Pre hospital care

Question 1

Components of the initial assessment

Answer 1

1. Develop a general impression.
2. Assess mental status.
3. Assess airway.
4. Assess breathing.
5. Assess circulation.
6. Identify priority patients and make transport decision.

Question 2

AVPU scale components are

Answer 2

1. Alert
   a. Eyes open as EMT approaches
   b. Patient follows commands
   c. Eyes track people and objects
2. Responsive to Verbal stimulus
   a. Eyes do not open spontaneously
   b. Patient able to respond meaningfully when spoken to
3. Responsive to Pain
   a. Does not respond to questions
   b. Cries out or moves in response to painful stimuli
4. Unresponsive
   a. Does not respond to verbal or painful stimuli

Question 3

Abnormal mental status may be caused by a variety of conditions such as

Answer 3

1. Head trauma
2. Hypoxemia
3. Hypoglycemia
4. Stroke
5. Cardiac problems
6. Drug use

Question 4

DCAP-BTLS

Answer 4

a. Deformities
b. Contusions
c. Abrasions
d. Punctures/Penetrations
e. Burns
f. Tenderness
g. Lacerations
h. Swelling

Question 5

Signs of inadequate breathing are

Answer 5

1. Retractions (the use of accessory muscles)
2. Nasal flaring and see-saw breathing in pediatric patients
3. Two- or three-word dyspnea (only being able to speak two or three words without pausing for breath)

Question 6

Patients who should receive high-flow (15 L/min via nonrebreathing mask) oxygen include those:

Answer 6

1. Breathing faster than 20 breath/min
2. Breathing slower than 12 breaths/min
3. Breathing too shallow
4. With decreased level of consciousness
5. With respiratory distress
6. With poor skin color

Question 7

Good heart rate for an adult is

Answer 7

Rate 60–80 beats/min for adults; older patients and children have faster rates.

Question 8

Bleeding from a large vein is characterized by

Answer 8

steady flow of blood

Question 9

Bleeding from an artery is characterized by

Answer 9

spurting flow of blood.

Question 10

Perfusion is assessed by

Answer 10

evaluating skin color, temperature, and condition.

Question 11

Capillary refill most accurant in

Answer 11

children younger than 6 years of age

Question 12

Components of the Rapid Physical Exam

Answer 12

A. Continue spinal immobilization while checking the patient’s ABCs for any changes.
B. Assess the head for DCAP-BTLS and crepitus.
C. Assess the neck for DCAP-BTLS, jugular venous distention, tracheal deviation, and crepitus.
D. Apply a cervical spinal immobilization collar, if appropriate.
E. Assess the chest for DCAP-BTLS, paradoxical motion, and crepitus. Listen to breath sounds.
F. Assess the abdomen for DCAP-BTLS, rigidity, and distention.
G. Assess the pelvis for DCAP-BTLS. If no pain, compress downward and inward to assess for pain or instability.
H. Assess all four extremities DCAP-BTLS, distal pulses, motor and sensory function.
I. Roll the patient with spinal precautions, if appropriate, and assess the back and buttocks for DCAP-BTLS.

Question 13

Focused Physical Exam are Performed on:

Answer 13

1. Trauma patients without significant MOI

2. Responsive medical patients

Question 14

Specific chief complaints of chest pain look for

Answer 14

a. Look for trauma to chest.
b. Listen to breath sounds.
c. Measure pulse and respiratory rate.
d. Evaluate skin.

Question 15

Specific chief complaints of shortness of breath look for

Answer 15

a. Look for airway obstruction.
b. Listen to breath sounds.
c. Measure respiratory rate, pulse, and blood pressure.
d. Observe chest rise and fall.
e. Evaluate skin.

Question 16

Specific chief complaints of abdominal pain look for

Answer 16

a. Look for trauma or distention.

b. Palpate for tenderness, rigidity, or guarding.

Question 17

Specific chief complaints of Pain associated with bones or joints look for

Answer 17

a. Expose site.
b. Evaluate pulse and motor and sensory function next to and below the affected area.
c. Assess range of motion.

Question 18

Specific chief complaints of dizziness look for

Answer 18

a. Evaluate level of consciousness.
b. Evaluate speech.
c. Inspect head for trauma.
d. Pulse, blood pressure, and skin may indicate hypoperfusion of the brain.

Question 19

Significant mechanisms of injury are

Answer 19

1. Ejection from a vehicle
2. Death in passenger compartment
3. Falls greater than 15 to 20 feet.
4. Vehicle rollover
5. High-speed collision
6. Vehicle-pedestrian collision
7. Motorcycle crash
8. Unresponsiveness or altered mental status following trauma
9. Penetrating trauma to the head, chest, or abdomen

Question 20

Assessment steps for trauma patients with a significant MOI

Answer 20

Rapid trauma assessment
a. 60–90 second assessment
b. Treat life threats not apparent in initial assessment 
then baseline vitals
sample history

Question 21

The detailed physical exam is usually performed

Answer 21

en route to the hospital.

Question 22

Steps of the ongoing assessment

Answer 22

. Repeat the initial assessment.

a. Reassess mental status.
b. Maintain an open airway.
c. Monitor the patient’s breathing.
d. Reassess pulse rate and quality.
e. Monitor skin color and temperature.
f. Reestablish patient priorities.
2. Reassess and record vital signs.
3. Repeat focused assessment regarding patient complaint or injuries, including questions about the patient’s history.
4. Check interventions.
a. Ensure adequacy of oxygen delivery/artificial ventilation.
b. Ensure management of bleeding.
c. Ensure adequacy of other interventions.