Steps - PT Movement Assessment Tool

Question 1

STEP 1 - Nature of Complaint / General Impression

Answer 1

• Differential Diagnosis (consider MOI)

When the differential diagnosis indicates one of the following, these patients warrant a stretcher:

• Cardiac in nature
• Severe Respiratory w/ clinical indicators (sob w/ audible wheezes dec SPO2
• Life/Limb Threatening MSI

Question 2

Step 1 - Consider patient’s Acuity

Answer 2

• “Sick or Not sick”
• Mentation - is the pt able to follow a conversation/is the pt cooperative/is eye movement consistent w/ intentional cooperation/ age of pt

Question 3

Step 1 - Consider the Risks

Answer 3

• Risk to the pt - stable gait, do they normally use a walker?
• Risk to the paramedic, size of the pt, potential for violencr or contamination?
• Risk to the public?

Question 4

STEP 2 - Patient Assessment

Answer 4

Complete as much as possible prior to movement to help confirm or deny your thoughts formulated during step 1 - using best judgement

• Complete Vital Signs (are they normal for THIS pt?)
• Assessment of Mentation: GCS and/or LOC X3 (Person, Place, Time) to help determine suitability of ambulation
• History
• Functional Inquiry
• Physical Examination

Question 5

STEP 3 - Patient Conversation

Answer 5

• A discussion w/ the pt about the treatment plan allowing them to be part of the decision making process
• Reminder: in situation the distance to the stretcher is taken into consideration based on the acuity of the pt
• Ethics Framework (JAY Tool)
  depending on the situation , paramedics may need to use this tool

Question 6

STEP 4 - Walk, Minimal Assist, Stretcher

Answer 6

• Walk - self ambulate w/ or w/o an aid
• Minimal Assist - PHSA Safe Handling Standard and FAQ
• See the Staged Approach Standard Operating Procedudre

Question 7

STEP 5

Answer 7

At the Receiving Facility, a reassessment may occur as the pt’s condition and abilities may have changed