- Introduction
- You must assess each patient to detect possible illness or injury and determine the most appropriate emergency care for the patient.
- In this lesson, you will learn how to complete a thorough and methodical patient assessment.
- Patient Assessment—Assessment-Based Care
- Emergency Medical Responders are trained to identify, prioritize, and care for major signs and symptoms.
- A typical patient assessment contains four major components.
- Scene size-up—
- Primary assessment—
- Secondary assessment—
- History—
- Physical exam—
- Reassessment—
- Concerns
- Patient Assessment—Scene Safety
- Patient Assessment—Immediate Life Threats
- The primary assessment is a set of steps meant to detect and correct life-threatening problems.
- Unresponsive medical patient
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- Unresponsive medical patient
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- Trauma patients who have a significant mechanism of injury (MOI)
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- Trauma patients who do not have a significant MOI
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- Scene Size-Up
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- Scene Size-Up—BSI Precautions
- Scene Size-Up—Scene Safety
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- Scene Size-Up—Mechanism of Injury or Nature of Illness
- In most instances, the nature of illness (NOI) will be directly related to the patient’s chief complaint.
- Scene Size-Up—Number of Patients and Need for Additional Resources
- Scene Size-Up—Arrival at the Patient’s Side
- Ask the patient, “May I help you?” Gain consent from the patient to provide care.
- If someone is already providing care to the patient when you arrive, identify yourself as an Emergency Medical Responder.
- Primary Assessment
- The primary assessment is designed to help Emergency Medical Responders detect and correct immediate life threats.
- Seven components of primary assessment
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- Look for life-threatening problems in three main areas (ABCs).
- The Primary Assessment—The General Impression
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- The Primary Assessment—Mental Status
- Categorize the level of responsiveness based on the AVPU scale.
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- Alert—
- Verbal—
- Painful—
- Unresponsive—
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- The Primary Assessment—Airway and Breathing
- The Primary Assessment—Circulation
- Check for a pulse.
- Locate the patient’s larynx.
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- You do not need to determine the exact rate of the pulse.
- Check for serious bleeding.
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- The Primary Assessment—Patient Priority
- The Primary Assessment—Special Considerations for Infants and Children
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- Check capillary refill when assessing an infant’s or child’s circulation.
- The Primary Assessment—Alerting Dispatch
- Include the following information in an update.
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- Secondary Assessment
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- Important terms associated with patient assessment
- Patient history—
- Rapid secondary assessment—
- Focused secondary assessment—
- Vital signs—
- Symptoms—
- Signs—
- Secondary Assessment—The Trauma Patient
- To assess a trauma patient with no significant mechanism of injury
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- To assess a trauma patient with significant mechanism of injury
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- Significant mechanism of injury for an adult
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- Significant mechanisms of injury for a child
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- Secondary Assessment—The Medical Patient
- For the unresponsive medical patient
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- For the responsive medical patient
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- Secondary Assessment—Patient History
- Interviewing the patient
- Questions for patient who is alert
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- Remember to use the acronym SAMPLE to help you (signs/symptoms, allergies, medications, pertinent past medical history, last oral intake, and events leading up to the illness or injury).
- Interviewing bystanders
- Questions to bystanders
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- Secondary Assessment—Vital Signs
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- Use vital signs to determine which patients are a high priority for transport.
- Secondary Assessment—The Physical Exam
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- Rapid secondary assessment—Trauma patient with significant MOI
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- Performing the secondary exam
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- Secondary assessment—Trauma patient with no significant MOI
- Rapid secondary assessment—Unresponsive medical patient
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- Neck—
- Chest—
- Abdomen—
- Pelvis—
- Extremities—
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- Secondary assessment—Responsive medical patient
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- Completing the exam
- Reassessment
- Reassess the patient, watching closely for any changes in his condition (trending).
- When additional EMS providers arrive at the scene, give the responding EMTs a verbal report that includes the following.
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- Define the following terms:
- ABCs
- Brachial pulse:
- BP-DOC:
- Carotid pulse:
- Crepitus:
- Dorsalis Pedal pulse:
- Mechanism of Injury (MOI):
- OPQRST:
- Patient assessment:
- Primary Assessment:
- Rapid Secondary Assessment:
- Scene size-up:
- Trauma Patient:
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