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Z- AET 260 > Unit 4 - Assessment > Flashcards

Unit 4 - Assessment Flashcards

1
Q

Keys to knowing the MOI

A

Understand the sport
Know what to look for
Optimal viewpoint
Pay close attention to the field of play

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2
Q

Primary Assessment Steps

A
  • Introduce yourself (gain consent).
  • Spinal Motion Restriction (SMR).
  • Assess:
    ○ Chief Complaint (C/C)
    ○ Level of Responsiveness (LOR)
    ○ Airway
    ○ Breathing / Circulation
  • Pulse oximetry
  • Perform Rapid Body Survey
  • Reassessment (ABCs)
  • EMS & Rapid Transport Decision.
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3
Q

Precautions of a spinal injury

A

○ Unresponsiveness
○ Unknown MOI
○ Fall > 1 m (3.3 ft) or 5 stairs
○ MVC or ejection from motor vehicle
○ Patient’s helmet is broken
○ Severe blunt force to head or trunk
○ Penetration wound to head or trunk
○ Diving accident

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4
Q

Chief Complaint (C/C)

A
  • Always an injury or condition It is not the MOI!
  • Ask the patient “what seems to be the problem?”
  • If the patient is unresponsive, the C/C is unresponsive
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5
Q

Level of Responsiveness (LOR)

A

○ Alert: Eyes are open; patient is able to verbalize
○ Verbal: Patient responds to commands or questions.
○ Painful: Patient exhibits facial grimace; flexion, extension or withdrawal of body part; or moans.
○ Unresponsive: Patient makes no response

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6
Q

Assess Airway (A)

A
  • Responsive Unresponsive
    1. Ask a question & evaluate if the response is clear & unobstructed.
      § If so, they have a clear airway.
  • Unresponsive
    1. Open: grasp the tongue & draw the mandible anteriorly or use cross-finger technique.
    2. Inspect: Look inside for mouth guard, broken or loose teeth, vomit, blood, gum, etc.
    3. Clean: manually or with suction.
    4. Secure: HTCL / JT / OPA / NPA
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7
Q

Assess Breathing (B) & Circulation (C)

A
  1. Look, Listen & Feel
  2. Assess (10 sec) the presence of breathing & circulation simultaneously.
  3. If either are present, include assessment of their quality.
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8
Q

S / S: Abnormal Breathing

A
  • Inadequate rise & fall of the chest.
    ○ Too quiet breathing
  • Increased effort on respiration.
    ○ Loud breathing
  • Decreased LOR.
  • Dyspnea.
    ○ Labored breathing
  • Cyanosis.
    ○ Patient is blue
  • Bradypnea
    ○ Slow breathing
  • Tachypnea.
    ○ Fast Breathing
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9
Q

Pulse Oximetry (Sp02)

A
  • device that measures the % of hemoglobin saturated with oxygen.
  • % of oxygen saturation of blood and pulse
  • neurological, respiratory, cardiovasc complaints
  • abnormal vital signs
  • under effects of respiratory depressants
  • multi system trauma patients
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10
Q

Normal SP02 and treatment

A

95-100%
No treatment

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11
Q

Mild Hypoxia and treatment

A

91-94%
Oxygen via a nasal cannula or simple mask

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12
Q

Moderate Hypoxia and treatment

A

86-90%
Oxygen via a NRM or BVM with oxygen reservoir

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13
Q

Severe Hypoxia and treatment

A

<85%
Oxygen via a NRM or BMV with oxygen reservoir

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14
Q

Rapid Body Servey (RBS)

A
  • Rapid assessment for severe external bleeding, signs of internal bleeding or potential life- threatening fracture. - < 30 sec unless intervention is required.
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15
Q

When should you call EMS?

A

-Decreased LOR or unresponsive.
- Instability / absence of ABCs
- Severe or multi-system trauma
- Neurological deficits
- Internal or external hemorrhage
- Ongoing seizures
-Chest pain (MI suspected)
- Burns with signs of inhalation injury
- Extensive burns
- Abdominal distension & tenderness
- Unstable pelvic injury
- Femoral # (# = fracture)
- Amputation
- Childbirth complications
- Severe hypothermia
- Electrocution
- Decompression illness

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16
Q

Information to Provide EMS Dispatcher

A
  • Location of the emergency.
  • Telephone number from which the call is made.
  • Caller’s name.
  • What happened.
  • Number of casualties.
  • Condition of the casualties.
  • Care being provided.
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17
Q

Secondary Assessment

A
  1. Patient History
    ○ SAMPLE
    ○ PQRST
  2. Vital signs
  3. Physical Assessment
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18
Q

SAMPLE / MAPLES

A

M: medication (kind, dose, last time, why)
A: allergies (what are they? relevant?)
P: past medical history (anything like this? conditions?)
L: last oral intake (when, what, quantity)
E: events leading up
S: signs (objective) and symptoms (subjective)

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19
Q

PQRST

A

Onset (when, how long)
Provoke (what makes it worse/better)
Quality (describe pain: sharp, dull)
Region/Radiation (centralized, radiate)
Severity (how bad? 0-10)
Timing (constant, come and go)

