Patient Assessment & Movement Flashcards
1
Q
Secondary Assessment of Responsive Medical Patient
A
- Gather History of Present Illness
- Onset
- Provocation
- Quality
- Radiation
- Severity
- Time - Gather Past Medical History of Patient
- Signs and Symptoms (if additional info needed)
- Allergies
- Medications
- Past medical history
- Last oral intake
- Events leading up to illness - Conduct focused physical exam, as applicable
- Obtain baseline vitals
- Pulse
- Respiratory rate
- Blood pressure
- Pupils
- Skin color and temperature
- Oxygen saturation
- Blood glucose (as applicable) - Reassessment
2
Q
Secondary Assessment of Unresponsive Medical Patient
A
- Rapid physical exam
- Head
- Neck
- Chest
- Abdomen
- Pelvis
- Extremities
- Posterior - Obtain baseline vital signs
- Respiratory rate
- Pulse
- Blood pressure
- Skin color and temperature
- Pupils
- Oxygen saturation
- Blood glucose (as applicable) - Gather history of present illness from family/bystanders
- Onset
- Provocation
- Quality
- Radiation
- Severity
- Time - Gather past medical history from family/bystanders
- Signs & Symptoms
- Allergies
- Medications
- Past medical history
- Last oral intake
- Events leading up to illness - Reassessment
3
Q
Secondary Assessment of Trauma Patient with NO significant MOI
A
- Determine chief complaint, get history of present illness (how was patient injured?), Reconsider MOI
- Perform secondary assessmen/ focused physical exam based on chief complaint and mechanism of injury
- Assess for DCAP BTLS - Assess baseline vital signs
- Respiratory rate
- Pulse
- Blood pressure
- Skin color and temperature
- Pupils
- Oxygen saturation - Obtain PMH
- Reassessment
4
Q
Secondary Assessment of Trauma Patient w/ significant MOI
A
- Determine chief complaint, rapidly obtain history of present illness (how was patient injured?)
- Continue manual in-line stabilization of the neck
- Consider requesting ALS personnel
- Perform rapid trauma assessment
- Assess baseline vitals
- Respiratory rate
- Pulse
- Blood pressure
- Skin color and temperature
- Pupils
- Oxygen saturation - Obtain PMH
- Detailed physical exam
- Reassessment
5
Q
Body Systems Exam: Respiratory
A
- Note work of breathing/position
- Auscultate lung sounds
- Pedal & sacral edema (swelling in ankles&feet/ lower back)
- Lung sounds
- Pulse oximetry
- Respiratory specific history
- Dyspnea on exertion
- Orthopnea (shortness of breath while lying flat)
- Weight gain
6
Q
Body Systems Exam: Cardiovascular
A
- Check pulse presence, rate, regularity
- Skin color/temp/condition
- Blood pressure
- Orthostatic blood pressure changes
- JVD
- Components of respiratory exam
7
Q
Body Systems Exam: Neurological
A
- Cincinnati Prehospital Stroke Scale (when applicable)
- Pupils
- Mental status over time
8
Q
Body Systems Exam: Endocrine
A
- Blood glucose monitoring
- Skin color/temp/conditon
- Breath odors
- Excessive thirst, hunger, urination
- Diabetic specific history (Oral intake, medication history/use, recent illness)
9
Q
Body Systems Exam: GI/GU
A
- Palpation of abdominal quadrants
- GI/GU specific history (input/output & frequency, question bright red blood or dark blood in stool/vomit/urine, menstrual history/pregnancy as applicable)
10
Q
Primary Assessment
A
- Obtain General Impression
- Assess mental status (AVPU)
- Assess & maintain Airway
- Assess & maintain Breathing (rate, rhythm, quality; can bare chest & palpate)
- Assess & maintain Circulation (pulse RRQ, cap refill)
- Determine if oriented to person, place, time, event
- Determine patient priority
11
Q
Components of Rapid Trauma Assessment
A
- Head: Check for DCAP-BTLS & crepitation
- Face: Check for DCAP-BTLS (gently palpate structural bones)
- Ears: Check for DCAP-BTLS, fluid
- Eyes: Check for DCAP-BTLS, unequal pupils, discoloration, foreign bodies
- Nose: Check for DCAP-BTLS, fluid
- Mouth: Check for DCAP-BTLS, breath odor, airway obstructions, discoloration
- Neck: Check for DCAP-BTLS, JVD, tracheal deviation, crepitation
- *Apply cervical collar, if not done
- Chest: Inspect & palpate for DCAP-BTLS, crepitation, paradoxical movement. Auscultate breath sounds (presence, absence, equality)
- Abdomen: Inspect & palpate for DCAP-BTLS, tenderness, firmness, distention
- Pelvis: Inspect & palpate for DCAP-BTLS (use gentle pressure; in & out)
- Lower extremities: Check for DCAP-BTLS, CSM
- Upper extremities: Check for DCAP-BTLS, CSM
- Posterior: Check for DCAP-BTLS, gently palate spine
12
Q
Glasgow Coma Scale Components
A
- Eye opening
- Verbal response
- Motor response
13
Q
Steps to Reassessment
A
- Reassure patient
- Reassess vital signs
- Repeat appropriate portions of physical exam
- Check and adjust interventions
- Record trends in patient’s condition
14
Q
When to use emergency move
A
- Scene is hazardous
- Care for life threatening conditions requires repositioning
- You must reach other patients
15
Q
When to use urgent move
A
- Treatment of patient can only be performed if patient is moved
- Factors at scene cause patient decline
Involve moving patient to backboard