Unit 14, 15 flashcards

Question 1

what is the history of present illness (HPI)?

Answer 1

information gathered regarding symptoms and nature of patient’s current concern

Question 2

What is past medical history (PMH)?

Answer 2

information gathered regarding patient’s health problems in past

Question 3

What is SAMPLE? to learn about the patient’s past medical history.

Answer 3

signs and symptoms, allergies, medications, pertinent past history, last oral intake, and events leading to injury or illness

Question 4

OPQRST to learn about the chief
complaint and history of the present illness/injury.

Answer 4

– Onset
– Provocation
– Quality
– Region; radiation
– Severity
– Time

Question 5

Respiratory Assessment—Physical
Examination

Answer 5

Mental status
Level of respiratory distress
Chest wall motion
Auscultate lung sounds
Use pulse oximetry
Observe edema
Fever

Question 6

Cardiovascular System—History

Answer 6

• Existing cardiac conditions and medications
• Signs and symptoms of episode
• Description of chest pain using O P Q R S T
• Determine specific characteristics of discomfort

Question 7

cardiovascular system examination

Answer 7

1) look for signs condition may be severe
2) obtain pulse
3) obtain blood pressure
4) note pulse pressure
5) look for jungular vein distantion
6) palpate the chest
7) observe

Question 8

nervous system assessment

Answer 8

1) mental status
2) determine their normal state of mental functioning
3) obtain history of neurologic conditions
4) note patients speech

Question 9

nervous system examination

Answer 9

1) perform a stroke scale
2) check peripheral sensation and movement
3) gently palpate the spine
4) check extremity strength
5) check patients
6) examine the patient gait (pattern of walking)

Question 10

The most common endocrine emergency

Answer 10

is the diabetic
patient.

Question 11

Endocrine Assessment—History

Answer 11

• Diabetes mellitus or thyroid disease history
• Current medications and whether being taken properly
• Whether patient has eaten or exerted energy at an unusual level
• Whether patient is sick
• Whether patient has taken blood glucose or uses insulin pump

Question 12

Endocrine Assessment—Physical
Examination

Answer 12

Evaluate patient’s mental status.
Observe the patient’s skin.
Obtain a blood glucose level.
Look for an insulin pump.
Look for medical jewelry.

Question 13

Gastrointestinal System Looking for

Answer 13

– What has gone in
– What has come out
– What it looks like when it comes out

Question 14

Gastrointestinal Assessment—

Answer 14

History
Pain or discomfort (OPQRST)
Oral intake
History of gastrointestinal issues
Vomiting
Bowel movements

Question 15

Gastrointestinal Assessment—
Physical Examination

Answer 15

• Observe patient’s position.
• Assess the abdomen.
• Inspect other parts of the gastrointestinal system.
• Inspect vomitus or feces if available.

Question 16

immune system problem most relevant for EMS

Answer 16

allergic reaction
anaphylaxis

Question 17

Immune System—Physical
Examination

Answer 17

• Inspect point of contact with allergen.
• Inspect patient’s skin for rash or hives.
• Inspect the face, lips, and mouth for swelling.
• Listen to the patient speak.
• Listen to lungs to ensure adequate breathing.

Question 18

Musculoskeletal Assessment—
History

Answer 18

• Prior injuries
• Whether patient takes blood-thinning medication
• Underlying diseases or conditions that make
  fractures more common
• History to determine if a medical problem caused
  the traumatic injury

Question 19

Musculoskeletal Assessment—
Physical Examination

Answer 19

1) inspect for signs of injury, such as deformity
2) palpate areas with suspected injury
3) compare sides for symmetry
4) be alert for crepitation
5) Assess patient head-to-toe if there are multiple injuries or if the patient is unresponsive

Question 20

Crepitation

Answer 20

the grating sound or feeling of broken bones being rubbed together

Question 21

EMT diagnosis

Answer 21

Diagnosis is label for condition.
– Based on history, physical examination, vital signs
– Involves both physical and intellectual activity

Question 22

Diagnosis shortcuts and biases

Answer 22

– Representativeness
– Availability
– Overconfidence
– Confirmation bias
– Illusory correlation
– Anchoring and adjustment
– Search satisfying

Question 23

Secondary Assessment of MEDICAL pateint

Answer 23

• Assessment varies depending on patient’s ability to
  communicate.
  – Responsive medical patient
  ▪ Can answer history questions
  – Unresponsive medical patient
  ▪ Cannot answer history questions

Question 24

Responsive Medical Patient

Answer 24

1) Obtain a patient history.
2) Perform physical exam.
3) Obtain baseline vital signs.
4) Administer interventions and transport the patient.

Question 25

diagnosis

Answer 25

a description or label for a patient’s condition that assist a clinician in further evaluation and treatment

Question 26

differential diagnosis

Answer 26

a list of potential diagnoses compiled early in the assessment of the patient

Question 27

traditional approach to diagnosis in medicine

Answer 27

1) patient assessment (history, physical exam, vital signs, tests)
2) list of possible causes/ diagnoses
3) further evaluation
4) consider results of evaluation
5) narrow the list (may have to consider additional possibilities before reaching diagnosis)

Question 28

emergency approach to diagnosis

Answer 28

1) primary assessment to find and treat immediate threats to life
2) patient assessment (history, physical exam, vital signs, tests) with special attention to looking for red flags
3) consider the most serious conditions associated with the patient’s presentation and rule them in or out (rule out the worst-case scenario)
4) list of possible causes/diagnoses (differential diagnosis)
5) further evaluation in light of time and resources available in the ED
6) consider results of evaluation
7) narrow the list (may have to re-state the chief complaint as the diagnosis)

Question 29

EMS approach to diagnosis

Answer 29

1) primary assessment to find and treat immediate threats to life
2) patient assessment (history, physical exam, vital signs, tests) looking for red flags
simultaneously the EMT begins treatment that may be beneficial and is not harmful ex- oxygen
3) consider the most serious condition associated with the patient’s presentation that can be treated in the field and rule them in or out
4) list of possible causes/ diagnosis
5) further evaluation in light of limited time available and restricted resources present in the field
6) consider results of evaluation
7) narrow the list (may need to restate cheif complaint)

Question 30

representativeness in diagnosis

Answer 30

judging a condition based on symptoms that resemble a particular pattern leading to possible misdiagnosis if a patient doesn’t fit the classic case

Question 31

availability in decision making

Answer 31

tendency to think of diagnoses that are more easily remembered due to recent experiences

Question 32

History of the present illness or injury (HPI) versus past medical history (PMH)

Answer 32

HPI- the story of the current illness
PMH- past medical history

Question 33

primary assesment

Answer 33

initial evaluation focusing on life threatening conditions ABCs: airway, breathing, circulation

Question 34

secondary assessment

Answer 34

more detailed evaluation SAMPLE and head to toe examination

Question 35

confirmation bias

Answer 35

focusing on evidence that supports initial diagnosis and ignoring new evidence for a different condition

Question 36

illusory correlation

Answer 36

believing a relationship exists between two things when in reality there is no actual connection

Question 37

anchoring and adjustment

Answer 37

relying too much on the first piece of evidence and making minor adjustments when new info is presented

Question 38

search satisfying

Answer 38

stopping the search for other issues once an initial problem is found

Question 39

ambiguity importance

Answer 39

emts must be comfy with uncertainty when encountering unknown situations with limited info

Question 40

How do you open an airway in a spinal injury patient?

Answer 40

jaw thrust