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What is the primary focus during a primary assessment?
Which aspect is NOT part of assessing the Level of Consciousness (LOC) using the AVPU scale?
In the context of patient assessment, what does the 'P' in AVPU stand for?
What should the responder check for during a scene size-up?
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How should a health responder initially check if a patient is alert?
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What is the purpose of a secondary assessment?
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Which response indicates a patient is categorized as unresponsive on the AVPU scale?
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What type of assessment would you conduct after the primary assessment?
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What is the appropriate frequency for reassessing a stable patient during an ongoing assessment?
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Which of the following assessments should be included in an ongoing assessment?
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What crucial information should be relayed to EMS upon their arrival?
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When should parts of the secondary assessment be repeated during an ongoing assessment?
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What type of questions might EMS typically ask when they arrive on scene?
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What is the first step in gathering patient medical history during a secondary assessment?
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How do you calculate the average pulse rate during a physical assessment?
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What type of information is crucial to collect about medication during a medical history assessment?
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Why is it important to note the time of injury or sudden illness during patient assessments?
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What observation should be made to determine a patient’s breathing rate properly?
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What should be included in the report when handing over a patient to medical personnel?
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During the primary assessment, which of the following aspects does NOT get evaluated?
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Which information would NOT typically be gathered during a secondary assessment?
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What is the primary technique to stop bleeding from a wound?
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When assessing for respirations, which of the following signs indicates inadequate breathing?
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What is the appropriate first step when faced with an obstructed airway?
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Which pulse point should be checked on an infant?
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What immediate action should be taken if a patient is not breathing?
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Which of the following is NOT a sign of respiratory distress?
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Why is it crucial to establish an open airway before assessing for respirations?
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When assessing circulation, what should you do first?
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What is the highest priority when conducting a primary assessment?
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Which of the following signs is NOT typically associated with massive hemorrhage?
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In which sequence should the primary assessment guidelines be followed?
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What should you do first if an infant or child shows signs of respiratory distress?
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What is a critical action to take if a criminal justice officer becomes unresponsive?
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Which of the following is an important sign of severe bleeding?
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How should you approach a patient who is unresponsive?
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What does the 'C' in the MARCH mnemonic refer to?
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If the patient is stable, reassessment should occur every 15 minutes.
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The frequency of reassessment changes to every 10 minutes if the patient is unstable.
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It is important to update EMS as soon as they arrive on scene.
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You should not communicate with EMS while they are on their way.
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During ongoing assessment, only the patient's responsiveness level should be checked.
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A patient who is categorized as unresponsive will not respond to anything at all.
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The AVPU scale includes the categories of alert, verbal, pain, and unconscious.
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An alert patient is fully aware of their surroundings and can react to their environment.
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In a primary assessment, identifying life-threatening conditions is not essential.
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During a secondary assessment, a thorough head-to-toe examination is performed.
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If a patient only responds to painful stimuli, they are categorized as verbal on the AVPU scale.
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The first step in patient assessment is to conduct a scene size-up.
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The primary assessment follows the MARCH guidelines.
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An unresponsive patient will still respond to stimuli.
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The primary assessment must be conducted in the order outlined in the mnemonic MARCH.
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Massive hemorrhage is considered the number one preventable cause of trauma-related deaths.
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Visual assessment is the least valuable tool when determining the level of consciousness (LOC) in infants or children.
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Respiratory distress in a child should always be considered a serious condition.
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A patient experiencing hypothermia may have a decreasing level of consciousness.
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A patient with severe bleeding may show signs such as paleness and a rapid heart rate.
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Disarming a criminal justice officer is unnecessary if they drop below the level of alert.
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A blue skin coloring can indicate poor circulation.
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Capillary refill time test involves applying pressure for five seconds.
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Hypothermia can worsen bleeding symptoms.
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A secondary assessment should be conducted before addressing any life-threatening injuries.
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Assessing unequal pupil size is part of evaluating a potential head injury.
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Keeping the patient warm and dry is not necessary when treating hypothermia.
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Fluid coming out of a patient's ears can be a sign of a head injury.
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Assessing a patient's medical history is only necessary during the primary assessment.
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Nonreactive pupils are often associated with severe brain damage.
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Checking the throat for trauma and airway obstructions is part of neck assessment.
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Both sides of the chest should rise and fall equally during breathing.
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Assessing lower extremities includes checking for equal leg length.
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Checking for dampness in the abdomen is not relevant during physical assessment.
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The pelvis is stable unless there is visible bleeding or injury in the groin area.
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To assess for circulation in the upper extremities, checking the strength of both hands is sufficient.
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The spine should be checked without consideration for spinal precautions.
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Study Notes
Level of Consciousness (LOC) Assessment
- Assess LOC using the AVPU scale: Alert, Verbal, Pain, Unresponsive.
- Alert patients are awake, aware, and react to surroundings.
- Verbal patients respond to speech, even minimally.
- Pain patients respond to painful stimuli with movement.
- Unresponsive patients show no response to any stimuli; initiate CPR.
- For infants/children, visual assessment of drowsiness or respiratory distress is crucial.
- If a law enforcement officer's LOC drops below alert, disarm them for safety.
Primary Assessment: MARCH Guidelines
- Prioritize identifying and managing life-threatening conditions.
