Emergency Assessment Techniques

Narrative Writing Styles

• A way to tell a story using different methods

Scene Assessment

• Scene size-up: Quickly assess the scene for safety hazards
• Mechanism of injury: How the injury occured, helps to determine what injuries are likely
• Number of patients: How many people need treatment
• Resources needed: What equipment and personnel are needed
• Additional help: Are more resources required
• Safety of the scene: This is the primary concern and should be addressed first

Initial Assessment

• This is the most important part of the assessment and should be completed in the first 60-90 seconds
• Determine the patient's level of consciousness and airway
• Identify any life-threatening conditions
• Check for breathing and circulation
• Perform a rapid scan of the patient's body
• Take vital signs

GCS Score Predictions

• 15: No neurological disabilities
• 13-14: Mild dysfunction
• 9-12: Moderate to severe dysfunction
• 3-8: Severe dysfunction

Current Health Status Elements

• Medications
• Allergies
• Past medical history
• Last meal
• Events leading up to the injury
• Pain level
• Mental status

Three (3) Mechanisms that produce ABD pain

• Trauma: Falls, motor vehicle accidents, violence
• Surgical: Complications from surgery such as adhesions or infections
• Medical: Appendicitis, pancreatitis, gastrointestinal bleeding

Tilt-test

• Positive results indicate a decrease in blood pressure and increase in pulse
• The patient may also experience dizziness or lightheadedness

Rapid Trauma Assessment

• This is performed after the initial assessment and before the focused physical examination
• It is a quick assessment of the head, neck, chest, abdomen, pelvis, and extremities

Mental Status Evaluation - COASTMAP

• C: Consciousness - level of alertness
• O: Orientation - awareness of person, place, and time
• A: Activity - level of physical activity
• S: Speech - clarity, fluency, and appropriateness
• T: Thoughts - content and organization
• M: Memory - ability to recall recent and past events
• A: Affect - mood and emotional state
• P: Perception - awareness of surroundings and ability to interpret stimuli

Ongoing Assessment Elements

• Vitals signs: Pulse, respirations, blood pressure
• Level of consciousness
• Pain level
• Appearance
• Skin color and condition
• Pupil size and reactivity

Drug (Definition)

• A substance or mixture of substances manufactured, sold, or represented for use in:
  • Diagnosis, treatment, or prevention of disease
  • Other than food
  • Affecting the structure or function of the body

Health Canada - Approval of Medications

• Health Products and Food Branch (HPFB) is the branch of government that approves medication in Canada.

Medication Names

• Generic name: The chemical name of the drug (Acetaminophen)
• Brand name: The name given to the drug by the manufacturer (Tylenol)
• Trade name: A proprietary name for a drug (Ibuprofen)

Sources of Medicine

• Prescription: Requires a doctor's order
• Over-the-counter: Available without a doctor's order
• Complementary and alternative medicine: Herbal remedies, acupuncture, etc.
• Illicit drugs: Drugs that are illegal to buy, sell, or possess

Scheduled Drugs

• Schedule I: Narcotics such as opium, heroin, morphine, and cocaine
• Schedule II: Cannabis and cannabis resin
• Schedule III: Stimulants such as amphetamines, and hallucinogens such as LSD
• Schedule IV: Anabolic steroids, barbiturates, benzodiazepines
• Schedule V: Repealed
• Schedule VI: Precursors that can be used to create other scheduled drugs
• Schedule VII: Repealed
• Schedule VIII: Repealed
• Schedule IX: Devices that can be used to create tablets or capsules

Drug Development and Approval

• Average time for approval: 9 years
• Testing in animal species: Two species
• Clinical trial phases:
  • Phase I: Initial safety and dosage testing in a small group of healthy volunteers
  • Phase II: Further safety testing and dosage optimization in a larger group of people with the disease
  • Phase III: Large-scale efficacy and safety trials in a diverse patient population
  • Phase IV: Long-term surveillance for rare side effects

