Prehospital Emergency Care, Chapter 9, Patient Assessment

Front 1

What is the first component of the patient assessment?

Back 1

scene size-up (p. 241)

Front 2

Marco, a new EMT has ensured that the scene is safe and that the scene has been controlled. He is now prepared to begin the ____________________ ____________________.

Back 2

initial assessment (p. 242)

Front 3

What is the main purpose of the initial assessment?

Back 3

To identify and manage immediately life threatening conditions to the airway, breathing, or circulation. (p. 242)

Front 4

True or false: Any life-threatening condition that is identified must be treated immediately as found--before moving on to the next portion of the initial assessment.

Back 4

True. A life threat found during the initial assessment must be treated immediately after being identified. (p.243)

Front 5

What are the six steps of the initial assessment?

Back 5

1) form a general impression of the patient
2) assess mental status
3) assess airway
4) assess breathing
5) assess circulation
6) establish patient priorities
(p. 243)

Front 6

What are the two main types of trauma?

Back 6

penetrating and blunt force trauma (p. 243)

Front 7

As you form your general impression of the patient, you may categorize the patient as being ______________ or __________________.

Back 7

injured (trauma patient)
ill (medical patient)
(p.246)

Front 8

The _________________ _____________ is the patient's answer to the question, "Why did you call EMS today?"

Back 8

chief complaint (p. 245)

Front 9

You arrive on scene to a patient who has blood flowing steadily from a open stab wound to the chest. Should you place your gloved hand on his chest to stop the bleeding, or continue with the steps of the initial assessment?

Back 9

This is an immediate life threat that needs to be treated before moving through all the steps of the assessment. Place your gloved hand over the wound until your partner can prepare and apply the appropriate dressing--then continue with the steps of the assessment. (p. 246)

Front 10

What technique do you use if you suspect a spinal injury during the assessment?

Back 10

manual in-line stabilization. (p. 247)

Front 11

True or false. If you find the patient in a prone position, you should leave him that way.

Back 11

False. Log roll the patient after a quick assessment (DCAPBTLS) of the anterior.
(p. 247)

Front 12

What does AVPU stand for?

Back 12

A - Alert
V - Responds to Verbal Stimulus
P - Responds to Painful Stimulus
U - Unresponsive

Front 13

In this type of posturing, the patient arches the back and flexes the arms inward.

Back 13

flexion (decorticate) posturing (p. 249)

Front 14

In this type of posturing, the patient arches the back and extends the arms straight out, parallel to the body.

Back 14

extention (decerebrate) posturing
(p. 249)

Front 15

What techique would you use to open the airway of a medical patient?

Back 15

head tilt, chin lift (p. 250)

Front 16

What are four noises that may indicate partial airway obstruction?

Back 16

snoring
gurgling
crowing
stridor (high pitched)
(p. 251)

Front 17

What is the best method to assess breathing?

Back 17

Look, listen, feel
(p.252)

Front 18

What are three key steps to assess breathing?

Back 18

1) determine if breathing is adequate or inadequate
2) if adequate, determine need for 02 therapy
3) if inadequate, provide positive pressure ventilation with supplemental 02

Front 19

What does PENMAN stand for?

Back 19

Personnel/Patient Safety
Environmental Hazards
Number of Patients
Mechanism of Injury
Additional Resources (special equipment)
Need for extrication/spinal mobilization

Front 20

What are four key things should you look for when assessing breathing?

Back 20

Rate
Effort
Tidal Volume
Breath sounds

Front 21

What are four key things should you look for when assessing cirulation?

Back 21

Pulse (rate, rhythm, quality)
Skin - color, temp, moisture
Bleeding
Cap refill

Front 22

A respiratory rate that is too slow is ______________.

Back 22

bradypnea (p. 253)

Front 23

___________ is inadequate oxygen delivered to the tissues.

Back 23

hypoxia (p. 253)

Front 24

True or False: flexion and extension posturing are signs of serious head injury.

Back 24

True (p. 249)

Front 25

A respiratory rate that is too fast is _______________.

Back 25

tachypnea (p. 253)

Front 26

dyspnea means what?

Back 26

difficulty in breathing (p. 254)

Front 27

You take a pulse oximeter reading on a patient, and it reads 92%. Is this patient receiving adequate oxygenation?

Back 27

No. A pulse oximeter reading of 95% or greater is an indicator of adequate breathing. (p. 254)

Front 28

____________ is the sufficient supply of oxygen to the body's cells that results from adequate circulation of blood through the capillaries.

Back 28

perfusion (p. 257)

Front 29

Assess cap refill in infants and childrenless than ____ years of age.

Back 29

6 years of age (p. 257

Front 30

True or false: Cyanosis is an early sign of poor perfusion.

Back 30

False. Cyanosis is a late sign of poor perfusion. (p. 257)

Front 31

What do you do after the initial assessment?

Back 31

Perform a focused history and physical exam. (p. 241)

Front 32

What do you do after you perform a focused history and physical exam?

Back 32

Perform a detailed physical exam (p. 241)

Front 33

What do you do after you perform a detailed physical exam?

