Accessory muscles
The secondary muscles of respiration. They include the neck muscles (sternocleidomastoids), the chest pectoralis major muscles, and the abdominal muscles.
Auscultate
To listen to sounds within an organ with a stethoscope.
AVPU scale
A method of assessing the level of consciousness by determining whether the patient is awake and alert, responsive to verbal stimuli or pain, or unresponsive; used principally early in the assessment process.
Blood pressure
The pressure of circulating blood against the walls of the arteries.
Bradycardia
A slow heart rate, less than 60 beats/min.
Breath sounds
An indication of air movement in the lungs, usually assessed with a stethoscope.
Capillary refill
A test that evaluates distal circulatory system function by squeezing (blanching) blood from an area such as a nail bed and watching the speed of its return after releasing the pressure.
Capnography
A noninvasive method that can quickly and efficiently provide information on a patient's ventilatory status, circulation, and metobolism.
Carbon dioxide
Carbon dioxide is a component of air and typically makes up 0.3% of air at sea level. It is also a waste product exhaled during expiration by the respiratory system.
Chief complaint
The reason a patient called for help.
Coagulate
To form a clot to plug an opening in an injured blood vessel and stop bleeding.
Colorimetric devices
Capnometer or end-tidal carbon dioxide detectors are devices that use a chemical reaction to detect the amount of carbon dioxide present in expired gases by changing colors.
Conjunctiva
The delicate membrane that lines the eyelids and covers the exposed surface of the eye.
Crepitus
A grating or grinding sensation caused by fractured bone ends or joints rubbing together; also air bubbles under the skin that produce a crackling sound or crinkly feeling.
Cyanosis
A bluish gray skin color that is caused by a reduced level of oxygen in the blood.
DCAP-BTLS
A mnemonic for assessment in which each area of the body is evaluated for Deformities, Contusions, Abrasions, Punctures/penetrations, Burns, Tenderness, Lacerations, and Swelling.
Diaphoretic
Characterized by profuse sweating.
Diastolic pressure
The pressure that remains in the arteries during the relaxing phase of the heart's cycle when the left ventricle is at rest.
End-tidal CO2
The amount of carbon dioxide present in exhaled breath.
Focused assessment
A type of physical assessment that is typically performed on patients who have sustained nonsignificant mechanisms of injury or on responsive medical patients. This type of examination is based on the chief complaint and focuses on one body system or part
Frostbite
Damage to tissues as the result of exposure to cold.
Full-body scan
A systematic head-to-toe examination that is performed during the secondary assessment on a patient who has sustained a significant mechanism of injury, is unconscious, or is in critical condition.
General impression
The overall initial impression that determines the priority for patient care; based on the patient's surroundings, the mechanism of injury, signs and symptoms, and the chief complaint.
Golden Period
The time from injury to definitive care, during which treatment of shock and traumatic injuries should occur because survival potential is best.
Guarding
Involuntary muscle contractions (spasms) of the abdominal wall in an effort to protect an inflamed abdomen; a sign of peritonitis.
History taking
A step within the patient assessment process that provides detail about the patient's chief complaint and an account of the patient's signs and symptoms.
Hypertension
Blood pressure that is higher than the normal range.
Hypotension
Blood pressure that is lower than the normal range.
Hypothermia
A condition in which the internal body temperature falls below 95 degrees F after exposure to a cold environment.
Incident command system
A system implemented to manage disasters and mass and multiple causality incidents in which section chiefs, including finance, logistics, operations, and planning, report to the incident commander.
Jaundice
Yellow skin or sclera that is caused by liver disease or dysfunction.
Labored breathing
Breathing that requires visibly increased effort; characterized by grunting, stridor, and use of accessory muslces
Mechanism of injury (MOI)
The way in which traumatic injuries occur; the forces that act on the body to cause damage.
Nasal flaring
Flaring out of the nostrils, indicating that there is an airway obstruction.
Nature of illness (NOI)
The general type of illness a patient is experiencing.
OPQRST
An abbreviation for key terms used in evaluating a patient's pain: Onset, Provocation or Palliation, Quality, Region/radiation, Severity, and Timing of pain.
Orientation
The mental status of a patient as measured by memory of person (name), place (current location), time (current year, month, and appropriate date), and event (what happened).
Palpate
To examine by touch.
Paradoxical motion
The motion of the chest wall section that is detached in a flail chest.
Perfusion
Circulation of blood within an organ or tissue.
Personal protective equipment (PPE)
Clothing, or specialized equipment that provides protection to the wearer.
Pertinent negatives
Negative findings that warrant no are or intervention.
Primary assessment
A step within the patient assessment process that identifies and initiates treatment of immediate and potential life threats.
