Patient Assessment I

Question 1

Name the four components of a trauma patient assessment.

Answer 1

1. Scene Size-Up;
2. Primary Survey / Resuscitation;
3. History Taking;
4. Secondary Assessment;
   * -NREMT Advanced Level Psychomotor Examination, Patient Assessment - Trauma, 2016*

Question 2

What element is expeceted to precede all others in an NREMT Patient Assessment examination?

Answer 2

1. Take (or verbalize) appropriate PPE precautions;
   * Note: NREMT examination Critical Criteria - Failure to take or verbalize appropriate PPE precautions;
   * -NREMT Advanced Level Psychomotor Examination, Patient Assessment - Trauma, 2016*

Question 3

What are the elements of an NREMT Scene Size-Up?

Answer 3

1. Determine the scene / situation is safe;
   * Note: NREMT Examination Critical Criteria - Failure to determine scene safety;
2. Determine the mechanism of injury / nature of illness;
3. Determine the number of patients;
4. Request additional help if necessary;
5. Consider stabilization of spine;
   * Note: NREMT examination Critical Criteria - Failure to assess for and provide spinal protection when indicated;

Personal Shorthand:

• Scene safety;
• MOI/NOI;
• # of Pts
• Add. help?
• Spine?;

-NREMT Advanced Level Psychomotor Examination, Patient Assessment - Trauma, 2016

Question 4

What are the elements of an NREMT Primary Survey / Resuscitation during patient assessment?

Answer 4

1. Verbalize general impression of the patient;
2. Determine responsiveness / level of consciousness;
3. Determine chief complaint / apparent life-threats;
4. Airway;
5. Breathing;
   * Note: The NREMT’s examination of breathing contains multiple “Critical Criteria” sub-elements.
6. Circulation;
   * Note: The NREMT’s examination of circulation contains multiple “Critical Criteria” sub-elements.
7. Identify priority patients / make transport decision based upon calculated GCS;

• Note: NREMT examination Critical Criteria - Failure to differentiate patient’s need for immediate transportation versus continued assessment / treatment at the scene;
• Note: NREMT examination “Critical Criteria - Failure to initiate or call for transport of the patient within 10 minute time frame;

Personal Shorthand:

• Intro;
• gImp;
• LOC;
• CC;
• ABCDEs;
• Priority / Transport?;

-NREMT Advanced Level Psychomotor Examination, Patient Assessment - Trauma, 2016

Question 5

What are the sub-elements of airway assessment during an NREMT Primary Survey / Resuscitation?

Answer 5

1. Open and assess airway;
   * Note: NREMT examination Critical Criteria - Failure to find or appropriately manage problems associated with airway, breathing, hemorrhage or shock (hypoperfusion);
2. Insert adjunct as indicated;
   * Note: NREMT examination Critical Criteria - Failure to find or appropriately manage problems associated with airway, breathing, hemorrhage or shock (hypoperfusion);
   * -NREMT Advanced Level Psychomotor Examination, Patient Assessment - Trauma, 2016*

Question 6

What are the sub-elements of breathing assessment during an NREMT Primary Survey / Resuscitation?

Answer 6

1. Assess breathing;
2. Assure adequate ventilation;
   * Note: NREMT examination Critical Criteria - Failure to assess / provide adequate ventilation;
3. Initiate appropriate oxygen therapy;
   * Note: NREMT examination Critical Criteria - Failure to voice and ultimately provide high concentration of oxygen;
4. Manage any injury which may compromise breathing / ventilation;
   * Note: NREMT examination Critical Criteria - Failure to find or appropriately manage problems associated with airway, breathing, hemorrhage or shock (hypoperfusion);
   * -NREMT Advanced Level Psychomotor Examination, Patient Assessment - Trauma, 2016*

Question 7

What are the sub-elements of circulation assessment during an NREMT Primary Survey / Resuscitation?

