Pre hospital care Flashcards
Components of the initial assessment
- Develop a general impression.
- Assess mental status.
- Assess airway.
- Assess breathing.
- Assess circulation.
- Identify priority patients and make transport decision.
AVPU scale components are
- Alert
a. Eyes open as EMT approaches
b. Patient follows commands
c. Eyes track people and objects - Responsive to Verbal stimulus
a. Eyes do not open spontaneously
b. Patient able to respond meaningfully when spoken to - Responsive to Pain
a. Does not respond to questions
b. Cries out or moves in response to painful stimuli - Unresponsive
a. Does not respond to verbal or painful stimuli
Abnormal mental status may be caused by a variety of conditions such as
- Head trauma
- Hypoxemia
- Hypoglycemia
- Stroke
- Cardiac problems
- Drug use
DCAP-BTLS
a. Deformities
b. Contusions
c. Abrasions
d. Punctures/Penetrations
e. Burns
f. Tenderness
g. Lacerations
h. Swelling
Signs of inadequate breathing are
- Retractions (the use of accessory muscles)
- Nasal flaring and see-saw breathing in pediatric patients
- Two- or three-word dyspnea (only being able to speak two or three words without pausing for breath)
Patients who should receive high-flow (15 L/min via nonrebreathing mask) oxygen include those:
- Breathing faster than 20 breath/min
- Breathing slower than 12 breaths/min
- Breathing too shallow
- With decreased level of consciousness
- With respiratory distress
- With poor skin color
Good heart rate for an adult is
Rate 60–80 beats/min for adults; older patients and children have faster rates.
Bleeding from a large vein is characterized by
steady flow of blood
Bleeding from an artery is characterized by
spurting flow of blood.
Perfusion is assessed by
evaluating skin color, temperature, and condition.
Capillary refill most accurant in
children younger than 6 years of age
Components of the Rapid Physical Exam
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.
Focused Physical Exam are Performed on:
- Trauma patients without significant MOI
2. Responsive medical patients
Specific chief complaints of chest pain look for
a. Look for trauma to chest.
b. Listen to breath sounds.
c. Measure pulse and respiratory rate.
d. Evaluate skin.
Specific chief complaints of shortness of breath look for
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.
Specific chief complaints of abdominal pain look for
a. Look for trauma or distention.
b. Palpate for tenderness, rigidity, or guarding.
Specific chief complaints of Pain associated with bones or joints look for
a. Expose site.
b. Evaluate pulse and motor and sensory function next to and below the affected area.
c. Assess range of motion.
Specific chief complaints of dizziness look for
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.
Significant mechanisms of injury are
- Ejection from a vehicle
- Death in passenger compartment
- Falls greater than 15 to 20 feet.
- Vehicle rollover
- High-speed collision
- Vehicle-pedestrian collision
- Motorcycle crash
- Unresponsiveness or altered mental status following trauma
- Penetrating trauma to the head, chest, or abdomen
Assessment steps for trauma patients with a significant MOI
Rapid trauma assessment a. 60–90 second assessment b. Treat life threats not apparent in initial assessment then baseline vitals sample history
The detailed physical exam is usually performed
en route to the hospital.
Steps of the ongoing assessment
. 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.
