Emt: Brady Emergency Care 12Th Edition - Chapter 14 - Assessment Of The Medical Patient

Front 1

Define "medical patient."

Back 1

A patient suffering from one or more medical diseases or conditions.

Front 2

What is the most important source of information when assessing a medical patient?

Back 2

What a medical patient can tell you, which is why unconscious medical patients present a uniquely difficult situation.

Front 3

Why would the assessment of a medical patient be difficult if they've lost consciousness?

Back 3

Because the most important source of information pertaining to that patient is what they can tell you.

Front 4

How do you remember what questions to ask when interviewing a patient about the history of their present illness or complaint?

Back 4

OPQRST!

Onset
Provocation
Quality
Radiation
Severity
Time

Front 5

What's a mnemonic device for remembering what vital signs you have to take?

Back 5

BPSPB

Breathing
Pulse
Skin
Pulpils
Blood Pressure

Front 6

What's the first determination you must make when dealing with a medical patient that will dictate the course of the rest of the assessment?

Back 6

Whether they're responsive or unresponsive

Front 7

After your primary assessment of a responsive medical patient, what five steps do you take?

Back 7

1) Take a history of the present illness

2) Take a SAMPLE history

3) Perform a focused physical exam

4) Obtain baseline vital signs

5) Administer interventions and transport

Front 8

After your primary assessment of an unresponsive medical patient, what six steps do you take?

Back 8

1) Rapid physical exam

2) Obtain baseline vital signs

3) Consider and call for ALS

4) History of present illness (info gathered from family, friends, bystanders, medicine cabinet, fridge, ID bracelets, etc.).

5) SAMPLE history

6) Administer interventions and transport

Front 9

What does OPQRST stand for? When do you use it?

Back 9

OPQRST is a mnemonic device used to remember what information to gather when asking about the history of the present illness. Besides generally asking about the chief complaint, you will want to ask about:

Onset (what were you doing when this started?)

Provocation (does anything make the pain/illness worse?)

Quality (Describe the pain for me. Is it an ache? A stabbing pain? etc.)

Radiation (Does the pain spread to other parts of your body?)

Severity (How much does it hurt on a 1-10 scale?)

Time (How long has this been going on?)

Front 10

At what stage do you determine the chief complaint of a medical patient?

Back 10

During the initial assessment.

Front 11

How do you determine if a patient is a medical patient or a trauma patient?

Back 11

Look for a mechanism of injury. If there's no mechanism of injury, the patient is a medical patient. If there is a mechanism of injury, treat the patient as a trauma case.

Front 12

Define "medical patient."

Back 12

A patient suffering form one or more medical diseases or conditions.

Front 13

What is the key to moving from the initial assessment to the focused history and physical exam?

Back 13

Determining the mechanism of injury (or lack thereof) and the chief complaint.

Front 14

When you're interviewing a patient about their present illness, what two things are you trying to do?

Back 14

1) Gather important information

2) Reduce patient's fear and promote cooperation

Front 15

When you have a conscious, responsive patient, who should you interview first about the illness?

Back 15

The patient

Front 16

If the patient tells you that multiple things are bothering him, what do you do first?

Back 16

Ask what's bothering him the most

Front 17

What kind of questions should you ask your patient: open-ended questions, or questions that give the patient a specific choice (such as "is your pain dull or sharp?)

Back 17

Ask open-ended questions to gather most of your information.

Give the patient more pointed questions if they cannot answer open-ended questions adequately.

Front 18

What does SAMPLE stand for?

Back 18

Signs/symptoms
Allergies
Medications
Pertinent past medical history
Last oral intake
Events leading up to the illness

Front 19

To whom will you provide information gathered during the patient assessment?

Back 19

Emergency department staff

Front 20

Why is it important to gather a SAMPLE history?

Back 20

This will help you determine what interventions to take on scene and during transport, and it will give you important treatment information that you can pass on to hospital staff.

Front 21

When obtaining OPQRST and SAMPLE info from a child, what important changes must you make in your approach?

Back 21

1) Get to eye-level with the child

2) Speak simply, with easy to understand words.

3) Obtain necessary information from parents or guardians

Front 22

What three situations involving a known prior history deserve special mention because the patient may carry the treatment on his person?

Back 22

1) Patient with difficulty breathing that has an inhaler

2) Patient with chest pain who has nitroglycerin

3) Patient with an allergic reaction who has an epinephrine auto-injector

Front 23

How might you deal with a 79-year old woman that keeps rambling about things unrelated to the chief complaint?

Back 23

Be kind, respectful, and assertive. Redirect the patient and let them know that it's very important that they answer some specific questions so you can help.

Front 24

How might you deal with a 16-year-old female, surrounded by her family, with abdominal pain that could be a result of a pregnancy... but you haven't asked her yet if she's pregnant?

Back 24

Speak with the patient privately. That may require sending parents on a quick errand to get some medications or medical info. You might even have to put the patient in the ambulance. Once you're in private, ask the sensitive question.

Front 25

How would you get information from a 32-year-old male with diabetes, who hasn't eaten lately, that just kind of stares vacantly when you speak with him?

Back 25

Get information from family. His inaction might be a result of his medical condition.

Front 26

How might you get information from a 22-year-old college student that has been acting strangely for weeks, according to his roommate? He's currently sitting on his bed, rocking back and forth, mumbling.

Back 26

Ensure your own safety first, then get to eye level with the patient, and try to develop a rapport and see if he's responsive. Reel him in if you can and get the pertinent info.

Front 27

When in doubt...

Back 27

...get the patient to the hospital

Front 28

When dealing with a medical patient, what object on their person might be of great help?

Back 28

A medical ID bracelet or necklace. If you find one, make sure to alert hospital staff to it during transfer of care.

Front 29

Must you check a patient's pupils when they're unresponsive and their eyes are closed?

Back 29

Yes!

Front 30

When dealing with an unresponsive medical patient and you have to decide whether or not to request ALS backup, what do you do?

Back 30

You will request it.

Front 31

When obtaining a SAMPLE history from bystanders due to an unresponsive patient, what six questions should you ask?

Back 31

1) Patient's name

2) What happened?

3) Did the bystander see anything else?

4) Has the patient had any recent complaints leading up to the incident?

5) Does the patient have any known illnesses or problems?

6) Is the patient taking any medications?

Front 32

When dealing with medical patients, what extremely important clue should you be on the lookout for?

Back 32

A "Vial of Life" sticker on the main door, front window, or fridge. This will alert you to the presence of a "Vial of Life," which is a bottle or baggie with specific medical information inside it.

Front 33

What's the main difference between the focused history and exam of a trauma patient and that of a medical patient?

Back 33

In the case of a medical patient, the most important information will likely come straight from the patient's mouth rather than from examining the scene and the patient.