Answer 7

1. Check pulse;
2. Assess skin (either color, temperature, or condition);
3. Assess for and control major bleeding if present;
   * Note: NREMT examination Critical Criteria - Failure to find or appropriately manage problems associated with airway, breathing, hemorrhage or shock (hypoperfusion);
4. Initiate shock management;
   * Note: NREMT examination Critical Criteria - Failure to find or appropriately manage problems associated with airway, breathing, hemorrhage or shock (hypoperfusion);
   * ​-NREMT Advanced Level Psychomotor Examination, Patient Assessment - Trauma, 2016*

Question 8

What are the elements of History Taking during an NREMT patient assessment?

Answer 8

1. Obtain, or direct assistant to obtain, baseline vital signs;
2. Attempt to obtain SAMPLE history;
   * Note: NREMT examination Critical Criteria - Does other detailed history or physical exam before assessing / treating threats to airway, breathing, and circulation;
   * -NREMT Advanced Level Psychomotor Examination, Patient Assessment - Trauma, 2016*

Question 9

What are the elements of a Secondary Assessment during an NREMT trauma patient assessment?

Answer 9

1. Head;
2. Neck;
3. Chest;
4. Abdomen / pelvis;
5. Lower extremities;
6. Upper extremities;
7. Posterior thorax, lumbar, and buttocks;
8. Manage secondary injuries and wounds appropriately;
9. Reassess patient;
   * -NREMT Advanced Level Psychomotor Examination, Patient Assessment - Trauma, 2016*

Question 10

What are the sub-elements of the assessment of the head during an NREMT Secondary Assessment for trauma?

Answer 10

1. Inspect mouth, nose, and assess facial area;
2. Inspect and palpate scalp and ears;
3. Assess eyes for PERRL;
   * -NREMT Advanced Level Psychomotor Examination, Patient Assessment - Trauma, 2016*

Question 11

What are the sub-elements of the assessment of the neck during an NREMT Secondary Assessment for trauma?

Answer 11

1. Check position of trachea;
2. Check jugular veins;
3. Palpate cervical spine;
   * -NREMT Advanced Level Psychomotor Examination, Patient Assessment - Trauma, 2016*

Question 12

What are the sub-elements of the assessment of the chest during an NREMT Secondary Assessment for trauma?

Answer 12

1. Inspect chest;
2. Palpate chest;
3. Auscultate chest;
   * -NREMT Advanced Level Psychomotor Examination, Patient Assessment - Trauma, 2016*

Question 13

What are the sub-elements of the assessment of the abdomen / pelvis during an NREMT Secondary Assessment for trauma?

Answer 13

1. Inspect and palpate abdomen;
2. Assess pelvis;
3. Verbalize assessment of genitalia / perineum as needed;
   * -NREMT Advanced Level Psychomotor Examination, Patient Assessment - Trauma, 2016*

Question 14

What are the sub-elements of the assessment of the lower extremities during an NREMT Secondary Assessment for trauma?

Answer 14

1. Inspect, palpate, and assess motor, sensory, and distal circulatory functions;

-NREMT Advanced Level Psychomotor Examination, Patient Assessment - Trauma, 2016

Question 15

What are the sub-elements of the assessment of the upper extremities during an NREMT Secondary Assessment for trauma?

Answer 15

1. Inspect, palpate, and assess motor, sensory, and distal circulatory functions;

-NREMT Advanced Level Psychomotor Examination, Patient Assessment - Trauma, 2016

Question 16

What are the sub-elements of the assessment of the posterior thorax, lumbar, and buttocks during an NREMT Secondary Assessment for trauma?

Answer 16

1. Inspect and palpate posterior thorax;
2. Inspect and palpate lumbar and buttocks area;
   * -NREMT Advanced Level Psychomotor Examination, Patient Assessment - Trauma, 2016*

Answer 17

-NREMT Advanced Level Psychomotor Examination, Patient Assessment - Trauma, 2016