Patient Assessment in detail Flashcards
What are the steps to patient assessment?
- Scene size-up
- Primary assessment
- Secondary assessment/focused history
- Reassessment
What are the parts for scene size up?
- BSI
- Safety, aka, is the scene safe? If not, how can I make it safe?
- Mechanism of injury (MOI) for trauma or nature of illness (NOI) for medical
- Number of patients
- Additional help (Fire, PD, additional ambulances)
- C-Spine
If there is any possibility of a C-spine injury, how do you open the airway?
Jaw-thrust maneuver
If there is NO possibility of C-spine injury, how do you open the airway?
Head-tilt/chin-lift maneuver
What are the parts of primary assessment?
- General impression
- AVPU
- Cheif complaint & life threats
- ABC’s
- Priority (severity of the condition)
What do you use AVPU for?
Assessing level of consciousness
What does AVPU stand for?
A- Alert
V- Responds to verbal stimuli
P- Responds to physical stimuli
U- Unresponsive
What is an example of someone being A in AVPU?
Pt is alert and oriented x4 (oriented to person/self, place, time, and event)
What is an example of someone being V in AVPU?
EMT: “Sir can you open your eyes for me?”
Pt: opens eyes
What is an example of someone being P in AVPU?
Pt responding to sternal rub
What is an example of someone being U in AVPU?
Pt is nonresponsive to verbal or physical stimuli
What is a chief complaint?
What is the patient most concerned about. Usually, but not always, the reason they call 911.
When do you do CPR on someone with a pulse?
- A child with a heart rate less than 60 bpm
- An unconcious/disoriented person who is unable to follow simple commands who has a weak, thready, and bradycardic (<60 bpm) pulse
When does a MOI become a serious MOI?
If the MOI is life threatening
Where do you take severe trauma patients?
A trauma center (ex: THFW or JPS in Tarrant county/Parkland or Baylor Dallas in Dallas county)
When do you take a severe trauma patient to the closest ER?
If you cannot manage their airway
Where do you take burn patients?
Burn center (Ex: Parkland in Dallas county)
What are the parts to the secondary assessment/focused history?
- If it’s trauma, is it a serious MOI or an isolated injury. If it’s medical, is the person concious or unconscious?
- PEx
- Transport decision
- Vitals
- SAMPLE/OPQRST
- Diagnostics
- Diagnosis
- Interventions
- Detailed PEx
- Patient transfer report
If the patient is conscious in a medical call, what do you focus on?
The chief complaint
What must you keep in mind when making a transport decision?
Factor in geographical area, time of day, and traffic conditions
What is considered a “full” set of vitals?
- Pulse
- Respirations
- Blood pressure
- Temperature
- Pulse oximetry
What must you do regarding vitals?
Compare them to patient’s normal, if known
What must you keep in mind about pulse oximetry?
It does not tell you the oxygen saturation, just the saturation of the RBC
What is the SAMPLE history?
S - signs/symptoms
A - allergies (especially drug)
M - medications/recreational drug use/medication compliance
P- past medical history
L - last oral intake
E - events leading up
