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40 Cards in this Set

  • Front
  • Back
Define "initial assessment."
The first element in assessment of a patient; steps taken for the purpose of discovering and dealing with any life-threatening problems.
What are the six parts of an initial assessment?
1) Forming a general impression
2) Assessing mental status
3) Assessing airway
4) Assessing breathing
5) Assessing circulation
6) Determining priority of patient for treatment and transport to the hospital.
Define "interventions."
Actions taken to correct a patient's problems
Define "general impression."
Impression of the patient's condition that is formed on first approaching the patient, based on the patient's environment, chief complaint, and appearance
Define "chief complaint."
The reason EMS was called, usually in the patient's own words.
If you encounter any life-threatening condition during initial assessment, what do you do?
Perform the appropriate interventions to fix it.
Define "clinical judgment."
Judgment based on experience in observing and treating patients.
What do you do before beginning initial assessment?
Take standard precautions.
If you're assessing a patient's mental status and you suspect head or spine injury, what intervention do you take?
Manual spinal stabilization
What interventions might you take to open and maintain a patient's airway?
Head-tilt/Chin-lift maneuver (if no spinal injury is suspected), jaw thrust maneuver (if spinal injury is suspected), inserting an orophoryngeal or nasopharyngeal airway, suction if necessary.
How do you assess circulation?
Take the patient's pulse, evaluate skin temperature, color, and condition, and assess for bleeding.

With children, also test capillary refill time.
What interventions do you take if you see poor circulation?
Control any severe bleeding, treat for shock.
What does AVPU stand for?
Verbal stimuli
Painful stimuli
Define "mental status"
Level of responsiveness
How can you further describe an awake patient's mental status?
Check to see what they're oriented to in this order. See if they can tell you their name. See if they know where they are. See if they know what time it is. (person, place, time)
What must you do immediately if a patient's level of responsiveness is less than alert?
Provide high-concentration oxygen and consider the patient a high transport priority.
If you've ensured that a patient's airway is open but the patient is in respiratory arrest, how do you proceed?
Perform rescue breathing.
If you've ensured that a patient's airway is open but his respiration rate is lower than 8 per minute, how do you proceed?
Provide positive pressure ventilations with 100 percent oxygen
If you've ensured that a patient's airway is open and breathing is adequate but the rate is greater than 24 per minute, how do you proceed?
Give high concentration oxygen via nonrebreather mask.
If you've ensured that a patient's airway is open, breathing is inadequate, and the rate is greater than 24 per minute, how do you proceed?
Ventilate with 100 percent oxygen.
When do you take a patient's pulse?
After you've determined that the airway is open and that proper breathing interventions have been taken. Remember, ABC.
If there is no pulse, what do you do?
Begin CPR
How do you evaluate circulation?
Assess pulse, skin, and bleeding.
What factors do you consider when evaluating a patient's skin to determine if their circulation is adequate?
Color - Pale or blue is bad
Temperature - cold is bad
Condition (Moist or clammy is bad. Dry is good)
Define "priority."
The decision regarding the need for immediate transport of the patient versus further assessment and care at the scene.
What are a few reasons to determine that a patient has an immediate priority for transport?
1) Life threatening problems that cannot be controlled or may recur

2) Depressed level of responsiveness
Patient assessment takes different forms depending on what characteristics?
1) Medical vs. Trauma
2) Reponsive vs. Unresponsive
3) Adult vs. Child vs. Infant
What are 9 conditions that indicate a high transport priority?
1) Difficulty breathing
2) Uncontrolled bleeding
3) Shock
4) Chest pain with systolic BP less than 100
5) Severe pain anywhere
6) Unresponsive
7) Responsive, but not following commands
8) Childbirth complications
9) Poor general impression
What steps do you take to assess and correct problems with mental status and ABCs in an infant?
Mental status: If not alert, shout as a verbal stimulus. Flick feet as a painful stimulus. Crying is expected response.

Airway: Consider an airway and suctioning, and maintain neutral head position.

Breathing: Look, listen, and feel, and make sure breathing is between 25 and 50 breaths per minute

Circulation: Assess skin, brachial pulse, bleeding, capillary refill.
How do you test for responsiveness to painful stimulus?
1) Sternum rub
2) Pen roll
3) For infants, flick the feet
If you're going through the initial assessment and you find an unresponsive patient and he accepts an oropharyngeal airway (no gag reflex), what's the next step?
Quickly assess breathing and begin either assisted or artificial ventilations.
When assessing the airway, what three factors must you observe?
1) Is airway open?

2) Is patient able to maintain his own airway?

3) If unable to, is patient a medical or trauma patient?
What steps do you take to open the airway of medical patients?
Use head-tilt, chin-lift

Suction as necessary
What steps do you take to open the airway of trauma patients?
Immobilize head manually

Use jaw thrust as necessary

Insert oropharyngeal airway -- beware of nasopharyngeal airways, because they can be deadly in the case of a patient with a head injury.
How do you assess pulse in adults and children?
Check radial pulse first. If no radial pulse, take carotid pulse.
In what case might you bypass reading a radial pulse?
In cases of unresponsive patients that look like they are in very rough shape, check carotid pulse immediately.
How do you assess pulse in infants?
Check the brachial pulse
When do you check a patient's skin?
While you're checking the pulse. Determine:
1) Color
2) Temperature (use back of hand)
3) Condition
What's the FIRST thing you do with any trauma patient?
Apply manual stabilization of spine.
What comes after basic assessment?
Focused history and physical assessment.