Pulse
The pressure wave that occurs as each heartbeat causes a surge in the blood circulating through the arteries.
Pulse oximetery
An assessment tool that measures oxygen saturation of hemoglobin in the capillary beds.
Rales
A crackling, rattling breath sound that signals fluid in the air spaces of the lungs; also called crackles.
Reassessment
A step within the patient assessment process that is performed at regular intervals during the assessment process. Its purpose is to identify and treat changes in a patient's condition.
Responsiveness
The way in which a patient responds to external stimuli, including verbal stimuli (sound), tactile stimuli (touch), and painful stimuli.
Retractions
Movements in which the skin pulls in around the ribs during inspiration.
Rhonchi
Coarse, low-pitched breath sounds heard in patients with chronic mucus in the upper airways.
SAMPLE history
A brief history of a patient's condition to determine signs and symptoms, allergies, medications, pertinent past history, last oral intake, and events leading to the injury or illness.
Scene size-up
A step within the patient assessment process that involves a quick assessment of the scene and the surroundings to provide information about the scene safety and the mechanism of injury or nature of illness before you enter and begin patient care.
Sclera
The white portion of the eye.
Secondary assessment
A step within the patient assessment process in which a systematic physical examination of the patient is performed.
Shallow respirations
Respirations that are characterized by little movement of the chest wall (reduced tidal volume) or poor chest excursion.
Sign
Objective findings that can be seen, heard, felt, smelled, or measured.
Sniffing position
An upright position in which the patient's head and chin are thrust slightly forward to keep the airway open.
Spontaneous respirations
Breathing that occurs with no assistance.
Standard precautions
Protective measures that have traditionally been developed by the Centers for Disease Control and Prevention for use in dealing with objects, blood, body fluids, and other potential exposure risks of communicable disease.
Stridor
A harsh, high-pitched, crowing respiratory sound, such as the sound often heard in acute laryngeal (upper airway) obstruction; may sound like crowing and be audible without a stethoscope.
Subcutaneous emphysema
The presence of air in soft tissues, causing a characteristic crackling sensation on palpation.
Symptom
Subjective findings that the patient feels but that can be identified only by the patient.
Systolic pressure
The increased pressure in an artery with each contraction of the ventricles (systole).
Tachycardia
A rapid heart rate, more than 100 beats/min.
Tidal volume
The amount of air (in milliliters) that is moved in or out of the lungs during one breath.
Triage
The process of establishing treatment and transportation priorities according to severity of injury and medical need.
Tripod position
An upright position in which the patient leans forward onto two arms stretched forward and thrusts the head and chin forward.
Two to three word dyspnea
A severe breathing problem in which a patient can speak only two to three words at a time without pausing to take a breath.
Vasoconstriction
Narrowing of a blood vessel.
Vital signs
The key signs that are used to evaluate the patient's overall condition, including respirations, pulse, blood pressure, level on consciousness, and skin characteristics.
Quality
What does the pain feel like?
Timing
How long have you had the pain?
Medications
Are you taking any medications?
Last oral intake
Did you eat this morning?
Provocation/palliation
Does anything make the pain feel better or worse?
Severity
On a scale of 1 to 10, how do you rate your pain?
Events leading up to illness
What were you doing before this happened?
Allergies
What type of reaction do you have when you take medication?
Region/radiation
Does the pain move anywhere?
Onset
When did the problem begin?
Signs and symptoms
Does your chest hurt?
Past medical history
Have you been recently ill?
The scene size-up consists of all of the following EXCEPT:
A. determining the mechanism of injury
B. requesting additional assistance
C. determining level of consciousness
D. personal protective equipment (PPE)/standard precautions
Determining level on consciousness.
Your primary safety concern is for:
Yourself.
With ___________, the force of the injury occurs over a broad area, and the skin is usually not broken.
Blunt trauma.
With _________________, the force of the injury occurs at a small point of contact between the skin and the object piercing the skin.
Penetrating trauma.
____________ is the measure of the amount of air that is moved into and out of the lungs in one breath.
Tidal volume.
The physical examination consists of all of the following EXCEPT:
A. puncture
B. inspection
C. palpation
D. auscultation
Puncture.
When determining the initial general impression, you should note all of the following EXCEPT:
A. the patient's age
B. the level of distress
C. the events leading up to the incident
D. the patient's sex
The events leading up to the incident.
When considering the need for additional resources, which of the following is NOT a question you should ask?
A. how many patients are there?
B. is it raining?
C. who contacted EMS?
D. does the scene pose a threat to you or your patient's safety?
Is it raining.
The primary assessment includes evaluation of all of the following EXCEPT:
A. mental status
B. pupils
C. airway
D. circulation
Pupils.
