Podcast
Questions and Answers
What is the primary focus during the triage process after casualties are triaged?
What is the primary focus during the triage process after casualties are triaged?
- Treating patients with yellow tags first
- Conducting psychological assessments of the patients
- Establishing command and a medical officer
- Focusing on treatment of patients based on their tag color (correct)
Which of the following actions should be performed first for a patient identified with a RED TAG?
Which of the following actions should be performed first for a patient identified with a RED TAG?
- Document the patient's injuries before moving on
- Provide immediate surgery to stabilize the patient
- Control any major hemorrhage (correct)
- Administer an antidote and move to the next patient
What does the 'RPM' acronym stand for in assessing patients during triage?
What does the 'RPM' acronym stand for in assessing patients during triage?
- Respiratory, Perfusion, Mental Status (correct)
- Resuscitation, Pressure, Mentality
- Respiration, Pulse, Motion
- Reaction, Pain, Mobility
In triage situations, what color tag indicates a deceased patient?
In triage situations, what color tag indicates a deceased patient?
What should be done for those who cannot walk during the global sorting step of triage?
What should be done for those who cannot walk during the global sorting step of triage?
Which protocol addresses the management of altered mental status?
Which protocol addresses the management of altered mental status?
What is the focus of the AC-5 protocol?
What is the focus of the AC-5 protocol?
Which section includes protocols related to pediatric airway management?
Which section includes protocols related to pediatric airway management?
Which protocol is associated with emergencies involving indwelling central lines?
Which protocol is associated with emergencies involving indwelling central lines?
What is the content of the protocol labeled UP-12?
What is the content of the protocol labeled UP-12?
What does the AC-6 protocol address?
What does the AC-6 protocol address?
Which of these protocols focuses on patient care during an emergency situation?
Which of these protocols focuses on patient care during an emergency situation?
Which protocol specifically addresses seizures?
Which protocol specifically addresses seizures?
Which type of precaution requires the use of a standard surgical mask for both healthcare providers and patients?
Which type of precaution requires the use of a standard surgical mask for both healthcare providers and patients?
Which condition is specifically contraindicated for the use of Ibuprofen?
Which condition is specifically contraindicated for the use of Ibuprofen?
What additional protective measures are included in all-hazards precautions compared to droplet precautions?
What additional protective measures are included in all-hazards precautions compared to droplet precautions?
Under which situation should all patients have drug allergies documented?
Under which situation should all patients have drug allergies documented?
Which of the following diseases requires airborne precautions?
Which of the following diseases requires airborne precautions?
What should be done if a patient is unable to walk?
What should be done if a patient is unable to walk?
What indicates a patient should receive immediate care during respiratory assessment for adults?
What indicates a patient should receive immediate care during respiratory assessment for adults?
In pediatric patients, what breathing rate indicates immediate intervention is needed?
In pediatric patients, what breathing rate indicates immediate intervention is needed?
What is the appropriate response in triage for an adult with no palpable pulse?
What is the appropriate response in triage for an adult with no palpable pulse?
When is a patient's mental status assessed in the triage process?
When is a patient's mental status assessed in the triage process?
Which of the following is considered a sign of poor perfusion in adults?
Which of the following is considered a sign of poor perfusion in adults?
What should be the primary focus in triaging infants?
What should be the primary focus in triaging infants?
What signifies a pediatric patient in need of immediate treatment based on mental status?
What signifies a pediatric patient in need of immediate treatment based on mental status?
In respiratory assessment, what breathing rate for adults is deemed normal?
In respiratory assessment, what breathing rate for adults is deemed normal?
What is the purpose of triage in emergency situations?
What is the purpose of triage in emergency situations?
What percentage of abdominal complaints may have no diagnosis after extensive testing in the emergency department?
What percentage of abdominal complaints may have no diagnosis after extensive testing in the emergency department?
Which patient population is most likely to present with vascular problems and significant morbidity after age 50?
Which patient population is most likely to present with vascular problems and significant morbidity after age 50?
What is critical to consider in women of childbearing age presenting with abdominal pain?
What is critical to consider in women of childbearing age presenting with abdominal pain?
How should an unstable patient with abdominal pain be treated?
How should an unstable patient with abdominal pain be treated?
What age-specific blood pressure threshold is critical for newborns aged 0 - 28 days?
