Module 2: Patient Assessment & Vital Signs

Questions and Answers

What is included in a rapid first impression observation of a patient?

Patient's general appearance (correct)

Patient's medical history

Patient's treatment plan

Patient's family history

How can paramedics determine if a patient's condition is urgent?

By asking the patient about their dietary habits

By reviewing the patient's past medical records

By checking the patient's height and weight

By observing the patient's overall appearance and breathing (correct)

Which component is NOT part of the rapid first impression assessment?

General appearance

Skin circulation

Breathing

Patient's vital signs (correct)

In assessing circulation, paramedics primarily evaluate which aspect?

Skin condition Signup and view all the answers

What does a paramedic observe to gather rapid first impressions?

Visual signs of stability or distress Signup and view all the answers

What does an alert mental status in a patient indicate?

The patient is in a non-urgent state. Signup and view all the answers

Which factor is typically associated with changes in a patient's mental state?

Hypoxia. Signup and view all the answers

What is an indication of a patient's urgent condition based on their mental status?

Patient shows signs of confusion or disorientation. Signup and view all the answers

What should be observed to assess the mental status of a patient in a rapid first impression?

The patient's alertness and response to introduction. Signup and view all the answers

Changes in mental state can result from what kind of brain conditions?

Inadequate perfusion due to hypoxia or hypoperfusion. Signup and view all the answers

Changes in mental state are often associated with inadequate ______ of the brain.

perfusion Signup and view all the answers

If the patient is alert, the situation is considered ______.

non-urgent Signup and view all the answers

An immediate response to your introduction indicates that the patient is ______.

alert Signup and view all the answers

Hypoxia or ______ can lead to changes in mental state.

hypoperfusion Signup and view all the answers

Other than alert, any other mental status indicates a ______ situation.

urgent Signup and view all the answers

What body position is considered normal for infants in a rapid first impression assessment?

Lying with flexed arms and legs Signup and view all the answers

Which of the following conditions in an adult would be classified as abnormal and urgent based on rapid first impression?

Floppy and unable to sit Signup and view all the answers

In the context of a rapid first impression, a patient described as 'stiff' would imply what kind of urgency?

Urgent condition requiring immediate assessment Signup and view all the answers

What does the term 'normal for age' refer to in the context of rapid first impression observations?

Expectations based on average age-related behaviors Signup and view all the answers

Which scenario represents a non-urgent condition in a rapid first impression assessment?

Elderly person sitting comfortably Signup and view all the answers

Infants lying with flexed arms and legs is considered ______ for age.

normal Signup and view all the answers

A patient who is floppy, stiff, or unable to sit is classified as ______.

urgent Signup and view all the answers

Adults sitting comfortably is an example of a ______ body position.

normal Signup and view all the answers

Rapid first impressions involve observing muscle tone and ______ position.

body Signup and view all the answers

When assessing a patient, abnormal findings indicate a ______ response is required.

urgent Signup and view all the answers

What is an indicator that a patient may be experiencing respiratory distress?

Presence of audible sounds associated with breathing Signup and view all the answers

Which observation would suggest that a patient is making an extra effort to breathe?

Use of accessory muscles for breathing Signup and view all the answers

In a rapid first impression assessment, what should be noted regarding the patient's breathing?

Any abnormal sounds or patterns of breathing Signup and view all the answers

Which factor is least likely to be assessed when observing a patient's breathing?

Presence of pallor in the skin Signup and view all the answers

What would indicate a lack of adequate air exchange in a patient?

Descreased movement of the chest during inhalation Signup and view all the answers

Observe and listen for ______ during the rapid first impression assessment.

breathing Signup and view all the answers

The movement of the ______ can indicate the effort a patient is making to breathe.

chest Signup and view all the answers

Are there audible ______ associated with breathing?

sounds Signup and view all the answers

Does the patient appear to be making extra ______ in order to move air in or out?

effort Signup and view all the answers

Assessing for any movement in the ______ is crucial during the rapid first impression.

abdomen Signup and view all the answers

What observation indicates a non-urgent condition during a rapid first impression assessment?

The chest wall moves without extra effort and without audible sounds Signup and view all the answers

Which condition should prompt an urgent response based on chest wall movement?

Chest wall movement with audible sounds Signup and view all the answers

What does no chest wall movement indicate during a rapid first impression assessment?

Urgent condition requiring immediate intervention Signup and view all the answers

Which statement correctly reflects a sign that indicates an urgent health condition?

Chest wall moves with visible effort during breathing Signup and view all the answers

What can excessive effort in chest wall movement suggest about a patient's condition?

Potential respiratory distress that may require urgent care Signup and view all the answers

What does a lack of chest wall movement most directly indicate about a patient's condition?

Ventilation is inadequate and oxygen exchange is compromised. Signup and view all the answers

What immediate action should be taken if it is observed that the chest wall is not rising?

Provide supplemental oxygen and ventilate with a bag-valve-mask. Signup and view all the answers

Which of these statements about the rapid first impression assessment is true?

The appearance of a patient should signal the need for immediate transport if breathing is inadequate. Signup and view all the answers

Why is immediate transport necessary when oxygen exchange cannot take place?

Lack of oxygen exchange can lead to rapidly deteriorating conditions. Signup and view all the answers

What sign indicates that a patient may be experiencing respiratory distress?

Excessive effort in the movement of the chest wall during breathing. Signup and view all the answers

If the chest wall is not rising, adequate ______ is not occurring.

breathing Signup and view all the answers

Oxygen exchange cannot take place, so you need to ventilate the patient with a ______ and supplemental oxygen.

bag-valve-mask Signup and view all the answers

If the chest wall is not moving, you will already have observed a problem with the patient’s ______.

appearance Signup and view all the answers

You need to ______ the patient immediately if there is inadequate breathing.

transport Signup and view all the answers

The lack of chest wall ______ most directly indicates a problem with the patient's condition.

movement Signup and view all the answers

What skin color observation indicates a non-urgent condition during a rapid first impression assessment?

