Chapter 12 Pt Assessment In The Field

Front 1

Components of a Pt Assessment

Back 1

Scene size up
Primary Assessment
Secondary Assessment
Detailed physical Exam
Reassessment

Front 2

Life-support activities that go beyond basic procedures to include adjunctive equipment and invasive procedures?

Back 2

Advanced life support (ALS)

Front 3

The primary assessments goal is to do what?

Back 3

Identify and correct immediately life threatening conditions

Front 4

People such as unresponsive medical pt and unstable trauma pt require what?

Back 4

Rapid head to toe exam and immediate transport to hospital.

Front 5

Never rush into any situation, first do what?

Back 5

Stop and look around

Front 6

Standard precautions
Scene safety
Location of all patients
Mechanism of injury
Nature of illness

Back 6

Components of a Scene Size-Up

Front 7

Best way to prevent transmitting disease between you and your patients.

Back 7

Washing hands

Front 8

With a TB pt, place a surgical type mask on pt and you wear what?

Back 8

Niosh approved respirator

Front 9

In order,
1. you
2. your crew
3. other responding personnel
4. your pt
5.bystanders

Back 9

Order of priorities for Scene Safety

Front 10

Listen to what because they are probably correct

Back 10

Instincts

Front 11

In every case, let ____ ___ dictate scene management?

Back 11

Common Sense

Front 12

Do not even consider entering hazardous scenes unless you have what?

Back 12

Proper equipment, training and clothing

Front 13

Four point suspension helmet
Eye goggles
Hearing protection
Leather work gloves
Steel toe boots
Insulated coveralls and
Turnout gear are all necessary for what?

Back 13

Having the minimum amount of gear for a Rescue-Operation
pg 658

Front 14

Call for assistance early, It is wise to ______ when asking for help?

Back 14

Overestimate

Front 15

Who is in charge of a Mass casualty incident?

Back 15

Incident Commander

Front 16

What is the combined strength, direction, and nature of forces that injured you patient?

Back 16

Mechanism of Injury

Front 17

The anticipation of possible injuries based on your analysis of the event?

Back 17

Index of suspicion

Front 18

What is usually the only clue to internal injuries?

Back 18

Mechanism of injury

Front 19

Steps of Primary Assessment are?

Back 19

1. Form general impression
2. Cspine as needed
3. Baseline level of response
4. Assess airway
5. Assess Breathing
6. Assess Circulation
7. Assign priority
pg 663

Front 20

Primary assessment should take how long?

Back 20

1 minute

Front 21

Your initial, intuitive evaluation of your patient?

Back 21

General impression

Front 22

Manually stabilize the neck when?

Back 22

On first patient contact

Front 23

AVPU means?

Back 23

Alert
Verbal
Painful
Unresponsive
pg 665

Front 24

This is crucial to assess any head trauma?

Back 24

Baseline mental status

Front 25

What do you place under the shoulders of a young person to align the airway?

Back 25

A folded towel

Front 26

Your pt is sleepy but responds to you when you speak to the, What AVPU level are they?

Back 26

Verbal

Front 27

Gurgling suggests what?

Back 27

Fluids blocking the upper airway

Front 28

Decorticate posturing and decerebrate posturing are both part of AVPU where?

Back 28

Painful stimulus

Front 29

Decorticate posturing is what position?

Back 29

Arms flexed, legs extended

Front 30

Decerebrate posturing is what position and indicates what?

Back 30

Arms and legs extended, suggests serious brain injury

Front 31

You hear stridor and notice poor air movement suspecting foreign body obstruction, first use abdominal thrusts(back blows for children under 1 year) what is the next step if not successful?

Back 31

Laryngoscopy with magill forceps

Front 32

Deep rapid breathing associated with diabetic coma are called?

Back 32

Kussmaul's respirations

Front 33

Evaluating the pulse and skin and controlling hemorrahage?

Back 33

Circulation assessment

Front 34

Radial pulse indicates a systolic BP of what number?

Back 34

At least 80 mmHg

Front 35

What provides important information about circulation in young children?

Back 35

Capillary Refill

Front 36

Secondary assessment is what stage of pt assessment?

Back 36

Second

Front 37

Problem-oriented assessment process based on primary assessment and chief complaint?

Back 37

Secondary assessment

Front 38

Person who has suffered a significant machanism of injury?

Back 38

Major trauma pt

Front 39

Signs of a major trauma are?

Back 39

Falls from higher then 20 feet
Ejection from a vehicle
Rollover of a vehicle
High speed accident with severe deformity
Vehicle-pedestrian collision
Motorcycle crash
Penetration of head, chest or abdomen

Front 40

Quick check for signs of serious life threatening injuries.

Back 40

Rapid Secondary Assessment

675

Front 41

5 areas of concern during rapid secondary assessment.