- Follow MARCH guidelines in order:
- Massive Hemorrhage: Control severe bleeding immediately. Low blood pressure, rapid heart rate, loss of consciousness, paleness, and weak pulse may accompany severe bleeding. Check for internal bleeding.
- Airway: Ensure airway is open; use head tilt-chin lift or jaw thrust if needed (refer to CPR training).
- Respirations: Assess chest rise/fall; note equal rise on both sides. Signs of inadequate breathing include labored/painful breathing, wheezing, snoring, cyanosis (blue/purple lips/nails), pale/gray skin. Absence of chest movement indicates respiratory arrest; initiate rescue breathing and request AED/CPR.
- Circulation: Check pulse (brachial for infants, carotid for unconscious adults/children, radial for conscious adults/children); note skin color & temperature. Assume conscious patients have a pulse.
- Hypothermia/Head Injury: Assess for low body temperature and decreasing LOC.
Secondary Assessment & Patient History
- Conduct a comprehensive head-to-toe physical examination.
- Gather patient medical history:
- Ask about symptoms, allergies, medications (including last dose), past medical problems.
- Note time of last food/drink intake.
- Document events leading to the emergency and time of injury/illness.
- If the patient is unconscious, question family or bystanders.
- Relay all information to EMS.
Recording Vital Signs
- After primary and secondary assessments, record pulse and breathing rates.
- Count pulse beats for 15 seconds, multiply by 4 for rate per minute.
- Count breaths for 15 seconds, multiply by 4 for rate per minute.
Ongoing Assessment & Communication with EMS
- Reassess stable patients every 15 minutes, unstable patients every 5 minutes.
- Continue until EMS arrival.
- Reassess LOC, airway, breathing, and pulse. Repeat parts of secondary assessment as needed.
- Relay scene and patient information to EMS, including treatment rendered.
- Be prepared to answer questions from EMS about patient numbers, location, priority, and treatment provided.
- Assist EMS as trained and permitted, focusing on safety and your training limits.
Bleeding Control Techniques
- Apply direct pressure with a sterile dressing.
- Pack the wound.
- Apply a tourniquet if necessary (detailed techniques will be covered later).
Level of Consciousness (LOC) Assessment
- Assess LOC using the AVPU scale: Alert, Verbal, Pain, Unresponsive.
- Alert: Patient is awake, aware, and reacts to surroundings. Eyes open spontaneously.
- Verbal: Patient responds to verbal stimuli, even minimally (grunting, movement).
- Pain: Patient responds only to painful stimuli with voluntary or involuntary movement.
- Unresponsive: Patient does not respond to any stimuli. Requires CPR if unresponsive.
- For infants/children, visual assessment is crucial; drowsiness or respiratory distress indicates a serious condition (e.g., head trauma, infection).
- Disarm a criminal justice officer if their LOC drops below alert for safety.
Primary Assessment (MARCH)
- Prioritizes immediate life-threatening conditions. Follow MARCH guidelines:
- Massive Hemorrhage: Control severe bleeding immediately. Signs include low blood pressure, rapid heart rate, loss of consciousness, paleness, weak pulse.
- Airway: Ensure airway is open and unobstructed.
- Respiration: Check for chest rise and fall, indicating breathing.
- Circulation: Assess pulse and blood flow. Check capillary refill time (<2 seconds is adequate). Blue skin indicates circulation problems. A absent pulse may require CPR and AED.
- Hypothermia/Head Injury: Assess for low body temperature (minimize exposure, keep patient warm and dry); head injury signs include unequal pupils, fluids from ears, skull deformity, decreasing LOC.
Secondary Assessment
- Conducted after stabilizing life-threatening injuries.
- Includes comprehensive physical examination and detailed medical history. May not always be possible before EMS arrives.
- Assess:
- Neck: Check for trauma, swelling, airway obstruction; ask patient about numbness, tingling, neck pain.
- Shoulders: Check for grinding (possible fracture).
- Chest/Abdomen: Observe chest rise and fall, bruising, holes; listen for noises; feel for pain, tenderness, fractured ribs; check abdomen for swelling (internal injury or pregnancy).
- Pelvis/Groin: Check for tenderness, deformities, stability; look for bleeding (life-threatening).
- Lower Extremities: Check for leg length discrepancies (possible femur fracture), pressure from soles of feet.
- Upper Extremities: Assess DOTS (deformities, open wounds, tenderness, swelling), circulation, movement, sensation.
- Spine/Back: Roll patient with spinal precautions if necessary (e.g., blood pooling).
Ongoing Assessment & Communication with EMS
- Reassess stable patients every 15 minutes, unstable patients every 5 minutes until EMS arrives.
- Reassess responsiveness, airway/breathing, pulse rate/quality. Repeat parts of secondary assessment as needed.
- Relay scene and patient information to EMS upon arrival or via radio to dispatch. Be prepared to answer questions about number of patients, location, priorities, and treatment rendered.
- Criminal Justice first-aid providers should act within their training and utilize available equipment. May assist with other aspects of rescue as per protocol and department policies.
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Description
Test your understanding of the Level of Consciousness (LOC) assessment using the AVPU scale and the MARCH guidelines for primary assessment. This quiz will help reinforce your knowledge of identifying and managing life-threatening conditions effectively. Make sure you're familiar with the signs and appropriate responses for each LOC category.