The best indicator of brain function is the patient's:
Mental status.
What does the "P" on the AVPU scale represent?
Responsive to pain.
A normal respiratory rate for an adult is typically:
12 to 20 breaths/min.
For children younger than 1 year old, you should palpate the ________ artery when assessing the pulse.
Brachial.
The automated external defibrillator (AED) should be used on pediatric medical patients who are at least ___ year(s) old and have been assessed to be unresponsive, apneic, and pulseless.
1
When there are low levels of oxygen in the blood, the lips and mucous membranes appear blue or gray. This condition is called:
Cyanosis.
Your first consideration when assessing a pulse is to determine:
If one is present.
To obtain the pulse rate in most patients, you should count the number of pulses felt in a ________ period and the multiple by two.
30-second.
In deeply pigmented skin, you should look for changes in color in areas of the skin that have less pigment, including:
The sclera, the conjunctiva, and the mucous membranes of the mouth.
All of the following are conditions not related to the body's circulation that may slow capillary refill EXCEPT
A. local circulatory compromise
B. hypothermia
C. age
D. abdominal pain
Abdominal pain.
Which of the following is NOT considered a method for controlling external bleeding?
A. direct pressure
B. tourniquet
C. cold water
D. elevation
Cold water.
The ______________ is/are the most serious thing that the patient is concerned about; the reason why they called 9-1-1.
Chief complaint.
The four items used to assess the orientation of a patient's mental status include all of the following EXCEPT:
A. person
B. place
C. history
D. events
History.
An integral part of the rapid scan is evaluation using the mnemonic:
DCAP-BTLS.
In the absence of light, the pupils will:
Dilate.
_______ cause the pupils to constrict to a pinpoint.
Opiates.
When assessing breathing, you should obtain all of the following EXCEPT:
A. respiratory rate
B. depth of breathing
C. quality/character of breathing
D. breath odor
Breath odor.
Which of the following statements regarding assessment of the airway is TRUE?
A. the body will not be supplied the necessary oxygen if the airway is not managed
B. you should use the head tilt-chin lift maneuver to open the airway in trauma patients
C. th
The body will not be supplied the necessary oxygen if the airway is not managed.
Which of the following is NOT considered a type of breath sound?
A. rhonchi
B. vibration
C. wheeze
D. stridor
Vibration
The MOST important thing to consider in patients with multiple injuries in various stages of healing is that:
The patient might be a victim of abuse.
Which of the following questions should you ask yourself when dealing with a patient who is not answering.
A. is the patient hungry?
B. is there a language problem?
C. is the patient tired?
D. is the patient angry with me?
Is there a language problem.
_______________ is an assessment tool used ti evaluate the effectiveness of oxygenation.
Pulse oximetry.
The pressure felt along the wall of the artery when the ventricles of the heart contract is referred to as the:
Systolic pressure.
A blood pressure cuff that's too large for the patient:
May result in a falsely low reading.
When examining the abdomen, you should palpate for all of the following EXCEPT:
A. guarding
B. crepitation
C. tenderness
D. rigidity
Crepitation.
Crackling sounds produced by air bubbles under the skin are know as:
Subcutaneous emphysema.
Unstable patients should be reassessed every ___ minutes.
5
In the ______ position, the patient sits leaning forward on outstretched arms with the head and chin thrust slightly forward.
Tripod.
In an unresponsive adult patient, the primary location to assess the pulse is the ______ artery.
Carotid.
Liver disease or dysfunction may cause ________, resulting in the patient's skin and sclera turning yellow.
Jaundice.
When obtaining a blood pressure by palpation in the arm, you should place your fingertips on the _______ artery.
Radial.
The first set of vital signs that you obtain is called the:
Baseline vital signs.
Which of the following is NOT considered a sign?
A. dizziness
B. marked deformities
C. external bleeding
D. wounds
Dizziness.
When blood pressure drops, the body compensates to maintain perfusion to the vital organs by:
Decreasing the blood flow to the skin and extremities.
When assessing and treating a patient who is visually impaired, it is important that you do all of the following EXCEPT:
A. speak loudly into the person's ear, because he or she can't see you
B. announce yourself when entering the residence
C. put items t
Speak loudly into the person's ear, because he or she can's see you.
Which of the following statements is FALSE regarding the assessment of patients with a language barrier?
A. you should find an interpreter
B. determine whether the patient understands you
C. questioning should be lengthy and complex
D. be aware of the lan
Questions should be lengthy and complex.
Which of the following is an example of a symptom?
A. cyanosis
B. tachycardia
C. headache
D. hypertension
Headache.
Which of the following actions would NOT be performed during the scene size-up?
