Chapter 8 Assessing The Patient

Front 1

Scene Size-Up

Back 1

1. BSI
2. Scene Safety
3. Consider MOI / NOI
4. Determine the # of patients
5. Do you need help (fire fighters, cops, ambulance)
6. C-Spine Immobilization

Front 2

Scene Safety Incudes

Back 2

- oncoming traffic
- unstable surfaces
- leaking fluids and fumes
- broken utility poles and downed electrical wires
- hostile bystanders
- smoke or fire
- hazardous/toxic material
- violence and crime scenes

Front 3

Initial Assessment

Back 3

1. Approach and Form a General Impression
2. Assess mental status
3. Assess the airway
4. Assess breathing
5. Assess circulation
6. identify priority patient and make transport decision

Front 4

Assessing Mental Status

Back 4

AVPU, Person- who they are, Place- where they are, Time- what year/time is, Event- what happened (MOI/NOI)

Front 5

Assessing the Airways

Back 5

Check for:
dyspnea, use of accessory muscles nasal-flaring, and labored breathing

Front 6

Dyspnea

Back 6

a patient who can only speak two or three words without pausing to take a breath

Front 7

Nasal Flaring

Back 7

(also know as see-saw breathing)
in pediatric patients indicates inadequate breathing

Front 8

Assessing Breathing

Back 8

Check for:
choking, rate, depth, lung sounds, air movement

Front 9

Pulse Rate

Back 9

Infant (1month-1) 100-160
Toddler (1-3) 90-150
Pre-schooler (3-6) 80-140
school-age (6-12) 70-120
Adolescent (12-18) 60-100

Front 10

Asessing Circulation

Back 10

1. Pulse
2. Assess and Control External Bleeding
3. Skin

Front 11

How to Control External Bleeding
(Assessing Circulation)

Back 11

1. Direct Pressure
2. Elevation
3. Pressure Points

Front 12

Assessing the Skin
(Assessing Circulation)

Back 12

1. skin color- capillary refill, conjunctiva and sclera color, cyanosis

2. Temperature- cool/clammy

3. Condition

4. Capillary Refill- should only take 2 seconds

Front 13

IPA

Back 13

Inspect Palpatate Auscultate

Front 14

Ongoing Assessment

Back 14

- reassess mental status
- maintain an open airway
- monitor the patients breathing
- reassess pulse rate and quality
- monitor skin color and temperature
- reestablish patient priorities
- reassess and record vital signs
- repeat focused assessment
check interventions
- ensure adequacy of oxygen delivery/articifial ventilation
- ensure management of bleeding
- ensure adequacy of other interventions

1. Repeat the initial assessment
2. Reassess and record vital signs
3. repeat the focused assessment
4. check intervention

Front 15

PATIENT ASSESSMENT

Back 15

1. Scene Size-up
2. Intial Assessment
3. MOI- focused history and physical exams followed by detailed physical exam, NOI- focused history and physical exam
4. Ongoing Assessment

Front 16

Stridor

Back 16

a harsh, high-pitched inspiratory sound that is often heard in acute laryngeal (upper airway) obstructions; may sounds like crowing and be audible without a stethoscope

Front 17

guarding

Back 17

involuntary muscle contractions (spasm) of the abdominal wall in an effort to protect the inflamed abdomen

Front 18

crepitus

Back 18

a grating ir 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

Front 19

DCAP-BTLS

Back 19

Deformities
Contusions
Abrasions
Punctures/penetrations
Burns
Tenderness
Lacerations
Swelling

Front 20

Rales

Back 20

crackling, rattling, breath sound that signals fluid in the air spaces of the lungs; also called crackles

Front 21

rhonchi

Back 21

coarse, low-pitched breath sounds heard in patients with chronic mucus in the upper airways