What age-specific blood pressure threshold is critical for newborns aged 0 - 28 days?
What should be evaluated for in a patient over 50 years with abdominal pain?
What should be evaluated for in a patient over 50 years with abdominal pain?
What vital sign is often the first indicator of dehydration?
What vital sign is often the first indicator of dehydration?
In pediatric patients, abdominal pain and nausea/vomiting can initially indicate what condition?
In pediatric patients, abdominal pain and nausea/vomiting can initially indicate what condition?
Study Notes
Triage
- Triage is used to manage a large number of patients, focusing first on those who cannot walk or have obvious life threats.
- The RPM system is used to assess patients: Respiratory, Perfusion, Mental Status.
- Red tag patients have priority, meaning their treatment is started first followed by yellow and then black.
- Deceased patients can be indicated by pulling their shirt over their head.
- Capillary refill, a measure of perfusion, might be affected by skin temperature.
- Consider age-appropriate heart rate in triage decisions.
- The SMART triage tag system is used in NC.
Abdominal Pain
- Abdominal pain may arise from many organ systems including; Cardiac, Pulmonary, Endocrine, Genitourinary and Renal systems.
- Common causes are difficult to diagnose in the prehospital setting.
- Special attention is needed for:
- Elderly: can signal significant morbidity and mortality; Consider cardiac etiology and obtain ECG if warranted.
- Immunocompromised: HIV, Diabetes, Renal Failure, Transplant patients, Patients taking chronic steroids.
- Women of childbearing age: Consider ectopic pregnancy until proven otherwise.
- Pediatric: Blood Glucose Analysis as abdominal pain and N/V can be an initial sign of diabetes or DKA.
Stable vs. Unstable Patients
- Stable patients with undifferentiated abdominal pain may require only supportive care, anti-emetics, and pain medications.
- Unstable patients need more directed therapy based on their presentation and vital signs.
Recommended Exam for Abdominal Pain
- Mental Status, Skin, HEENT, Neck, Heart, Lungs, Abdomen, Back, Extremities, Neuro.
- Age specific blood pressure:
- 0 – 28 days > 60 mmHg
- 1 month - 1 year > 70 mmHg
- 1 - 10 years > 70 + (2 x age) mmHg
- 11 years and older > 90 mmHg
- Abdominal / back pain in women of childbearing age should be treated as pregnancy related until proven otherwise.
- Consider the diagnosis of abdominal aneurysm with abdominal pain, with or without back and/or lower extremity pain or diminished pulses, especially in patients over 50 and/or patients with shock/poor perfusion. Notify receiving facility early with suspected abdominal aneurysm.
- Consider cardiac etiology in patients > 50, diabetics and/or women especially with upper abdominal complaints.
- Repeat vital signs after each fluid bolus.
- Heart Rate:
- One of the first clinical signs of dehydration
- Almost always increased heart rate (tachycardia)
- Increases as dehydration becomes more severe
- Very unlikely to be significantly dehydrated if heart rate is close to normal.
Infection Control
- Droplet precautions: include standard PPE plus surgical mask for providers accompanying patients, and a surgical mask or NRB O2 mask for the patient.
- Utilized for: Influenza, Meningitis, Mumps, Streptococcal Pharyngitis, and other illnesses spread via large particle droplets.
- Utilize when a potentially infectious rash is suspected.
- Airborne precautions: include standard PPE plus a gown, change of gloves after every patient contact, and strict hand washing precautions.
- Utilized for: Multi-drug resistant organisms (e.g.MRSA), Scabies, Zoster (Shingles), or other illnesses spread by contact.
- All-hazards precautions: include standard PPE plus airborne and contact precautions. Utilized during the initial phases of an outbreak when the etiology of the infection is unknown or the causative agent is found to be highly contagious (e.g. SARS).
- Document all drug allergies before administering pain medications.
- NSAIDs (non-steroidal anti-inflammatory medications) are contraindicated for patients with renal disease or renal transplant.
- Do not administer aspirin to children under 15 years old.
- Contact medical control before administering any medication, at the Agency Medical Director’s discretion.
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Description
Test your knowledge on triage protocols and the evaluation of abdominal pain in emergency medicine. This quiz covers the RPM system, prioritization of patients, and considerations for various organ systems related to abdominal pain. Enhance your understanding of crucial assessment techniques used in prehospital settings.
