The Primary Assessment Flashcards
What things do you keep in mind with the primary assessment
• Focus on life threats
• Airway (A), breathing (B), circulation (C) • May vary depending on
– Patient’s condition
– On the scene resources
– Other
• Order of A-B-C depends on initial impression of patient
• Sequence will vary
– A-B-C if patient has signs of life
– C-A-B if patient appears lifeless, no pulse – Immediate interventions may be needed
What are the Primary Assessment Steps
• Forming a general impression • Assessing mental status • Assessing airway • Assessing breathing • Assessing circulation • Determining patient priority
What are the steps in forming a General Impression
• Assesses environment, patient’s chief
complaint, and appearance
• Helps determine patient severity
• Helps set priorities for care and transport
• “Look Test”: feeling from environmental observations as well as first look at patient
What are the findings during a General Impression that indicate the patient may be critical
– Altered mental status – Anxiety – Pale, sweaty skin – Obvious trauma to head, chest, abdomen, pelvis – Specific positions indicating distress
During the general impression if the patient appears lifeless what do you do
– Resuscitate by beginning CPR compressions
– Prepare AED as soon as possible
What do you do while forming a general impression
• Look – Patient’s age, sex, and position • Listen – Moaning, snoring, or gurgling respirations • Smell – Fumes, urine, feces, vomitus, or decay
Chief Complaint
• Patient’s description of why EMS was
called
• May be specific—“abdominal pain” • May be vague—“not feeling good”
What does AVPU stand for
• Alert – Document orientation to person, place, and time • Verbal response • Painful response • Unresponsive
During the primary assessment what are situations that require action
• If airway is not open or is endangered, take measures to open
• Situations calling for breathing assistance
– Respiratory arrest
– Not alert, inadequate breathing
– Some alertness, inadequate breathing
– Adequate breathing, but signs suggesting respiratory distress or hypoxia
How do you assess circulation
- Assess pulse
- Assess skin
- Assess bleeding
What are the three results when assessing pulse
– Within normal limits
– Unusually slow
– Unusually fast
Other than pulse what other indicator is used
• Assessing skin
– Good circulation: warm, pink, dry skin
– Shock: pale, clammy (cool and moist) skin
During the primary assessment what issues require immediate intervention
• Treat any life- threatening ABC problem as soon as discovered!
How do you determine patient priority
• Stable – Vital signs in normal range • Potentially unstable – Potential for deterioration can indicate potentially unstable category • Unstable – Threat to ABC’s rules out stability
How do you determine the need for a priority transport
- Initiate priority transport if a life-threatening problem cannot be controlled or threatens to recur
- Continue assessment and care en route
What characteristic of the Patient determine the form of assessment
– Medical or traumatic problem?
– Altered mental status?
– Child or adult?
What do you need to do when assessing a pediatric patient
• Adjust assessment to social and physiological norms of children
How might normal findings in a primary assessment differ for a child compared with an adult?
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What are the steps of the Primary Assessment
• Despite patient characteristics, follow primary assessment steps systematically
– General impression – Mental status
– ABCs
– Priority for transport
Things to keep in mind for the primary assessment
- Primary assessment is a systematic approach to quickly find and treat immediate threats to life.
- General impression, although subjective, can provide extremely useful information regarding urgency of a patient’s condition.
- Determination of mental status follows the AVPU approach.
- Evaluating airway, breathing, and circulation quickly but thoroughly will reveal immediate threats to life that must be treated before further assessment.
- Patient’s priority describes how urgent patient’s need to be transported is and how to conduct the rest of the assessment.
During the primary assessment remember
• Determine if a problem is medical or
traumatic in nature.
• Determine if a patient is responsive or unresponsive; an adult, child, or infant.
• Rapidly identify the need for immediate airway intervention.
• Determine if the patient’s condition is stable enough to allow further assessment and treatment at the scene.
• What factors will you take into account in
forming a general impression of a patient?
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How should you assess a patient’s mental status with regard to the AVPU levels of responsiveness?
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• How should you assess airway, breathing, and circulation during the primary assessment?
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• What is meant by the term priority decision?
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• A middle-aged male is lying on the street after being hit by a car. He appears unresponsive as you approach. You notice that he is bleeding from a laceration on his forearm and making gurgling sounds from his airway.
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• If you are alone, what factors do you consider in deciding what to do first? Why?
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