Pediatric Assessment Triangle

• A quick and easy method for assessing a child's condition
• Appearance: General appearance and demeanor
• Work of breathing: Effort needed to breathe
• Circulation: Skin color, capillary refill, and pulse

Pediatric Appearance Features

• T: Tone - muscle tone
• I: Interactiveness - level of engagement with the environment
• C: Consolability - ability to be comforted
• L: Look or gaze - eye contact and alertness
• S: Speech or cry - quality and strength of cry

Stridor

• Obstruction at the level of the glottis (voice box)
• Causes a high-pitched, whistling sound during breathing

Grunting

• Obstruction in the lower airway
• Used as a form of auto-PEEP (positive end-expiratory pressure) to keep the airways open

Wheezing

• Constricted or blocked small airways
• Causes a whistling or wheezing sound during breathing

Pallor

• Initial sign of poor circulation, anemia, or hypoxia
• Causes a pale skin color

Mottling

• Vasomotor instability in the capillary beds
• Causes a blotchy or mottled skin color
• It can also be a normal response to a cold environment

Cyanosis

• Blue or purple discoloration of the skin and mucous membranes indicating poor perfusion or poor oxygenation
• Caused by low levels of oxygen in the blood

Acrocyanosis

• Blue hands or feet in an infant less than 2 months old
• A normal finding when the infant is cold

How to use a Browlow Tape

• Placement: Place the tape on the child's forehead
• Measurement: Measure the distance between the brow line and the top of the child's head
• Age: Use the tape to determine the child's approximate age
• Medications: Use the tape to estimate the appropriate dosage of medication

Skin CTC

• Color: Skin color
• Temperature: Skin temperature
• Condition: Skin condition. Such as, moist, dry, clammy, or sweaty

Children aged 1 - 10 Minimum BP

• 70 + (age x 2)

Pediatric Respiration Rates

• Age Resp rate HR SBP DBP

Neonate (0 - 1 month) 30 - 60 90 - 160 67 - 84 35 - 53 Infant (1 month - 1 year) 30 - 53 90 - 160 72 - 104 37 - 56 Toddler (1 year - 2 years) 22 - 37 80 - 120 86 - 106 42 - 63 Preschool (3 - 5 years) 20 - 28 65 - 100 89 - 112 46 - 72 School-aged (6 - 12 years) 18 - 25 58 - 90 97 - 120 57 - 80 Adolescent (12 - 15) 12 - 20 50 - 90 110 - 131 64 - 83

Geriatric Assessment Tool - GEMS Diamond

• G: Geriatric patient
• E: Environmental assessment - Living conditions, safety, support systems
• M: Medical assessment - Physical exam, vital signs, medication review
• S: Social assessment - Family and social support, mental status, financial resources

PE Triad

• P: Pain - Assess location, intensity, and quality of pain
• E: Edema - Assess the presence of swelling
• E: Ecchymosis - Assess the presence of bruising

Causes of Delirium

• D: Drugs or toxins
• E: Emotional (depression, anxiety) or electrolytes (sodium, potassium)
• L: Low PaO2 (low oxygen levels)
• I: Infection (pneumonia, urinary tract infection)
• R: Retention of stool or urine
• I: Ictal state (seizures)
• U: Undernutrition or underhydration
• M: Metabolism (thyroid disease, liver failure)
• S: Subdural hematoma (bleeding in the brain)

Types of Elderly Maltreatment

• Physical abuse: Hitting, kicking, slapping, or other physical harm
• Sexual abuse: Any non-consensual sexual contact
• Emotional abuse: Verbal abuse, intimidation, or threats
• Neglect: Failure to provide basic needs such as food, water, shelter, or medical care
• Financial exploitation: Misuse or theft of money or property

This quiz covers essential emergency assessment techniques, including scene assessment, initial patient evaluation, and GCS score predictions. Learn how to quickly assess safety, identify life-threatening conditions, and determine required resources when treating patients in an emergency scenario.