Pink Signup and view all the answers

In individuals with darker skin tones, which areas should be assessed for circulation?

Lips, tongue, palms or soles Signup and view all the answers

What does a pale, bluish, or mottled color in skin indicate during a rapid first impression assessment?

Urgent condition Signup and view all the answers

Which observation regarding skin tone suggests that oxygen delivery may be ineffective?

Pale or bluish Signup and view all the answers

When observing skin color, which of the following conditions should raise immediate concern?

Mottled complexion Signup and view all the answers

The skin tone gives you the first clue about how effectively ______ is being delivered throughout the body.

oxygen Signup and view all the answers

Pale, bluish or mottled color indicates a ______ condition.

Urgent Signup and view all the answers

In people with dark skin tones, look at the lips, tongue, palms or ______.

soles Signup and view all the answers

When you see anything other than pink, think high concentration ______ and transport.

oxygen Signup and view all the answers

Pink tones indicate a ______ condition.

Non-Urgent Signup and view all the answers

What should be prioritized for a patient with an urgent condition?

Immediate intervention and rapid transport Signup and view all the answers

Which aspect of patient assessment continues throughout transport for urgent conditions?

Initial assessment to clarify the problem Signup and view all the answers

Why is time considered critical for patients in urgent conditions?

Delays can result in deterioration of the patient's condition. Signup and view all the answers

What is the best clinical decision for any patient with an urgent condition?

Supporting the ABCs while transporting Signup and view all the answers

Which condition is likely to necessitate care that is not available in a pre-hospital setting?

A patient showing signs of severe respiratory distress Signup and view all the answers

A person with an urgent condition requires immediate intervention to support Airway, Breathing and/or ______.

Circulation Signup and view all the answers

Immediate intervention and Rapid transport are the ______.

priority Signup and view all the answers

Supporting the ABCs while transporting is the best clinical ______ to be made for any patient with an urgent condition.

decision Signup and view all the answers

In doing the initial assessment, the nature of the ______ may become clearer and further treatment may be indicated.

problem Signup and view all the answers

The patient needs care not available in the pre-hospital ______.

setting Signup and view all the answers

What should be prioritized over completing a focused history or initial assessment during urgent situations?

Moving to definitive care Signup and view all the answers

Why is it acceptable to delay additional physical exams during transport?

Time is often critical in urgent cases. Signup and view all the answers

During a rapid first impression, how should paramedics communicate with the patient?

Briefly explain interventions and transport Signup and view all the answers

What is the primary goal during a rapid first impression assessment?

Initiating transport to definitive care Signup and view all the answers

What approach should a paramedic take when they encounter an urgent situation during initial assessment?

Immediately start interventions while preparing to transport Signup and view all the answers

It is always more important to be moving to definitive care than it is to complete the focused ______ or initial assessment.

history Signup and view all the answers

Additional physical exam and ______ taking (if not essential) are delayed until after transport has begun.

history Signup and view all the answers

Briefly explain ______ to patients and begin transport.

interventions Signup and view all the answers

Rapid first impressions involve observing muscle ______ and body position.

tone Signup and view all the answers

You need to transport the patient immediately if there is ______ breathing.

inadequate Signup and view all the answers

What is the first priority in treating an unresponsive patient?

Maintain an open airway Signup and view all the answers

Why is rapid transport essential for an unresponsive patient?

Transportation delays can worsen their condition. Signup and view all the answers

What treatment should be administered to a patient with severe trauma immediately?

Immobilization and airway management Signup and view all the answers

Which action should follow the opening of an airway in a severely traumatized patient?

Start the transport process immediately Signup and view all the answers

What is a critical component of airway management in an unresponsive child?

Strictly maintaining circulation Signup and view all the answers

A patient presenting as unresponsive needs immediate ______ and rapid transport.

intervention Signup and view all the answers

Treatment of the unresponsive child begins with strict attention to maintaining an open ______.

airway Signup and view all the answers

A patient with severe trauma should be treated with immobilization and modified jaw ______, if needed.

thrust Signup and view all the answers

Once the airway is opened, ______ must be started.

transport Signup and view all the answers

The unresponsive patient cannot afford ______ delays.

transportation Signup and view all the answers

What is the primary goal when assessing a non-urgent patient?

To establish rapport and minimize agitation Signup and view all the answers

Which method is appropriate for conducting the initial assessment of a non-urgent patient?

Conducting assessments at the scene or during transport Signup and view all the answers

What approach should be taken to mitigate patient agitation during an assessment?

Engage in conversation to build trust Signup and view all the answers

When dealing with a non-urgent patient, what is important to consider during the assessment?

Ensuring the patient is calm and relaxed Signup and view all the answers

How should the focused history be approached in a non-urgent situation?

Take time to gather relevant information gradually Signup and view all the answers

In treating critically ill patients, which approach should be utilized to assess and manage their condition?

A-E approach focusing on Airway, Breathing, Circulation, Disability, and Exposure Signup and view all the answers

What is the primary aim of the initial treatment when caring for deteriorating patients?

To keep the patient alive and achieve some clinical improvement Signup and view all the answers

Which of the following statements best describes the significance of regular reassessment in patient management?

It helps in monitoring the effects of treatment and making necessary adjustments. Signup and view all the answers

When should additional help be sought in the care of a critically ill patient?

Immediately, as early intervention can be vital Signup and view all the answers

What is a critical aspect to remember about the effects of treatments administered to critically ill patients?

It can take several minutes for treatments to show effects. Signup and view all the answers

What indicates that a patient is likely to be critically ill during the initial assessment?

The patient is unresponsive to verbal stimuli. Signup and view all the answers

During a rapid first impression assessment, what should be the immediate response if a patient shows occasional gasping breaths?

Initiate CPR immediately. Signup and view all the answers

When a patient speaks only in short sentences, what does this likely indicate?