Back 33

Perform an ongoing assessment. (p. 241)

Front 34

What's the last step in the patient assessment?

Back 34

communication and documentation (p. 241)

Front 35

What three key steps are completed during the focused history and physical exam?

Back 35

1. Conduct a physical exam
2. Take baseline vital signs
3. Obtain a SAMPLE history (p. 261)

Front 36

What is the treatment for shock?

Back 36

Control any serious bleeding. If possible, splint any bone or join injuries (but only if there's no delay in transport), elevate patient's feet 8-12 inches if no spine injury, apply positive pressure ventiliation with supplemental 02, keep patient warm, immediate transport (p. 258)

Front 37

A patient presents with an extremely high temperature of 104. Should you perform a detailed physical or rapidly transport?

Back 37

rapidly transport (p. 261)

Front 38

True or false. For a trauma patient, you will perform the physical exam and vital signs before the history, because the most significant information about injuries will usually come from the physical exam.

Back 38

True (p. 262)

Front 39

What does SAMPLE stand for?

Back 39

Signs and Symptoms
Allergies
Medications
Pertinent Past History
Last oral intake
Events leading to injury or illness

Front 40

What are the criteria to check if a person is alert and oriented?

Back 40

TIME - Do you know what year, month and day it is?
PLACE - Can you tell me where you are right now?
PERSON - WHo is this with you right now? What is your full name? (p. 267)

Front 41

You check if a person is alert and oriented. He can tell you his name, but he doesn't know where he's at and he can't tell you the date. How would you document this?

Back 41

Alert and oriented X 1 (or A/O X 1) p. 267. If he can answer all three questions then it's A/O X 3)

Front 42

What are the 3 categories used to rank the patient's level of consciousness on the Glascow Coma Scale?

Back 42

Eye Opening
Best Verbal Response
Best Motor Response (p. 267)

Front 43

A GCS score of ____ or less iindicates a severe alteration in brain function.

Back 43

8 or less (p. 269)

Front 44

What does DCAPBTLS stand for?

Back 44

Deformities
Contusions
Abrasions
Punctures/Penetrations
Burns
Tenderness
Lacerations
Swelling

Front 45

You are completing an assessment and notice an extreme shift of the patients trachea. This may be a sign of what?

Back 45

Lung injury with excessive fluid build up in the plueral space (tension pneumothorax)(p. 276)

Front 46

You are performing an assessment and notice that the patient's skin on the neck is bloated and inflated. This is a sign of what?

Back 46

This could be subcutaneous emphysema and indicates there is an air leak somewhere in the respiratory tract, lungs, or esophagus. (p. 277)

Front 47

True or false: It's okay to let go of manual in-line stabilization once the c-collar is applied to the patient.

Back 47

False. Even after the c-collar is applied, in-line spinal stabilization must be maintained until the patient is placed on a backboard. (p. 278)

Front 48

What is paradoxical movement?

Back 48

Paradoxical movement occurs when a section of the chest sinks inward upon inhalation while the rest of the chest is moving outward, and upon exhalation bulges outward while the rest of the chest is moving inward. (p. 278) AKA Flail Segment or Flail Chest when two or more adjacent ribs are fractured in two or more places.

Front 49

What does PMS stand for?

Back 49

Pulse
Motor Function
Sensation (p. 282)

Front 50

What does OPQRST stand for?

Back 50

Onset
Provocation
Quality
Radiation
Severity
Time

Front 51

What are the 3 key steps of the detailed physical exam?

Back 51

1) Perform the detailed physical exam
2) Reassess the vital signs
3) Continue emergency care

Front 52

What are the 5 key steps of the ongoing assessment?

Back 52

1) repeat initial assessment
2) Reassess and record vital signs
3) Repeat the focused assessment for other complaints or injuries
4) check interventions
5) note trends in the patient's condition (p. 321)

Front 53

What is orthopnea?

Back 53

Shortness of breath while lying flat. (p. 293)

Front 54

An AED can be used on a child, as long as he or she is ____ year old.

Back 54

1 year old.

Front 55

If a ______________ pulse is palpable, the systolic pressure is at least 60 mmHg.

Back 55

radial

Front 56

true or false: Sluggish pupils may indicate an inadequate oxygen supply.

Back 56

True

Front 57

When assessing the chest, you should inspect it for adequate rise and fall, and auscultate breath sounds where?

Back 57

At the midclavicular line and at the 4th or 5th intercostal space, midaxillary line.

Front 58

The mnemonic for remembering the questions to ask when assessing the patient's chief complain or major symptoms is _____________?

Back 58

OPQRST

Front 59

The "R" in OPQRST stands for what?

Back 59

Radiation (radiating pain)

Front 60

The "S" in OPQRST stands for what?

Back 60

Severity

Front 61

True or false: Our exhaled breath is 16% oxygen.

Back 61

True.

Front 62

True or False: No matter what its size, an oxygen tank is full at a pressure of 2,000 psi.

Back 62

True.

Front 63

True or False: Nail polish will not adversely affect the accuracy of a pulse oximeter reading.

Back 63

False.