Podcast
Questions and Answers
Which of these are considered vital signs as outlined in the content?
Which of these are considered vital signs as outlined in the content?
What does OPQRSTI stand for, as referred to in the content?
What does OPQRSTI stand for, as referred to in the content?
Which of the following is NOT part of the secondary assessment of the chest and CVS, as outlined in the content?
Which of the following is NOT part of the secondary assessment of the chest and CVS, as outlined in the content?
When assessing a patient's extremities, what is being observed specifically related to tread marks?
When assessing a patient's extremities, what is being observed specifically related to tread marks?
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What is the essential factor that determines the type of facility required for a patient, as stated in the content?
What is the essential factor that determines the type of facility required for a patient, as stated in the content?
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Beyond the facility's resources, what other factor influences the patient's location, as outlined in the content?
Beyond the facility's resources, what other factor influences the patient's location, as outlined in the content?
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When conducting a secondary assessment of the abdomen, what is a key aspect of the interview process?
When conducting a secondary assessment of the abdomen, what is a key aspect of the interview process?
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Which of these terms is NOT explicitly mentioned in the content as part of the secondary assessment of the chest and CVS?
Which of these terms is NOT explicitly mentioned in the content as part of the secondary assessment of the chest and CVS?
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Which of these categories are part of the secondary assessment, according to the document? (Select all that apply)
Which of these categories are part of the secondary assessment, according to the document? (Select all that apply)
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Based on the information provided, which of these is NOT considered a part of the assessment of a patient’s 'Mental Status Examination'?
Based on the information provided, which of these is NOT considered a part of the assessment of a patient’s 'Mental Status Examination'?
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When assessing a patient's neurological status, what information related to pain should be gathered?
When assessing a patient's neurological status, what information related to pain should be gathered?
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What does the document suggest about the importance of creating and observing vital sign trends?
What does the document suggest about the importance of creating and observing vital sign trends?
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What does the document state about the role of technology in observing vital signs?
What does the document state about the role of technology in observing vital signs?
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What is the main focus of the 'Reassessment and Management (Discussion)' section of the document?
What is the main focus of the 'Reassessment and Management (Discussion)' section of the document?
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According to the document, what is the importance of understanding the events leading up to a patient's pain?
According to the document, what is the importance of understanding the events leading up to a patient's pain?
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What does the statement '...Should you just transport the patient as is and cross your fingers enroute?' suggest about the importance of reassessment and management?
What does the statement '...Should you just transport the patient as is and cross your fingers enroute?' suggest about the importance of reassessment and management?
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What is the most important task of the job according to the information provided?
What is the most important task of the job according to the information provided?
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Which of the following is NOT a factor considered during the scene size-up?
Which of the following is NOT a factor considered during the scene size-up?
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What is the purpose of the primary survey?
What is the purpose of the primary survey?
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What does AVPU stand for?
What does AVPU stand for?
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What is the order of assessment in the primary survey for a conscious patient?
What is the order of assessment in the primary survey for a conscious patient?
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Which of the following is NOT a sign to look for during the assessment of circulation?
Which of the following is NOT a sign to look for during the assessment of circulation?
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Which of the following is NOT considered a potential hazard at the scene?
Which of the following is NOT considered a potential hazard at the scene?
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Why is determining the mechanism of injury or nature of illness important?
Why is determining the mechanism of injury or nature of illness important?
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What type of additional resources might be required at a scene?
What type of additional resources might be required at a scene?
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Which of the following is NOT considered part of the general impression?
Which of the following is NOT considered part of the general impression?
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Study Notes
Medical Emergencies - Patient Assessment
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Learning Objectives:
- Understand the importance of scene size-up
- Outline steps for scene size-up
- Identify potential hazards at the scene
- Explain self-protection and safety for colleagues
- Determine the number of patients at the scene
- Identify necessary assistance
- Determine the mechanism of injury
- Explain the purpose of the primary survey
- Describe the general impression of a patient
- Utilize AVPU to assess patient consciousness levels
- Outline the primary survey process
Introduction
- Patient assessment is the most crucial task in emergency medical response.
- A thorough assessment leads to an accurate field diagnosis.
- This diagnosis guides the pre-hospital plan, transport type, and required resources of the receiving facility.
Scene Size-up
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Safety:
- Use appropriate personal protective equipment (PPE)
- Identify hazards: chemical, thermal, atmospheric, electrical, weapons, riots, traffic, violent/hostile patients, and potential for sudden behavior change.
- Assess bystanders, ambient temperature, space availability, and time of day/night.
- Evaluate the number of patients and location.