The patient is experiencing breathing difficulties. Signup and view all the answers

What is the purpose of establishing a response and introducing yourself to a patient?

To assess the patient's level of alertness. Signup and view all the answers

Why is monitoring vital signs important in critically ill patients?

To identify any immediate life-threatening conditions. Signup and view all the answers

What is a sign that a patient is experiencing respiratory distress during the rapid assessment?

The patient does not exhibit any chest wall movement. Signup and view all the answers

During the rapid first impression, ensure you have appropriate help coming if ______.

needed Signup and view all the answers

If the patient is unconscious and unresponsive, start ______ immediately.

CPR Signup and view all the answers

If a patient responds by talking normally, they have a patent ______.

airway Signup and view all the answers

Monitor vital signs early in all critically ill patients, including ______ oximetry.

pulse Signup and view all the answers

Occasional gasps are NOT normal and are a sign of ______ arrest.

cardiac Signup and view all the answers

A rapid first impression assessment should take no more than ______ seconds.

30 Signup and view all the answers

A patient who appears to be unconscious and does not respond is likely to be critically ill.

True Signup and view all the answers

If a patient speaks only in short sentences, they are guaranteed to have a patent airway.

False Signup and view all the answers

The first step in assessing a critically ill patient involves ensuring personal safety and wearing appropriate PPE.

True Signup and view all the answers

Occasional gasps during breathing can be considered normal and do not require immediate action.

False Signup and view all the answers

Monitoring vital signs should be initiated as soon as possible for all critically ill patients.

True Signup and view all the answers

A rapid first impression assessment should take more than 30 seconds to ensure accuracy.

False Signup and view all the answers

What does complete airway obstruction signify in terms of breath sounds?

No breath sounds are present at the mouth or nose. Signup and view all the answers

Which of the following is a late sign of airway obstruction?

Central cyanosis Signup and view all the answers

What is commonly required for airway clearance in most cases of airway obstruction?

Simple airway clearance methods Signup and view all the answers

In which situation is airway obstruction most likely to occur?

Due to depressed consciousness. Signup and view all the answers

What indicates a partial airway obstruction?

Diminished and often noisy air entry. Signup and view all the answers

Airway obstruction causes paradoxical chest movement and ______ movements.

abdominal Signup and view all the answers

In complete airway obstruction, there are no breath sounds at the ______ or nose.

mouth Signup and view all the answers

Central cyanosis is a late sign of ______ obstruction.

airway Signup and view all the answers

In most cases, only simple methods of airway ______ are required.

clearance Signup and view all the answers

Tracheal intubation by an ALS paramedic may be required when these ______.

fail Signup and view all the answers

Signs of airway obstruction include paradoxical chest and abdominal movements.

True Signup and view all the answers

Complete airway obstruction allows for audible breath sounds at the mouth or nose.

False Signup and view all the answers

Central cyanosis is an early sign of airway obstruction.

False Signup and view all the answers

In most airway obstruction cases, complex surgical interventions are required for clearance.

False Signup and view all the answers

Depressed consciousness can contribute to airway obstruction in critically ill patients.

True Signup and view all the answers

Which of the following conditions necessitates immediate treatment during the assessment of breathing?

Pulmonary Oedema Signup and view all the answers

What is the normal range for respiratory rate in adults?

12 – 24 / minute Signup and view all the answers

What does a decrease in breath sounds during auscultation typically suggest?

Pneumothorax or pleural fluid Signup and view all the answers

What finding during a breathing assessment would indicate that the trachea has deviated?

Mediastinal shift Signup and view all the answers

Which of the following indicates that a patient's breathing may be inadequate?

Use of accessory muscles Signup and view all the answers

What respiratory sign could indicate a significant airway obstruction?

Rattling airway noises Signup and view all the answers

Which action should be taken if a patient's breathing is assessed as absent or inadequate?

Initiate bag valve mask ventilation Signup and view all the answers

What assessment might indicate that a patient is experiencing an immediate breathing emergency?

Decrease in breath sounds during auscultation Signup and view all the answers

During the immediate assessment of breathing, it is vital to assess and treat immediately life-threatening conditions, such as acute severe _____.

asthma Signup and view all the answers

Look, listen and feel for the general signs of respiratory _____ such as sweating and central cyanosis.

distress Signup and view all the answers

A normal respiratory rate is between 12 - _____ breaths per minute.

24 Signup and view all the answers

____ breathing suggests partial airway obstruction, often accompanied by stridor.

Wheeze Signup and view all the answers

Check the position of the trachea in the suprasternal notch as deviation to one side indicates a _____ shift.

mediastinal Signup and view all the answers

Use bag valve mask ventilation to improve _____ if a patient’s depth or rate of breathing is inadequate.

oxygenation Signup and view all the answers

Listen to the patient's breath sounds noting rattling airway noises which indicate the presence of airway _____.

secretions Signup and view all the answers

Specific treatment of breathing problems depends on the _____ underlying the condition.

cause Signup and view all the answers

What is a normal respiratory rate for an adult?

12 – 24 / minute Signup and view all the answers

An increase in respiratory rate to over 24 breaths per minute is a marker of health.

False Signup and view all the answers

List two signs that may indicate respiratory distress.

Sweating and central cyanosis Signup and view all the answers

Rattling airway noises usually indicate the presence of ______.

airway secretions Signup and view all the answers

Match the following terms with their descriptions:

Pulmonary Oedema = Fluid accumulation in lungs Stridor = High-pitched wheezing sound Pneumothorax = Air in the pleural space Anaphylaxis = Severe allergic reaction Signup and view all the answers

Which of the following conditions requires immediate oxygen administration?

Acute severe asthma Signup and view all the answers

Chest deformity does not affect a patient's ability to breathe normally.

False Signup and view all the answers

What is the purpose of using a bag valve mask ventilation?