A. rapidly assessing a patient's respiratory status
B. notifying the dispatcher to send fire personnel
C. noting the position of a crashed motor vehicle
D. asking a neighbor t
Rapidly assessing a patient's respiratory status.
Which of the following statements regarding the mechanism of injury (MOI) is correct?
A. a significant MOI always results in patient death or permanent disability
B. the exact location of a patient's injuries can be determined by the MOI
C. the MOI may al
The MOI may allow you to predict the severity of a patient's injuries.
The goal of the primary assessment is to:
Identify and rapidly treat all life-threatening conditions.
Observations made when forming a general impression of a patient would include all of the following, EXCEPT:
A. appearance
B. pulse strength
C. level of distress
D. race and gender
Pulse strength.
A 29-year-old male with a head injury opens his eyes when you speak to him, is confused as to the time and date, and is able to move all of his extremities on command. His Glasgow Coma Scale (GCS) score is:
13
Which of the following findings indicates that your patient has a patent airway?
A. inspiratory stridor
B. unresponsiveness
C. forceful coughing
D. audible breathing
Forceful coughing.
Typical methods of assessing a patient's breathing include all of the following, EXCEPT:
A. listening to breath sounds with a stethoscope
B. observing the chest for adequate rise and fall
C. observing for nasal flaring during inhalation
D. quickly scannin
Observing for nasal flaring during inhalation.
Clinical signs of labored breathing include all of the following, EXCEPT:
A. shallow chest movement
B. use of accessory muscles
C. gasping attempts to breathe
D. supraclavicular retractions
Shallow chest movements.
During the primary assessment, circulation is evaluated by assessing:
Pulse quality, external bleeding, and skin condition.
If you cannot palpate a pulse in an unresponsive patient, you should:
Immediately begin cardiopulmonary resuscitation (CPR).
In the adult, bradycardia is defined as a pulse rate less than ____ beats/min, and tachycardia is defined as a heart rate greater than _____ beats/min.
60,100
In patients with deeply pigmented skin, changes in color may be apparent only in certain areas, such as the:
Lips or oral mucosa.
After performing a primary assessment, a rapid scan of the body should be performed in order to:
Identify less obvious injuries that require immediate treatment.
Which of the following situations or conditions warrants immediate transport?
A. decreased ability to move an extremity
B. severe chest pain and cool, pale skin
C. responsiveness and ability to follow commands
D. mild pain in the lower abdomen
Severe chest pain and cool, pale skin.
An unstable patient should be reassessed at least every:
5 minutes.
The chief complaint is MOST accurately defines as the:
Most serious thing the patient is concerned about.
Which of the following questions would you ask a patient to ascertain the "M" in the SAMPLE history?
A. "when was the last time you ate a meal?"
B. "have you ever had any major surgeries?"
C. how much Tylenol do you take each day?"
D. "how long have you h
How much Tylenol do you take each day?
Pain that moves from its point of origin to another body location is said to be:
Radiating.
The pulse oximeter is an assessment tool used to evaluate the:
Effectiveness of oxygenation.
The goal of the full-body scan that is performed during the secondary assessment is to:
Locate injuries not found in the primary assessment.
A full-body scan should be performed on:
Patients with a significant MOI and unresponsive medical patients.
When you use the palpation method to obtain a blood pressure, the measurement you obtain is the:
Systolic blood pressure.
When performing a reassessment of your patient, you should first:
Repeat the primary assessment.
Which of the following statements regarding the mechanism of injury (MOI) is correct?
A. a nonsignificant MOI rules out the possibility of serious trauma
B. the MOI may allow you to predict the severity of a patient's injuries
C. the exact location of a p
The MOI may allow you to predict the severity of a patient's injuries.
The MOST effective way to determine whether your patient's problem is medical or traumatic in origin is to:
Perform a careful and thorough assessment.
When approaching a 32-year-old male who is complaining of traumatic neck pain, you should:
Ensure that the patient can see you approaching.
External bleeding from an extremity can usually be controlled by a combination of:
Direct pressure and elevation.
When performing a full-body scan on a supine patient, what part of the body is typically assessed last?
Posterior.
After the first 60 minutes of experiencing a significant injury:
The body's ability to compensate for shock decreases.
When performing a full-body scan on a trauma patient, you note the presence of Battle's sign. This is defined as:
Bruising behind the ear.
A crackling sound produced by air bubbles under the skin is called.
Subcutaneous emphysema.
Jugular venous distention suggests a problem with blood returning to the heart if the patient is:
Sitting up at a 45� angle.
Which of the following MOST accurately describes paradoxical movement of the chest wall?
A. only one section of the chest rises on inspiration while another area falls
B. one side of the chest wall moves opposite the direction of the other
C. multiple rib
Only one section of the chest rises on inspiration while another area falls.