EMT Chapter 12 The Primary Assessment Flashcards

Emergency Medical Technician (EMT) Primary Assessment Overview

• ABCs stand for airway, breathing, and circulation; critical focus areas during assessment.
• AVPU is a mnemonic for assessing patient responsiveness: alert, verbal response, painful response, and unresponsive.
• Chief Complaint refers to the patient's primary reason for calling EMS, often expressed in their own words.
• General Impression involves assessing the patient's overall condition based on appearance, environment, and chief complaint upon first approach.
• Interventions are medical actions taken to address or manage the patient's problems effectively.

Assessment Process

• Primary Assessment is the first step in evaluating a patient, focusing on identifying and addressing life-threatening issues; consists of forming a general impression, assessing mental status, airway, breathing, circulation, and determining patient priority.
• Priority determines the urgency of patient transport versus the need for further assessment and care on-site.
• High-Priority Conditions include unresponsive patients, difficulty breathing, shock, severe injuries, and uncontrolled bleeding.

Initial Steps

• Approach focuses on life threats, where airway (A), breathing (B), and circulation (C) are prioritized based on the patient's presentation.
• Immediate Interventions are necessary for any life-threatening problems identified during the ABC assessment.
• Depending on the patient's responsiveness, the sequence of assessments may vary (ABCs for responsive patients; CAB for lifeless patients).

Mental and Physical Status Evaluation

• Mental Status is assessed through the AVPU scale, indicating the patient's responsiveness and awareness of their surroundings.
• Circulation Assessment involves evaluating pulse rate, rhythm, temperature, skin color, and checking for any significant bleeding.
• Findings Indicating Critical Conditions include altered mental status, anxiety, pale or sweaty skin, and evident trauma.

Skin Assessment and Vital Signs

• Skin Color & Condition: Normal skin is warm, pink, and dry; pale or clammy skin indicates poor circulation or shock.
• Pulse Check: Rapid assessment is conducted to identify normal, slow, or fast rates; any abnormal finding necessitates further concern.

Patient Stability Classification

• Stable: Vital signs within normal range, no immediate threats.
• Unstable: Patient presents threats to ABCs or is at high risk for deterioration.
• Potentially Unstable: Patients whose conditions may worsen even without immediate threats.

Adapting Assessments and Handling Patients

• Patient characteristics, such as age and condition (medical vs. traumatic), dictate the assessment approach; adjustments are made based on these factors.
• For children, the assessment must account for social and physiological norms.
• Handling Patients Post-Assessment: Unstable patients should be rapidly transported with minimal on-scene intervention, while stable ones can undergo slower, more detailed evaluations.

Critical Assessment Situations

• A General Impression is formed through observational skills, providing clues to patient urgency.
• Levine's Sign indicates cardiac distress, characterized by the patient clutching their chest with a fist.
• Tripod Position suggests the patient is experiencing significant breathing difficulty.

Special Considerations

• In the case of respiratory arrest, perform rescue breathing; if the airway is compromised, take immediate corrective action.
• Altered Mental Status could signal various underlying issues such as hypoxia or head trauma; immediate attention is necessary.
• Emergency Responses to life-threatening conditions discovered during assessment must be prompt and appropriate, focusing on the ABCs.

Key Terms and Concepts

• Clinical Judgment derives from experience in patient observation and treatment.
• Exsanguinating describes severe, life-threatening bleeding requiring urgent intervention.
• Flail Chest indicates multiple rib fractures leading to compromised breathing efficiency.