To improve oxygenation Signup and view all the answers

Which sign would indicate the worst outcome in evaluating a patient's circulation?

Cool extremities Signup and view all the answers

What does a low diastolic blood pressure typically suggest?

Arterial vasodilation Signup and view all the answers

When assessing for hypovolaemia, which type of pulse presence is crucial if a patient has a blood pressure of greater than 70 systolic?

Femoral pulse Signup and view all the answers

Which observation during a circulation assessment indicates potential compensatory mechanisms at play?

Normal blood pressure in shock Signup and view all the answers

What is an immediate treatment step that should be taken for patients experiencing cardiovascular collapse?

Immediate fluid replacement Signup and view all the answers

Which of the following findings would NOT be considered a sign of reduced cardiac output?

Warm and pink extremities Signup and view all the answers

What does a narrowed pulse pressure indicate?

Increased peripheral resistance Signup and view all the answers

In trauma patients, which action is critical to quickly identify a life-threatening condition?

Check for obvious external bleeding Signup and view all the answers

In almost all medical and traumatic emergencies consider hypovolaemia to be the likeliest cause of ______ until proven otherwise.

shock Signup and view all the answers

Blood pressure may be normal even if the patient is in ______.

shock Signup and view all the answers

BP Systolic: The pressure exerted against the arterial walls when the heart ______.

contracts Signup and view all the answers

Look thoroughly for external ______ (obvious external and concealed).

bleeding Signup and view all the answers

Low Diastolic BP suggests arterial ______.

vasodilation Signup and view all the answers

Narrowed pulse pressure suggests arterial ______.

vasoconstriction Signup and view all the answers

The treatment of cardiovascular collapse depends on the cause but should be directed at control of ______, shock position, fluid replacement, and restoration of tissue perfusion.

bleeding Signup and view all the answers

Seek signs of conditions that are immediately life threatening and treat them ______.

urgently Signup and view all the answers

What is the primary aim when assessing circulation in an emergency situation?

Controlling bleeding and restoring tissue perfusion Signup and view all the answers

A normal blood pressure reading guarantees that the patient is not in shock.

False Signup and view all the answers

What does a narrowed pulse pressure indicate?

Arterial vasoconstriction Signup and view all the answers

In cases of shock, hypovolaemia is often considered the likeliest cause until _______.

proven otherwise Signup and view all the answers

Match the type of pulse with the corresponding systolic blood pressure range it implies:

Femoral pulse = >70 systolic Brachial pulse = >60 systolic Carotid pulse = >40 systolic No pulse = Indicates severe shock Signup and view all the answers

Which observation is NOT associated with assessing the circulatory state of a patient?

Patient's respiratory rate Signup and view all the answers

Looking for signs of concealed bleeding is essential in trauma and post-surgery patients.

True Signup and view all the answers

The diastolic blood pressure measures the pressure against the arterial walls when the heart is in a ______ state.

relaxed Signup and view all the answers

What is a common cause of unconsciousness in patients?

Cerebral hypoperfusion Signup and view all the answers

Which action is essential to assess a patient's level of consciousness?

Use the Glasgow coma scale (GCS) Signup and view all the answers

What is the normal blood glucose level that should be assessed to exclude hypoglycaemia?

<blockquote> 4.0 mmol/l </blockquote> Signup and view all the answers

When should an antagonist medication be administered?

In case of drug overdose Signup and view all the answers

Which of the following observations about pupils indicates a possible problem?

Unequal size with no reaction to light Signup and view all the answers

Which condition is NOT a common cause of unconsciousness?

Hypertension Signup and view all the answers

Hypoglycaemia is defined as a blood glucose level greater than 4.0 mmol/l.

False Signup and view all the answers

What is the normal range for tympanic temperature in degrees Celsius?

36.5 - 37.5 Signup and view all the answers

The ______ scale is used to make a rapid assessment of the patient’s conscious state.

Glasgow coma Signup and view all the answers

Match the cause of unconsciousness with its related action or management:

Profound hypoxia = Administer oxygen Hypercapnia = Encourage ventilation Recent sedative administration = Administer antagonist Hypoglycaemia = Measure blood glucose Signup and view all the answers

What is primarily necessary for a thorough examination according to the ABCDE approach?

Full exposure of the patient's body Signup and view all the answers

Which of the following should be a priority when exposing a patient for examination?

Respecting the patient's dignity Signup and view all the answers

What should be minimized to ensure patient comfort during exposure?

Heat loss Signup and view all the answers

In the ABCDE approach, what areas of the body should be examined?

Skin surface and extremities Signup and view all the answers

Which of the following is NOT a component of the examination process according to the ABCDE approach?

Monitoring patient’s psychological state Signup and view all the answers

What should be done to respect a patient's dignity during an examination?

Expose only the necessary areas Signup and view all the answers

Minimizing heat loss during examination is not important.

False Signup and view all the answers

What body areas are particularly important to examine for proper exposure?

Skin surface and extremity Signup and view all the answers

To properly examine a patient, full ______ of the body may be necessary.

exposure Signup and view all the answers

Match the following examination focuses with their significance:

Skin surface = Assessing for rashes or lesions Extremity = Checking for circulation and sensation Patient dignity = Maintaining respect during the examination Minimizing heat loss = Ensuring patient comfort Signup and view all the answers

What is the primary objective when obtaining a chief complaint from a patient?

To understand what happened to the patient Signup and view all the answers

Why is it important to evaluate the circumstances surrounding a patient's chief complaint?

To identify if there is a high risk for injury Signup and view all the answers

What aspect should be considered when assessing whether the mechanism of injury is high risk?

The type of incident and its impact Signup and view all the answers

When obtaining a chief complaint, what should be the paramedic's initial focus?

To identify what specifically caused the incident Signup and view all the answers

What is a crucial question to evaluate after determining the chief complaint?

What were the circumstances that led to the incident? Signup and view all the answers

What is the first step in performing a focused history on a patient?

