Patient Assessment EMT Exam 1 Flashcards

Scene Size Up

• First major step in patient assessment.
• Key components: Body Substance Isolation (BSI), determine scene safety, number of patients, medical vs. trauma, additional resources needed.

Primary Assessment

• Second major step with eight sub-steps.
• Includes general view, stabilization of C Spine, assessment of patient status, level of consciousness (LOC), airway, breathing, circulation, and transport decision.

General Impression

• Utilizes the acronym AAMBIRPC for assessment components.

AAMBIRPC Components

• A: Age, sex, race
• A: Audible breath sounds
• M: Mechanism of Injury (MOI) or Nature of Illness (NOI)
• B: Body fluids present
• I: Imminent life threats
• R: Responsiveness
• P: Patient's position
• C: Skin color

Levels of Patient Response

• Four levels: A (alert), V (verbal), P (pain), U (unresponsive).

Circulation Assessment

• Three assessments: pulse, body fluids (hemorrhage), and perfusion.

Trauma Assessment Steps

• Significant trauma patients: Rapid Trauma Assessment (RPE), baseline vitals, SAMPLE history.
• Not significant trauma and unresponsive medical patients: Focused physical exam, vitals, SAMPLE history.

Medical Patients Assessment

• Responsive medical patients: SAMPLE and OPQRSTI history, focused physical exam, baseline vitals.

Rapid Physical Exam (RPE) Purpose

• To expose the patient and identify life-threatening injuries.

Techniques for RPE

• Techniques include IPA (Inspect, Palpate, Auscultation) and DCAP-BTLS (Deformities, Contusions, Abrasions, Penetrations & Punctures, Burns, Tenderness, Lacerations, Swellings).

Components of RPE

• Examines head, neck, chest, abdomen, pelvis, extremities, and back.
• RPE head considerations: blood/CSF leaks, airway burns, deformities, pupil response.
• Neck components: jugular vein distension, stoma, tracheal alignment, medical alert tag.
• Chest components: equal chest rise and paradoxical motion.
• Abdomen components: assessed using GBREAD (Guarding, Bruising, Rigidity, Evisceration, Aortic Aneurism, Distention).

Extremities and Back Assessment

• Extremity assessment includes PMS: Pulse, Motor function, Sensation.
• Back assessment focuses on identifying holes and readiness for backboarding.

Reassessment

• Fourth major step involves re-evaluating primary assessment, vital signs, focused assessment, interventions, and establishing priorities.

MOI and NOI Definitions

• MOI: Mechanism of injury specific to trauma patients.
• NOI: Nature of illness specific to medical patients.

History of Present Illness (HPI)

• Relates to OPQRSTI components.

Gathering Patient History

• Essential for determining medical complaints, including allergies, medications, and past medical history (PMH).

Symptoms vs. Signs

• Symptoms: Subjective experiences not observable (e.g., nausea).
• Signs: Objective findings observable by others (e.g., vomiting).

Scene Control

• Effective scene control requires competence, confidence, and compassion.

Types of Questions in History Taking

• Open-ended questions: Encourage descriptive responses.
• Closed-ended questions: Elicit yes/no answers.

SAMPLE and OPQRSTI Acronyms

• SAMPLE: Signs, Allergies, Medications, Past medical history, Last oral intake, Events leading to illness/injury.
• OPQRSTI: Onset, Proactive/palliative factors, Quality, Region/radiation, Severity, Time, Interventions attempted.

Pertinent Negatives

• Identifies symptoms not present that influence the differential diagnosis.

Vital Signs Assessment (PRBABESS)

• Includes Pulse, Respiration, Breath Sounds, AVPU (Level of Consciousness), Blood Pressure, Pupillary response, Skin perfusion, Pulse Oximetry.

Signs of Airway Obstruction

• Indicators include no breathing, snoring, gurgling, and stridor.

Positive Pressure Ventilation (PPV)

• Administered when the patient is not breathing by opening the airway and providing PPV with O2.

Respiratory Rates

• Bradypnea: slow breathing rate.
• Tachypnea: fast breathing rate.

Skin and Appearance Indicators

• Cyanosis: bluish tint, often in fingers.
• Jaundice: yellow tint in eyes.
• Turgor: measures skin elasticity.

Blood Pressure Basics

• Systolic (top number): safe if 90 or higher.
• Diastolic (bottom number): measures pressure when heart is at rest.

Pulse Oximetry

• Measures oxygen saturation in peripheral blood.
• Normal range: 95% or greater; below 89% indicates moderate to severe hypoxia.

Blood Glucose and Temperature

• Normal blood glucose range: 80 mg/dL - 120 mg/dL.
• Core temperature can be measured using oral, rectal, or tympanic methods.