Back 41

Head
Neck
Chest
Abdomen
Pelvis

675

Front 42

DCAP-BTLS stands for:

Back 42

Deformities
Contusions
Abrasions
Penetration
Burns
Tenderness
Lacerations
Swelling

676

Front 43

What angle should you have the feet in semi-fowler's position?

Back 43

45

676

Front 44

Crackling sensation caused by air just underneath the skin.

Back 44

Subcutaneous Emphysema

676

Front 45

When assessing the neck, the ___ ___ can be an indication of a possible air embolism or hypovolemia?

Back 45

Jugular veins

676

Front 46

Most commonly fractured bone in the body?

Back 46

Clavicle

678

Front 47

T to F: A flail segment is can be seen immediately?

Back 47

False
Muscles fatigue and then paradoxial movement is seen.

678

Front 48

What type of dressing for an open chest wound?

Back 48

Occlusive dressing with vasoline base
Book says 3 sides
Field covers all 4

678

Front 49

Tracheal deviation is a ___ sign on a tension pneumothorax.

Back 49

Late sign

678

Front 50

Bruising over the umbilicus?

Back 50

Cullen's sign

678

Front 51

Sticking a large bore catheter into pleural space at the 2nd intercostal space of the tip of the rib, midclavicular, allowing trapped air out is known as:

Back 51

Needle decompression

678

Front 52

Bruising over the flanks?

Back 52

Grey Turner's sign

678

Front 53

If PT has bleeding in abdomen leading to irritation of the peritoneum, when palpated, PT will feel pain on the ___?

Back 53

Rebound of palpation

680

Front 54

4 parts to baseline vitals:

Back 54

Pulse rate and quality
BP
Resp rate and quality
Skin Temp and cond

682

Front 55

SAMPLE:

Back 55

Symptoms
Allergies
Medications
Past Med Hx
Last Oral Intake
Events leading up

682

Front 56

T or F:
You do not have to perform a systemic assessment for an isolated injury.

Back 56

T

682

Front 57

___ takes precedence over the physical exam.

Back 57

History

683

Front 58

4 parts of History:

Back 58

Chief Complaint
Hx of present illness
Past Hx
Current Health status

684

Front 59

OPQRST-ASPN

Back 59

Onset
Provocation
Quality
Radiation
Severity
Time
Associated Symptoms
Pertinent Negatives

684

Front 60

HEENT:

Back 60

Head
Eyes
Ears
Nose
Throat

685

Front 61

Distention beyond __% of the Jugular veins indicates a serious concern.

Back 61

45

685

Front 62

Prolonged inspiratory phase denotes:

Back 62

Upper airway obstruction

686

Front 63

Prolonged expiratory phase denotes:

Back 63

Lower airway obstruction

686

Front 64

The point of maximum impulse (PMI) is located at the ___ intercostal space near the midclavicular line.

Back 64

5th

686

Front 65

PT's P will increase 10-20 beats, while their BP will drop 10-20 if ___ is found positive.

Back 65

Tilt test (orthostatic vitals)

688

Front 66

3 steps to assessing unresponsive PT:

Back 66

Primary assessment
Rapid secondary
Brief Hx

690

Front 67

Careful, thorough process of eliciting the Hx and conducting a physical exam.

Back 67

Detailed Physical Exam

692

Front 68

Black and blue discoloration surrounding the eye sockets.

Back 68

Periorbital ecchymosis (Raccoon's Eyes)

692

Front 69

Black and blue over mastoid process.

Back 69

Battle's sign

692

Front 70

Bilaterally sluggish pupils usually indicates?

Back 70

Decreased Cerebral Perfusion and hypoxia.

692

Front 71

Fixed and dilated pupils indicate severe:

Back 71

Cerebral anoxia

692

Front 72

2 of the more common causes leading to unequaled pupils are:

Back 72

Meningitis and Intracranial pressure

692

Front 73

CSF from the ears is a sign of:

Back 73

Basilar skull fracture

693

Front 74

Infants less than __ months are nose breathers?

Back 74

3

693

Front 75

___ ___ is an ominous sign of central circulatory hypoxia.

Back 75

Lip cyanosis

693

Front 76

When checking for JVD have the PT sit at an __% incline.

Back 76

45

693

Front 77

When percussing the chest, if their is hyperresonant sound then the chest may be filled with:

Back 77

Air (pneumothorax)

693

Front 78

When percussing the chest, if there is hyporesonant sound then the chest may be filled with:

Back 78

Blood (hemothroax)

693

Front 79

Priapisms are usually caused by:

Back 79

Spinal injury

696

Front 80

T or F: When dealing with a rape victim the most important treatment is checking for bleeding and trauma?

Back 80

F (Emotional support is best treatment)

696

Front 81

3 keys to reassessment:

Back 81

Detect Trends
Determines changes
Assess intervention effects

698

Front 82

3 areas of concern when reassessing as it pertains to specific PTs:

Back 82

Mental status
ABCs
Areas already compromised

698