Obtain the Chief Complaint Signup and view all the answers

The mechanism of injury should always be evaluated to determine if it is a high risk for injury.

True Signup and view all the answers

What is meant by 'evaluating the chief complaint' in a medical assessment?

Assessing the circumstances surrounding the incident that led to the patient's condition. Signup and view all the answers

To effectively assess a patient's condition, one must first obtain the ______.

Chief Complaint Signup and view all the answers

Match the following terms with their correct definitions:

Chief Complaint = The main reason for the patient's visit. Mechanism of Injury = The circumstances that caused the patient's condition. Focused History = A detailed assessment regarding the patient’s issue. Evaluate = To assess and make a judgment about the situation. Signup and view all the answers

What is one of the main purposes of ongoing assessment in patient care?

To check for changes in the patient’s condition Signup and view all the answers

Which procedure is NOT part of the reassessment process?

Wait for the patient to speak Signup and view all the answers

What is assessed to determine the effectiveness of treatment in a patient?

Vital Signs and interventions Signup and view all the answers

During reassessment, what should be performed after checking vital signs?

Repeat Focused Assessment Signup and view all the answers

Why is it essential to identify missed injuries or conditions during reassessment?

To provide a more comprehensive treatment Signup and view all the answers

What is the primary purpose of ongoing assessment in patient care?

Identify missed injuries or conditions Signup and view all the answers

Ongoing assessments are performed solely on trauma patients.

False Signup and view all the answers

List one of the steps involved in the ongoing assessment procedure.

Reassess Vital Signs Signup and view all the answers

The ongoing assessment procedure includes repeating the initial assessment and checking ______.

interventions Signup and view all the answers

Match the steps of the ongoing assessment procedure to their descriptions:

Repeat Initial Assessment = Evaluate the patient as a whole again Reassess Vital Signs = Check current health indicators like heart rate and blood pressure Repeat Focused Assessment = Assess specific injuries or conditions Check Interventions = Evaluate the effectiveness of actions taken Signup and view all the answers

What should be the immediate action if a life-threatening condition is detected that cannot be alleviated?

Rapidly transport to an appropriate facility. Signup and view all the answers

What is a consideration before transporting a patient in need of rapid evacuation?

Consider ALS/ICP intercept. Signup and view all the answers

During a rapid evacuation process, which of the following is not a step you should take?

Use a slow and careful approach. Signup and view all the answers

Why is it crucial to transport a patient rapidly if your intervention fails to address their life-threatening condition?

To ensure they receive appropriate facility care. Signup and view all the answers

What indication would prompt the need for a rapid evacuation of a patient?

The intervention does not alleviate a life-threatening condition. Signup and view all the answers

Which condition requires rapid evacuation due to its potential severity?

Severe pain in any part of the body Signup and view all the answers

What is a sign that a patient may be experiencing respiratory distress?

Difficulty breathing Signup and view all the answers

Which of the following is NOT a criterion for rapid evacuation?

Minor bruising Signup and view all the answers

How should a patient presenting with signs of anaphylaxis be classified?

Potentially life-threatening and requires immediate evacuation Signup and view all the answers

Which scenario indicates a need for urgent medical attention in terms of circulation?

Poor perfusion Signup and view all the answers

Which of the following conditions indicates an urgent need for rapid evacuation? A) Uncontrolled bleeding B) Mild headache C) Slight dizziness D) Minor bruise

Uncontrolled bleeding Signup and view all the answers

Severe allergic reactions (anaphylaxis) do not require urgent medical attention during a rapid evacuation.

False Signup and view all the answers

What is a sign that indicates a patient may be suffering from poisoning or overdose?

Altered mental status or unresponsiveness. Signup and view all the answers

A high body temperature above ______°C is a criterion for rapid evacuation.

40 Signup and view all the answers

Match the emergency signs with their corresponding conditions:

Unresponsive - no gag reflex = Severe brain injury Signs of generalised hypothermia = Extreme cold exposure Severe chest pain = Possible heart attack Inability to move any part of body = Severe neurological issue Signup and view all the answers

Signs of ______ can indicate a need for rapid evacuation due to severe body temperature issues.

generalised hypothermia Signup and view all the answers

An ______ reaction, such as anaphylaxis, requires immediate attention during rapid evacuation.

allergic Signup and view all the answers

Uncontrolled ______ can be a critical sign that necessitates urgent evacuation.

bleeding Signup and view all the answers

Inability to move any part of the body is a serious indicator of a ______ situation.

urgent Signup and view all the answers

A high body temperature of over ______°C can be a criterion for rapid evacuation.

40 Signup and view all the answers

What is the primary purpose of the Glasgow Coma Scale?

To evaluate the floor of consciousness and coma states Signup and view all the answers

In what context is the Glasgow Coma Scale typically utilized?

During trauma scenes or hospitalizations Signup and view all the answers

What aspect can the Glasgow Coma Scale help predict?

Mortality risk associated with impaired consciousness Signup and view all the answers

Which of the following is NOT a factor assessed by the Glasgow Coma Scale?

Nutritional status of the patient Signup and view all the answers

Which population is most commonly evaluated using the Glasgow Coma Scale?

Individuals experiencing trauma or altered consciousness Signup and view all the answers

The Glasgow Coma Scale (GCS) is designed to assess the depth of impaired ______.

consciousness Signup and view all the answers

The GCS helps to measure acute and chronic brain ______ within a trauma scene.

impairment Signup and view all the answers

The Glasgow Coma Scale is also used to predict whether a victim is likely to ______.

die Signup and view all the answers

The GCS assesses ______ states and their duration.

coma Signup and view all the answers

A higher GCS score indicates a better level of ______.

consciousness Signup and view all the answers

What is the total score range for the Glasgow Coma Scale?

3 to 15 Signup and view all the answers

What is the minimum score a patient can achieve on the Glasgow Coma Scale?

