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EMT-B J > Patient Assessment in Depth > Flashcards

Patient Assessment in Depth Flashcards

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1
Q

What are the five main parts of patient assessment?

A
  1. Scene size up
  2. Primary assessment
  3. History taking
  4. Secondary assessment
  5. Reassessment
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2
Q

What questions help you determine if you require additional resources?

A
  • Does the scene pose a threat to you, your patient, or others?
  • How many patients are there?
  • Do we have the resources to respond to their conditions?
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3
Q

What are the categories for gross LOC?

A
  • Unconscious
  • Conscious with an altered LOC
  • Conscious with an unaltered LOC
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4
Q

What should you focus your initial assessment on of a patient who is unconscious?

A

Problems with airway, breathing, and circulation (critical life threats)

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5
Q

What is the AVPU scale and what does it stand for?

A

AVPU scale tests a patient’s responsiveness.

  • Awake and alert
  • Responsive to verbal Stimuli
  • Responsive to pain
  • Unresponsive
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6
Q

What is A&O x 4? Describe

A

Alert and oriented times 4:

  • Name
  • Place (do they know where they are)
  • Time (day of the week, year, season)
  • Event (what happened to you?)
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7
Q

What should you keep in mind while testing A&Ox4?

A

Take into account who you are interviewing. What is their standard capability? (ex. mental disability, elder, etc.)

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8
Q

What are the indications for spinal immobilization?

A
  1. Either blunt or penetrating trauma with any of the following:
    - Pain or tenderness on palpation of the neck or spine
    - Patient report of pain in neck or back
    - Paralysis or neurologic complaint (numbness, tingling, partial paralysis of the legs or arms)
    - Priapism (male patients) (a painful, tender, persistent erection of the penis)
  2. Blunt trauma with any or the following:
    - Altered mental status
    - Intoxication
    - Difficulty or inability to communicate
  3. Distracting injury
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9
Q

What are the few general conditions that cause sudden death?

A
  1. airway obstruction
  2. respiratory failure
  3. respiratory arrest
  4. shock
  5. severe bleeding
  6. primary cardiac arrest
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10
Q

How should you open an airway if there is a potential for trauma?

A

Jaw-thrust maneuver

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11
Q

Signs of airway obstruction in an unconscious patient

A
  1. Obvious trauma, blood, or other obstruction
  2. Noisy breathing, such as snoring, bubbling, gurgling, crowing, stridor, or other abnormal sounds
  3. Extremely shallow or absent breathing
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12
Q

What are the signs of respiratory distress?

A
  1. Agitation, anxiety, restlessness
  2. Stridor, wheezing
  3. Accessory muscle use
  4. Tachypnea
  5. Mild tachycardia
  6. Nasal flaring
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13
Q

What are the signs of respiratory failure?

A
  1. Lethargy, difficult to rouse
  2. Tachypnea with periods of bradypnea or agonal respirations
  3. Inadequate chest rise/ poor excursion
  4. Bradycardia
  5. Diminished muscle tone
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14
Q

How long should a rapid exam take in the primary assessment?

A

60 to 90 seconds

for detection of life threats

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15
Q

What does DCAP-BTLS stand for?

A
  • Deformities
  • Contusions
  • Abrasions
  • Punctures
  • Burns
  • Tenderness
  • Lacerations
  • Swelling
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16
Q

What is included in the rapid exam?

A

Its like a trauma secondary exam, but fast, feeling for DCAP-BTLS and looking for life threats.

17
Q

What patients are considered high priority and should be transported immediately?

A
  1. Unresponsive
  2. Poor general impression
  3. Difficulty breathing
  4. Uncontrolled bleeding
  5. Responsive but unable to follow commands
  6. Severe chest pain
  7. Pale skin or other signs or poor perfusion
  8. Complicated childbirth
  9. Severe pain in any area of the body
18
Q

What is the golden hour?

A

The time during which treatment of shock or traumatic injuries is most critical and the potential for survival is best

19
Q

Breakdown the golden hour

A

0-20 minute: Discovery of incident and activation of EMS
20-30 minute: The platinum 10 minutes; initial assessment, intervention, and packaging
30-60 minute: EMS transport and initial hospital stabilization

20
Q

Other than sample and OPQRST, what should you document about patient?

A
  • Date of the incident
  • Patient’s age
  • Patient’s gender
  • Patient’s race
  • Past medical history: medical problems, traumatic injuries, surgeries
  • Patient’s current health status: diet, meds, drug use
21
Q

What questions go with OPQRST?

A

Onset- What were you doing when the symptoms began?
Provocation- Does anything make the symptoms better or worse?
Quality- What does the symptoms feel like? Dull, sharp, crushing, tearing?
Radiation- Where do you feel the symptom? Does it move anywhere?
Severity- 0 to 10
Timing- Has the symptom been constant or does it come and go

22
Q

What is inspection?

A

Inspection is simply looking at your patient for abnormalities.

23
Q

What is palpation?

A

Describes the process of touching or feeling the patient for abnormalities.

24
Q

What is auscultation?

A

The process of listening to sounds the body makes by using a stethoscope

25
Q

Secondary Assessment: How should you assess the head?

A
  1. Observe the face
  2. Inspect the area around the eye and eyelids
  3. Examine the eyes for redness and contact lenses, and check pupil function
  4. Look behind the ears for battle sign
  5. Check the ears for drainage or blood
  6. Observe and palpate the head
  7. Palpate the zygomas
  8. Palpate the maxillae
  9. Check the nose for blood and drainage
  10. Palpate the mandible
  11. Assess the mouth and nose
  12. Check for unusual breath odors
26
Q

Secondary Assessment: How should you assess the neck?

A
  1. Inspect the neck. Observe for jugular vein distention

2. Palpate the front and back of the neck

27
Q

Secondary Assessment: How should you assess the chest?

A
  1. Inspect the chest, and observe breathing motion
  2. Gently palpate over the ribs
  3. Listen to anterior breath sounds
  4. Listen to posterior breath sounds
28
Q

Secondary Assessment: How should you assess the abdomen and pelvis?

A
  1. Observe and then palpate the abdomen and pelvis
  2. Gently compress the pelvis from the sides
  3. Gently press the iliac crest
29
Q

Secondary Assessment: How should you assess the extremities?

A

Inspect the extremities; assess distal circulation and motor and sensory function

30
Q

Secondary Assessment: How should you assess the back?

A

Log roll the patient and inspect the back

31
Q

When assessing breathing, what are you observing?

A
  1. Respiration rate
  2. Rhythm, regular or irregular
  3. Quality or character of breathing
  4. Depth of breathing
32
Q

Where should you listen for lungs sounds?

A

Back is easier to hear

33
Q

What are the sounds you might hear?

A
  1. Normal- clear and quiet
  2. Snoring- Usually upper airway obstruction
  3. Wheezing- Obstruction or narrowing of the lower airways
  4. Crackles- Wet; possibly fluid in the lung
  5. Rhonchi- Congested; may suggest mucus in lungs
  6. Stridor- Can be heard before stethoscope; possible airway obstruction in neck or upper part of chest.
34
Q

What is PEARRL used for and what does it stand for?

A 
Pupils
Equal
And
Round
Regular in size
React to light
35
Q

How do you assess neurovascular status in a conscious patient?

A
  1. Pulse
  2. Capillary refill
  3. Sensation
  4. Motor function
    (PMS)

EMT-B J (8 decks)

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