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20
Q

Anatomical Differences in Children

A
  • Tongue – larger
  • Airway – smaller
  • Nose & face – flat
  • Brain tissue – thinner & softer
  • Neck – short
  • Respiratory rate – faster
  • Ribs – more flexible
  • Body surface – larger
  • Bones – softer
  • Skin – thinner
21
Q

7 Vitals in secondary assessment

A
  1. Level of responsiveness (LOR)
  2. Respiration
  3. Pulse
  4. Sp02
  5. Skin characteristics
  6. Blood pressure
  7. Pupils
22
Q

LOR in Secondary Assessment

A
  • Reassess LOR: Glasgow Coma Scale (GCS)
    1. Eye opening.
    2. Best verbal response.
    3. Best motor response.
23
Q

Glasgow Coma Scale (GCS)

A

Max = 15
Mild = 13-15
Moderate 8-12
Severe = <8 - coma

24
Q

Respirations

A
  • Assessing rate, rhythm & volume.
  • “regular, quiet, effortless” shallow, deep, wheezy, laboured, raspy…
  • Rate = 15 sec assessment X4
  • Normal is 12-20
25
Q

Pulse

A
  • Assessing rate, rhythm & quality
  • “regular, strong”
  • Rate = 15 sec assessment X4
  • 1st = carotid, 2nd = brachial
  • moderate hypothermia = 45 sec
  • severe hypothermia = 60 sec
26
Q

Skin Characteristics: Colour, Temperature & Moisture

A
  • Assess with dorsal side of your hand
  • Temperature: Warm? Cool? Hot? Cold?
  • Moisture: Moist? Clammy? Dry?
  • Colour: Flush? Pale? Ashen? Blue? Pink?
27
Q

What Do Abnormal Skin Findings Mean?

A
  • Pale = shock
  • Flushed, red = heat illness, anaphylaxis, hypertension, emotional distress
  • Clammy or moist = shock
  • Hot = heat illness, fever
  • Cool = shock
  • Cold = prolonged cold exposure
28
Q

Reassessing ABC

A

○ q5 min – unstable / life-threat
○ q10 min – stable / no life-threat

29
Q

Blood Pressure (BP)

A

force exerted by blood against blood vessels as it travels through the body
- systolic / diastolic (120mmHg/80mmHg)
- sphygmomanometer and stethoscope

30
Q

palpation method (BP)

A
  • find radial pulse
  • inflate 20mmHg past when pulse disappear
  • slowly release until pulse returns (2mmHg/sec)
31
Q

Estimation method (BP)

A

palpate bilaterally if equipment not accessible (systolic)
- radial 80mmHg
- femoral 70mmHg
- carotid 60 mmHg

32
Q

Pupils

A

PEARL (pupils equal and reactive to light)

33
Q

capillary refill

A

estimates blood flowing through capillaries
- more than 3 sec means impairment to fingertip
- shock, dehydration, hypothermia, vascular disease

34
Q

pulse averages

A

neonate: 120-160
infant: 100-120
child: 80-120
adult: 60-80 bpm

35
Q

respiration averages

A

neonate: 40-60
infant: 30-40
child: 16-24
adult: 12-20 breaths per minute

36
Q

blood pressure averages

A

neonate: 80/40
infant: 80/40
child: 90/50
adult: 120/80mmHg

37
Q

temperature average

A

98.6 F

38
Q

impact of exercise on vitals

A

faster and stronger pulse
faster and deeper breaths
elevated SBP
same DBP
flushed (warm) or gray (cold)
cool with sweat or warm
could be significant sweating

39
Q

physical assessment

A

detect all injuries life threatening
or focused on c/c
- direct patient remain still
- ask them to inform of pain and discomfort
- compare bilaterally

40
Q

SHARP assessment

A

S (swelling)
H (heat)
A (altered function)
R (redness)
P (pain)

41
Q

head and face (Phys Ass)

A
  • integrity of bony structures
  • reassess pupils
  • periauricular or periorbital ecchymosis
  • reassess airway
  • blood, CSF from ears, eyes
  • feel skull
  • load mandible and maxilla
  • grab nose
42
Q

neck (Phys Ass)

A
  • start at C7 and work way up feeling vertebrae and intervertebral disks
  • tracheal deviation
  • jugular distension
43
Q

torso (Phys Ass)

A
  • assess signs of dypsnea
  • load clavicle then wait for breath
  • load sternum
  • assess ribs
  • palpate 4 ab quadrants
44
Q

pelvis (Phys Ass)

A

assess for pulse, motor, sensory
- remove shoes, socks, gloves, etc
-pulse of each extremity
- motor (tell them to move the phalanges)
- sensory (“which toe/finger am i touching?”)

  • reassess ABCs
45
Q

pulse oximetry factors

A

hypoperfusion, shock
hypotension
decreased circulation to extremities
cardiac arrest
finger nail polish
CO poisoning
hypothermia
smokers
edema

46
Q

Eye Opening (Glasgow Coma Scale)

A

Eye-opening /4
- spontaneous = 4
- to voice = 3
- to pain = 2
- no response = 1

47
Q

Verbal Response (GCS)

A

Oriented - 5
Confused conversation - 4
Inappropriate words - 3
Incomprehensible sounds - 2
Nil - 1

48
Q

Motor response (GCS)

A

Z- AET 260 (11 decks)

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