3 Signup and view all the answers

Which statement is important when passing on information regarding a patient’s Glasgow Coma Scale score?

Highlight where points have been lost. Signup and view all the answers

In the context of the Glasgow Coma Scale, what does a score of 15 indicate?

Full consciousness Signup and view all the answers

What is a critical aspect of handover information related to the Glasgow Coma Scale?

Include where points have been lost in the assessment. Signup and view all the answers

The maximum score on the Glasgow Coma Scale is 20.

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A minimum score of 3 on the Glasgow Coma Scale indicates a fully alert patient.

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Identifying points lost during a handover can contribute to better patient care.

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The Glasgow Coma Scale is typically used to assess a patient's respiratory rate.

False Signup and view all the answers

A total score on the Glasgow Coma Scale reflects a patient's overall neurological status.

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Study Notes

Patient Assessment Overview

Urgency Assessment

Paramedics are trained to quickly determine the urgency of a patient's condition.
Recognition of urgent conditions can lead to timely interventions and can be life-saving.
Non-urgent cases, while still requiring medical attention, may have a lower priority for immediate treatment based on visual assessment.

Rapid First Impression: Visual Appearance

Rapid first impressions are crucial for initial patient evaluation, focusing on visual observations.
Key areas of observation include:
1. The patient's general appearance, which can indicate overall health and distress.
2. Breathing assessment is essential; look for signs of respiratory distress or irregularities in breathing patterns.
3. Circulation evaluation involves examining the skin's condition (e.g., color, temperature, moisture) to assess perfusion and possible shock.

Rapid First Impression: Mental State

Changes in mental state can indicate inadequate brain perfusion, leading to conditions like hypoxia (low oxygen) or hypoperfusion (insufficient blood flow).
Monitoring mental status is crucial for assessing neurological health.

Assessment of Mental Status

Check if the patient is alert: Alertness indicates stable condition and is classified as non-urgent.
Evaluate the patient's immediate response to introductory engagement: An immediate response suggests a functioning mental state.
A non-alert patient or delayed response signals an urgent medical situation requiring prompt intervention.

Rapid First Impression: Muscle Tone

Assessing muscle tone and body position is crucial for initial evaluations.
Normal muscular tone varies by age; specific observations indicate developmental appropriateness.
Infants typically exhibit normal tone by lying with flexed arms and legs, which indicates good neurological function.
Adults generally present a normal body position by sitting comfortably, reflecting appropriate muscle tone and posture.

Urgency of Muscle Tone Abnormalities

Abnormal muscle tone signals potential urgent medical concerns.
Floppy muscle tone in infants suggests hypotonia, warranting immediate attention.
Stiff muscle tone may indicate hypertonia or other neurological issues, also requiring urgent evaluation.
Inability to sit suggests significant muscular or neurological impairment that necessitates prompt intervention.

Rapid First Impression: Breathing Assessment

Assess the patient's initial breathing status for rapid first impressions.
Observe for any movement in the chest or abdomen to determine if breathing is occurring normally.
Listen for audible sounds during breathing, which may indicate underlying issues (e.g., wheezing, stridor, or grunting).
Note if the patient is displaying signs of increased effort while breathing, suggesting potential respiratory distress or obstruction.
Observe chest wall movement to assess adequate breathing; lack of movement indicates a potential problem.
Abnormal posture and mental status often accompany inadequate breathing.
Absence of chest wall rise signifies insufficient oxygen exchange.
Immediate intervention is required: start ventilation with a bag-valve-mask.
Administer supplemental oxygen to enhance patient oxygenation.
Prompt transportation of the patient is critical in cases of inadequate breathing.

Breathing Urgency:

Normal breathing is characterized by movement of the chest wall without exertion or noise, indicating a non-urgent situation.
When the chest wall exhibits additional effort or produces audible sounds during breathing, it signals a potentially urgent condition that requires immediate attention.
The absence of chest wall movement is a critical sign and denotes an urgent medical emergency necessitating prompt intervention.

Rapid First Impression: Circulation

Skin colour is a primary indicator of oxygen delivery in the body, reflecting circulatory effectiveness.
Normal skin tone observed is pink, indicating non-urgent conditions and adequate oxygen levels.
Variations from pink, such as pale, bluish, or mottled hues suggest urgent medical attention due to potential oxygen insufficiency.
In individuals with darker skin tones, assess the lips, tongue, palms, or soles for accurate evaluation of circulation.
Recognition of variances in skin colour is crucial for timely diagnosis and intervention in circulatory issues.

Rapid First Impression: Urgent Conditions and Immediate Response

Urgent conditions necessitate immediate medical intervention to ensure proper Airway, Breathing, and Circulation (ABCs) support.
Prioritization of immediate intervention and rapid transport is critical in urgent scenarios.
Timeliness is crucial; any patient exhibiting urgent symptoms requires swift action.
Patients with urgent conditions often need advanced care that cannot be administered in pre-hospital settings.

Clinical Decision-Making

Supporting the ABCs while ensuring transport is the most effective clinical strategy for urgent cases.
The initial assessment of the patient's condition should be ongoing throughout the transport process.
Continuous evaluation during transport allows for a clearer understanding of the patient's issue, which may lead to necessary further treatments.
Focus on urgent situations where immediate transport is prioritized over thorough assessments.
Additional physical exams and detailed history taking can be postponed until after transport starts.

Patient Interventions

Briefly explain interventions to patients to establish understanding and cooperation.
Ensure communication is clear and concise during the initial interaction.

Emphasis on Transport

Prioritize movement to definitive care over completing focused history or initial assessments.
The urgency of transport plays a critical role in outcomes, especially in time-sensitive medical emergencies.

Rapid First Impression: Always Urgent

Patient Presentation and Urgency

Immediate intervention is critical for patients who are unresponsive or suffering severe trauma.
Time-sensitive scenarios require rapid transport to appropriate medical facilities.

