 90

Question 7

Scene size up top seven

Answer 7

1. Scene safety
2. General impression: sick/not sick
3. Mech of injury / history of present illness
4. Obtain consent
5. Number of patients (ask)
6. Body substance isolation
7. Do we need additional resources?

Question 8

How to check CSM

Answer 8

Circulation - warmth, pulse, cap refill
Sensation - “What am I doing” (touch finger/toe)
Motion - hands: squeeze two fingers;
feet: push down, pull up

Question 9

SAMPLE History

Answer 9

Signs/symptoms
Allergies
Medications
Pertinent medical history
Last intake/output
Events leading up to problem
"Anything else I should know?"

Question 10

DCAP BTLS

Answer 10

What to look and feel for during patient exam.
Deformities
Contusions
Abrasions
Punctures
Burns
Tenderness
Lacerations
Swelling

Question 11

Vital signs

Answer 11

1. Time
2. LOR
3. HR
4. RR
5. Skin: color, temp, moisture
6. O2 saturation
7. BP
8. Pupils
9. Temp

Question 12

Protect the spine with these MOI

Answer 12

1. Fall from >1 meter
2. Landing on head or neck
3. Excessive extension / flexion
4. Feel/see spine deformity
5. Speed (cars, skis, bikes)
6. Falling over object
7. Blunt force trauma

Question 13

Focused Spine Assessment

Answer 13

1. Reliable patient
   - LOR=A+O x3 or 4
   - Patient not altered
   - No distracting injuries
2. Intact CSM in all extremities
3. No pain or tenderness on spine palpation

Failure: immobilize, evac. Or reassess in 20 minutes.

Question 14

Normal heart rate

Answer 14

Adult: 50-100 beats/min
Child (1-8 years): 80-100
Infant: 120-140

Question 15

How to measure blood pressure

Answer 15

systolic (1st sound)
_____________
diastolic (when you stop hearing beat)