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Clues/Evidence at the scene:
- Medication bottles, chemical containers, syringes, illicit drug paraphernalia, blood, dead snakes/scorpions/jellyfish.
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Additional Resources:
- Hazmat team, heavy rescue, law enforcement (especially local UAE drug abuse policies), bystanders, witnesses, historians, air medical, veterinarians/snake handlers, beekeepers.
- Evaluate how these resources impact handover procedure
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Nature of illness/Mechanism of injury:
- Identify the reason for call.
Primary Survey
- General Impression:
- Patient appearance (posture, position, distress), incontinence, vomiting/odors, pain
- Age, gender, weight of patient
- Level of consciousness (LOC) - AVPU
- CAB (if unconscious), ABC (if conscious)
- Airway:
- Assess patency, position, obstructions, clarity of speech and voice.
- Provide airway management (adjuncts, maneuvers, pharmacological interventions like Epi/RSI) if necessary.
- Breathing:
- Auscultate lung sounds (presence, clarity, abnormal sounds).
- Evaluate minute volume (rate, rhythm, tidal volume), equal chest rise/fall.
- Check for V/Q mismatch, hypoxia, hypoxemia, acidosis, respiratory fatigue, and respiratory arrest.
- Provide supplementary oxygen/ventilatory support as needed.
- Circulation:
- Palpate pulse (presence, rate, rhythm, quality).
- Evaluate skin color, moisture, temperature, turgor, edema, and capillary refill.
- Assess pupils (reactivity to light, size, equality).
- Determine GCS score
- Disability:
- Assess the patient's neurological function, including LOC.
- Chief complaint:
- Capture the main reason for the call.
Transport Decision
- Type of transport: HEMS or road, considering distance.
- Facility requirements: Resources (CT scans, psych ward, bed space) and the expertise of the healthcare providers.
- Transfer considerations: Determine if transfer to another facility is necessary and obtain approval from the appropriate authorities.
- Protocol/governance: Ensure transport decisions align with established protocols and clinical governance structures.
Vital Signs
- Measure and record:
- Blood pressure (BP)
- Heart rate (HR) (pulse)
- Respiration rate
- Capillary refill
- EtCO2
- SpO2
- ECG analysis
Secondary Assessment
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History:
- OPQRST
- SAMPLE
- Focused history
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Head and Neck:
- Evaluate eyes, mouth, jugular venous distention (JVD), membrane color and moisture, skin color, ears, nose, and possible foreign matter (e.g., white powder)
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Chest and CVS:
- Inspect breathing rate, rhythm, depth, symmetry, and effort. Look for color, scars, lumps.
- Palpate for tenderness and lumps.
- Auscultate breath sounds (vesicular, bronchial, bronchovesicular) in appropriate locations.
- Percuss for symmetry of sounds.
- Adjust oxygen flow, and use respiratory/cardiovascular medications. Monitor trends, conduct a 12-lead ECG
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Abdomen and Pelvis:
- Interview patient concerning location, type, duration, events leading up to the current complaint, medications/food or products ingested, self-medications.
- Inspect for scars, distention, needle marks, pulsations, and color (including flanks and posterior region).
- Auscultate for bowel sounds.
- Palpate for guarding, tenderness with pressure, pulsations, and rigidity.
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Extremities:
- Evaluate pulses, edema, capillary refill, grip strength, and drift.
- Look for any tread marks, especially in anatomical positions of superficial veins (e.g., ACF).
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Mental status examination:
- Observe patient appearance(dress, eye contact, posture), facial grimaces/mannerisms.
- Evaluate speech (spontaneous, slow/fast, volume, clarity, appropriateness).
- Assess mood (depressed, euphoric, manic, anxious, angry, agitated, fearful, guilty).
- Identify thought process (racing, hallucinations, delusions, suicidal, unconnected, disturbed, homicidal).
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Neurological:
- Interview patient concerning pain, paralysis, location, duration, events leading up to symptoms, and pertinent past medical history.
- Assess motor system, including posturing, involuntary movements, strength, coordination, flaccid condition, and seizures/gait.
- If needed, perform stroke scales like Cincinnati/LAPSS, and large vessel occlusion severity scales.
Reassessment and Management
- Assess and monitor vital signs frequently.
- Utilize current technology in patient management, like 12-lead ECGs, for trend analysis.
- Adjust management strategies based on observed trends (improvement or deterioration).
- Evaluate if management improves or worsens the patient's condition.
- Determine if transport without additional interventions is appropriate, and how this affects prognosis.
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Description
This quiz focuses on key concepts in patient assessment during medical emergencies. Learn the importance of scene size-up, identify potential hazards, and understand the primary survey process. By mastering these skills, you'll contribute to effective emergency medical responses.