Unresponsive Patient Care

Unresponsive patients cannot endure transportation delays; prioritize airway management.
Treatment begins with maintaining an open airway and ensuring adequate ventilation.
Support for circulation is essential alongside airway management.

Severe Trauma Care

Patients with severe trauma require immobilization to prevent further injury.
A modified jaw thrust maneuver may be necessary to maintain airway patency.
After establishing airway and ventilation, transport of the trauma patient should commence without delay.

Rapid First Impression: Non-Urgent Patient Approach

A gradual approach is appropriate for patients with non-urgent conditions.
Initial assessments can occur at the scene or during transport to the healthcare facility.
Aim to minimize patient agitation, as the non-urgent status allows for a calmer interaction.
Establishing rapport is crucial; take time to connect with the patient during the assessment process.
A thorough focused history can enhance understanding of the patient's condition and needs.

A-E Approach for Deteriorating and Critically Ill Patients

Utilize the Airway, Breathing, Circulation, Disability, Exposure framework for patient assessment and treatment.
Conduct a thorough initial assessment and continue re-assessment regularly to monitor the patient's condition.
Prioritize and treat life-threatening issues before progressing to subsequent assessment components.
Evaluate the effectiveness of interventions to ensure they are making a positive impact.
Be aware of the need for additional assistance; call for help early in the process.
Engage all team members and appropriate bystanders to enhance the response capability.
Maintain clear and effective communication among all parties involved in patient care.
The primary goal of initial treatment is to ensure patient survival while promoting clinical improvement when possible.
Remain calm during the process, recognizing that therapeutic effects may take several minutes to manifest.
The ABCDE approach is applicable regardless of the assessor's training or clinical experience.
The depth of the assessment and the treatment choices will vary based on the individual's clinical expertise and skills.

Initial Assessment Steps for Critically Ill Patients

Personal safety is paramount; wear appropriate personal protective equipment (PPE) and assess surroundings for potential dangers.
Conduct a rapid first impression assessment of the patient; this should take about 30 seconds to determine if the patient appears unwell.
Use the “Look, Listen and Feel” method to quickly evaluate the patient's condition.

Patient Interaction

Establish a response by introducing yourself and asking the patient’s name if they are conscious.
For unresponsive patients, gently shake and inquire, “Are you ok?”

Response Evaluation

Normal speech indicates a patent airway, adequate breathing, and sufficient brain perfusion.
Short sentence responses may suggest breathing difficulties.
Lack of response typically indicates critical illness; immediate action is required.

CPR Protocol

In cases of unconsciousness, unresponsiveness, and abnormal breathing (with occasional gasping considered abnormal):
- Initiate cardiopulmonary resuscitation (CPR) immediately.

Monitoring Vital Signs

For non-cardiac arrest patients, prioritize early monitoring of vital signs.
Implement pulse oximetry, ECG monitoring, and non-invasive blood pressure checks for all critically ill patients as soon as possible.

ABCDE Approach - Airway

Airway obstruction is classified as a medical emergency that requires immediate attention.
Signs of airway obstruction include paradoxical chest movement and "see-saw" respirations involving abdominal movement.
Patients with airway obstruction utilize accessory muscles for breathing.
Central cyanosis indicates a severe, late-stage sign of airway obstruction.
In cases of complete airway obstruction, no breath sounds can be detected at the mouth or nose.
Partial airway obstruction results in diminished air entry, which can be accompanied by noisy breathing.
Critically ill patients may experience airway obstruction due to depressed consciousness levels.
Most airway clearance can be managed with simple interventions such as airway opening maneuvers, suctioning, and basic airway adjuncts.
Tracheal intubation by Advanced Life Support (ALS) paramedics is necessary if simple methods fail to remediate the obstruction.

ABCDE Approach - Breathing

Immediate assessment must identify and treat life-threatening conditions like acute severe asthma, pulmonary oedema, anaphylaxis, and major haemorrhage.
Observe general signs of respiratory distress, including sweating, central cyanosis, accessory muscle use, and abdominal breathing.
Normal respiratory rate is between 12-24 breaths per minute; a rate over 24 indicates potential illness.

Key Assessment Steps

Evaluate the depth of breaths and the pattern or rhythm of respiration.
Ensure equal and normal bilateral chest expansion.
Identify any chest deformities which could impact breathing ability.
Record SpO2 levels; provide high-concentration oxygen when necessary.

Respiratory Sounds and Auscultation

Listen for rattling airway noises indicating secretions; associated with an inability to cough or inhale deeply.
Stridor or wheezing suggests partial airway obstruction.
Auscultation can reveal:
- Bronchial breathing indicating lung consolidation with open airways.
- Absent or reduced breath sounds pointing to pneumothorax, pleural fluid, or lung consolidation.

Tracheal Position and Chest Examination

Check trachea positioning; deviation suggests mediastinal shift, possibly from pneumothorax, lung fibrosis, or pleural fluid.
Examine the chest wall for signs of surgical emphysema or crepitus.

Treatment Protocols

Treatment varies based on the identified cause; medications like Salbutamol or GTN may be utilized.
If tidal volume or breathing rate is inadequate or absent, employ bag valve mask ventilation to enhance oxygenation.
Ensure prompt transport of the patient and seek specialized assistance if needed.

ABCDE Approach - Circulation

Consider hypovolaemia as the primary cause of shock in medical and traumatic emergencies until proven otherwise.
In trauma and postoperative patients, quickly assess for both obvious and hidden bleeding.
Recognize that respiratory issues, like tension pneumothorax, can affect circulatory status.
Evaluate hand color for indicators of circulation:
- Blue, pale, pink, or mottled hues signal potential circulatory problems.
Assess warmth of the hands by holding the patient's hand; coolness may indicate poor perfusion.
Measure capillary refill time as an indicator of circulation.

