What are the 5 main parts for patient assessment
#NAME?
When do you determine MOI or NOI
during the scene size up
when do you determine the number of patients and request for addition resources if appropriate
before starting any treatment during scene size up
always take what precautions with a patient
C-Spine
6 steps for scene size up
1-BSI
2-Scene Safety
3-MOI or NOI
4-# of patients
5-additional resources?
6-C-Spine Stabilization
how long should a primary assessment take
1-2 min
primary assessment focuses on
life threats
primary assessment includes
#NAME?
What order for ABCs when patient appears lifeless with no pulse
C-A-B because you immediately give CPR
What do we determine in general impression?
#NAME?
In the general impression, what findings indicate unstable patients
#NAME?
Level of Consciousness (LOC): asses for responsiveness
AVPU
A: Awake and Alert
V: Response to Verbal Stimuli
P: Responsive to Pain (Pinch)
U: Unresponsive/Unconscious
Where to test to response to painful stimuli
pinch the earlobe or pinch the neck muscles
What do you do to evaluate a person's ability to remember?
Test of orientation
-Person: what is your name?
-Place: do you know where you are?
-Time: Do you know about wha time of day it is?
-Event: DO you know what happened to you?
Glasgow Coma Scale (GCS)
a scale used to assess the consciousness of a patient upon physical examination, typically in patients with neurological concerns or complaints
GCS eye opening
Spontaneous=4; to speech=3; to pain=2; no response=1
GCS verbal response
5-Oriented
4-Confused conversation
3-Inappropriate words
2-Incomprehensible sounds
1-None
GCS motor response
6-Obeys commands
5-Localizes
4-Withdraws
3-Abnormal flexion (decorticate)
2-Extension response (decerebrate)
1-None
GCS injury
13-15: minor brain injury
9-12: moderate brain injury
3-8: sever brain injury
Asses airway
open/closed
Medical patient = HEAD TILT CHIN LIFT
-clear airway, insert oral/nasal airway as needed
Trauma patient = JAW THRUST
Asses Breathing
#NAME?
Describe what you look for in look, listen and feel
look for chest rise (bilateral) and listen with a stethoscope. By midclavicular feel across clavicle with tips of fingers or back of hands and ask them to take a deep breath
Be prepared to ventilate with an adult patient with less than___ bpm. and when its greater than 30 bpm they may be going into shock
8bpm be prepared to ventilate
30bpm might be going into shock
Asses Circulation
-pulse (presence / absence)
-assess for possible major bleeding
-assess skin color, temperature and condition
-assess capillary refill
How fast should capillary refill for kids be?
less then 2 seconds
Perfusion Status Assessment
skin temperature adults
skin temp and capillary refill children
What nemonic do you use for trauma patients
DCAP-BTLS
what nemonic is used to assess pain in medical
OPQRST
SAMPLE
signs and symptoms
allergies
medications
pertinent past history
last oral intake
events leading to injury
OPQRST
Onset, Provocation, Quality, Region/Radiation, Severity, Timing.
How and what to asses in Head to Toe survey
Inspection-look at the patient for abnormalities
Palpation-touch or feel the patient for abnormalities
Auscultation-listen to the sounds a body makes by using a stethoscope
DCAP-BTLS
deformities, contusions, abrasions, punctures, burns, tenderness, lacerations, swelling
Platinum 10 minutes
The time limit of on-scene care when treating a Patient with trauma or shock
all the parts of a head to toe survey
-head
-face
-neck anterior
-neck posterior
-chest (inspect, palpate, auscultation)
-abdomen (inspect, palpate)
-pelvis (inspect, palpate)
-down the legs
-lower extremities (asses pulse, motor and sensory in each foot)
-upper extremities (down each arm, asses PMS in each hand/fingers)
-posterior
-upper and lower back
-buttocks
-posterior lower extremities
What to do for a trauma patient with no significant MOI or combined critical findings (3)
#NAME?
Other components of the head to toe assessment (4)
#NAME?
head to toe trauma
#NAME?
conjunctiva
Delicate membrane lining the eyelids and covering the eyeball
A pulse may be be palpated in any place that allows an ____________ to be compressed against a _____________
artery to be compressed against a bone
blood pressure is the ________ exerted by circulating _________ upon the walls or _______________
the pressure exerted by circulating blood upon the walls of blood vessels