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47 Cards in this Set
- Front
- Back
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Problem-oriented evaluation of patient and establishment of priorities based on existing and potential threats to human life.
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Patient assessment
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Components of Patient Assessment
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- Scene size up
- Initial assessment - Focused history and physical exam - Ongoing assessment - Detailed physical exam |
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Life-support activities that go beyond basic procedures to include adjunctive equipment and invasive procedures.
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Advanced life support (ALS)
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Components of Scene Size-Up
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- Body substance isolation
- Scene safety - Location of all patients - Mechanism of injury - Nature of the ilness |
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Doing everything possible to ensure a safe environment.
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Scene safety
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Order of Priorities for Scene Safety
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1. You
2. Your crew 3. Other responding personnel 4. Your patient 5. Bystanders |
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Minimum Rescue Operation Equipment
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- Four-point suspension helmets
- Eye goggles or industrial safety glasses - High-quality hearing protection - Leather work gloves - High-top steel-toed boots - Insulated coveralls - Turnout gear |
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Minimum Patient Safety Equipment
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- Construction-type hard hats
- Eye goggles - Hearing and respiratory - Protective blankets - Protective shielding |
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Combined strength, direction, and nature of forces that injured your patient.
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Mechanism of injury
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Your anticipation of possible injuries based on your analysis of the event.
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Index of suspicion
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Prehospital process designed to identify and correct life-threatening airway, breathing, and circulation problems.
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Initial assessment
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Steps of Initial Assessment
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1. Form general impression
2. Stabilize cervical spine as needed 3. Assess baseline level of response 4. Assess airway 5. Assess breathing 6. Assess circulation 7. Assign priority |
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Your initial, intuitive evaluation of your patient.
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General impression
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AVPU
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- Alert
- Verbal stimuli - Painful stimuli - Unresponsive |
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Arms flexed, legs extended.
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Decorticate
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Arms and legs extended.
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Decerebrate
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Signs of Inadequate Breathing
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- Altered mental status
- Shortness of breath - Retractions - Asymmetric chest wall movement - Accessory muscle use - Cyanosis - Audible sounds - Abnormal rate or pattern - Nasal flaring |
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Evaluating the pulse and skin and controlling hemorrhage.
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Circulation assessment
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Top Priority Patients
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- Poor general impression
- Unresponsive - Responsive but cannot follow commands - Airway compromise - Difficult breathing - Signs and symptoms of hypoperfusion - Multiple injuries - Complicated childbirth - Chest pain and blood pressure below 100 systolic - Uncontrolled bleeding - Severe pain |
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Problem-oriented assessment process based on initial assessment and chief complaint.
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Focused history and physical exam
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Types of Patients
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- Trauma patient with significant mechanism of injury or altered mental status
- Trauma patient with isolated injury - Responsive medical patient - Unresponsive medical patient |
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Person who has suffered significant mechanism of injury.
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Major trauma patient
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Order of Focused History and Physical Exam for Major Trauma Patients
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- Initial assessment
- Rapid trauma assessment - Packaging - Rapid transport and ongoing assessment |
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Predictors of Serious Internal Injury
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- Ejection from vehicle
- Death in same passenger compartment - Fall from higher than 20 feet - Rollover of vehicle - High-speed vehicle collision - Vehicle-pedestrian collision - Motorcycle crash - Penetration of head, chest, or abdomen |
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Additional Predictors of Serious Internal Injury for Infants and Children
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- Fall from higher than ten feet
- Bicycle collision - Medium-speed vehicle collision |
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Quick check for signs and serious injury.
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Rapid trauma assessment
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DCAP-BTLS
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- Deformities
- Contusions - Abrasions - Penetrations - Burns - Tenderness - Lacerations - Swelling |
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Sitting up at 45 degrees.
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Semi-Fowler's position
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Crackling sensation caused by air just underneath the skin.
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Subcutaneous emphysema
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Bruising over the umbilicus.
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Cullen's sign
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Bruising over the flanks.
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Grey Turner's sign
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Baseline Vital Signs
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- Pulse rate and quality
- Blood pressure - Respiration rate and quality - Skin temperature and condition |
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Sample History
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- Symptoms
- Allergies - Medications - Pertinent past medical history - Last oral intake - Events leading up to the incident |
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The pain, discomfort, or dysfunction that caused your patient to request help.
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Chief complaint
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History for the Responsive Medical Patient
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- Chief complaint
- History of present illness - Past history - Current health status |
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OPQRST-ASPN
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- Onset
- Provocation/Palliation - Quality - Region/Radiation - Severity - Time - Associated Symptoms - Pertinent Negatives |
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Past Medical History
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- General state of health
- Childhood and adult diseases - Psychiatric illnesses - Accidents and injuries - Surgeries and hospitalizations |
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Current Health Status
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- Current medications
- Allergies - Tobacco use - Alcohol/substance abuse - Diet - Screening exams - Immunizations - Sleep patterns - Exercise/leisure activities - Environmental hazards - Use of safety measures - Family history - Social history |
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Additional Assessment Techniques
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- Pulse oximetry
- Capnography - Cardiac monitoring - Blood glucose determination |
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Assessing the Unresponsive Medical Patient
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- Initial assessment
- Rapid medical assessment - Brief history |
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Careful, thorough process of eliciting the history and conducting a physical exam.
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Detailed physical exam
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Black and blue discoloration surrounding the eye sockets.
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Periorbital ecchymosis
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Black and blue discoloration over the mastoid process.
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Battle's sign
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Areas of Nervous System Exam
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- Mental status and speech
- Cranial nerves - Motor system - Reflexes - Sensory system |
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Reflex Tests
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- Biceps
- Triceps - Brachioradialis - Quadriceps - Achilles - Abdominal - Plantar |
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Sensory System Tests
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- Pain
- Light touch - Temperature - Position - Vibration - Discriminative |
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Ongoing Assessment
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- Detects trends
- Determines changes - Assesses interventions' effects |