Pulse Presence and Blood Pressure Assessment

Presence of femoral pulse indicates blood pressure above 70 mmHg systolic.
Brachial pulse presence is a sign of blood pressure above 60 mmHg systolic.
Carotid pulse presence indicates blood pressure above 40 mmHg systolic.
Blood pressure readings may appear normal despite patient in shock.
Systolic blood pressure (normal range: 120/130 mmHg) is the pressure during heart contraction.
Diastolic blood pressure (normal range: 80/85 mmHg) is the pressure during heart relaxation.
Low diastolic blood pressure suggests arterial vasodilation.
Narrowed pulse pressure (normal difference of 35-45 mmHg) may indicate arterial vasoconstriction.

Signs of Reduced Cardiac Output

Monitor for decreased consciousness as a sign of reduced cardiac output.
Blood pressure can remain normal due to compensatory mechanisms that increase peripheral resistance.
Conduct a thorough examination for external bleeding, both visible and concealed.

Treatment of Cardiovascular Collapse

Tailor treatment based on underlying causes to effectively address cardiovascular collapse.
Key interventions include controlling bleeding, positioning for shock relief, fluid replacement, and restoring tissue perfusion.
Identify and treat any life-threatening conditions urgently, potentially requiring rapid transport.

ABCDE Approach – Disability (D)

Common causes of unconsciousness include profound hypoxia, hypercapnia, cerebral hypoperfusion, recent sedative or analgesic use, and hypoglycaemia.
ABCs (Airway, Breathing, Circulation) should be assessed and treated; specifically target hypoxia and hypotension.
Review the patient’s recent drug history to identify potential overdoses; use antagonists like naloxone for opioid overdose.
Pupils should be examined for size, equality, and reaction to light as part of neurological assessment.
Employ the Glasgow Coma Scale (GCS) for a rapid assessment of the patient's conscious state; scores range from 3 (deep coma) to 15 (fully awake).
Measure blood glucose levels to rule out hypoglycaemia; a normal blood glucose level is above 4.0 mmol/l.
Determine the patient's tympanic temperature; a normal range is between 36.5 to 37.5 degrees Celsius.

ABCDE Approach – Exposure (E)

Full body exposure may be essential for a thorough examination.
Important areas to examine include:
- Skin surface to identify any abnormalities or injuries.
- Extremities to check for circulation, movement, and potential injuries.
Patient dignity must be respected during the exposure process.
Strategies should be employed to minimize heat loss, ensuring patient comfort and safety.

Focused History Purpose

Aim to gather specific information about the patient's chief complaint.
Establish a clear understanding of the patient's current condition.

Obtain Chief Complaint

Identify the primary issue or symptom that prompted the patient to seek care.
Utilize open-ended questions to encourage detailed responses about what occurred.

Evaluate Chief Complaint

Investigate the circumstances leading to the incident, including:
- Environment where the injury or issue happened.
- Activities the patient was engaged in at the time.
Assess whether the mechanism of injury poses a high risk for further injury, considering factors such as:
- Severity and nature of the event (e.g., fall from height, car accident).
- Patient's age, medical history, and overall health status.
- Potential for long-term complications resulting from the incident.

SAMPLE History

S Signs & Symptoms

A Allergies

M Medications

P Previous Medical History

L Last Oral Intake

E Events leading up to the incident

Reassessment / Ongoing Assessment:

Purpose of Reassessment

Evaluates changes in the patient's condition since the initial assessment.
Aims to identify any undetected injuries or medical conditions.
Assesses the effectiveness of current treatments and determines if adjustments are needed.

Applicable Patient Types

Reassessment is essential for both trauma and medical patients to ensure ongoing care.

Procedure for Reassessment

Conduct a Repeat Initial Assessment to gather fresh findings.
Reassess Vital Signs to monitor any changes in the patient's physiological status.
Perform a Repeat Focused Assessment to look into specific areas of concern.
Check Interventions to verify the effectiveness and appropriateness of care provided.

Rapid Evacuation / Transport

Evaluate ALS (Advanced Life Support) and ICP (InterFacility Critical Patient) intercept for potential advanced care during transport.
Prioritize swift transport to a medical facility if a life-threatening condition is identified that cannot be treated effectively on-scene.
Ensure timely communication with receiving facilities to prepare for patient arrival and necessary interventions.
Maintain patient stability during transport to minimize risk and ensure safety.
Document all findings and interventions before and during transport to inform receiving medical personnel.

Criteria for Rapid Evacuation

A poor first impression can indicate an urgent need for evacuation.
Unresponsive individuals lack both the gag and cough reflex, necessitating swift action.
Responsive patients may be unable to follow commands, indicating significant impairment.
Inability to establish or maintain a patent airway is critical for survival; evacuate immediately.
Difficulty breathing or respiratory distress signals require urgent care.
Signs of poor perfusion suggest inadequate blood flow and necessitate rapid evacuation.
Uncontrolled bleeding poses a life-threatening risk; prompt intervention is necessary.
Severe pain in any body part can indicate serious underlying issues requiring immediate attention.
Severe chest pain can signal a heart condition, thus warranting rapid medical evacuation.
Inability to move any part of the body indicates potential paralysis or serious injury; respond quickly.
Complicated childbirth situations demand immediate medical support for both mother and child.
High body temperature exceeding 40°C may indicate serious illness or infection; speed up the evacuation process.
Signs of generalized hypothermia require prompt treatment, as it can rapidly become life-threatening.
Severe allergic reactions, such as anaphylaxis, need immediate medical attention and swift evacuation.
Poisoning or overdose with unknown substances poses significant risks, requiring urgent medical evacuation.

Glasgow Coma Scale Overview

The Glasgow Coma Scale (GCS) is a medical tool for evaluating consciousness levels in individuals.
Primarily used to assess the severity of impaired consciousness and coma conditions.
Measures both the depth and duration of impaired consciousness.

Applications of GCS

Useful in trauma scenarios to gauge brain function and injury level.
Employed in hospital settings to monitor patient conditions over time.
Serves as a predictive measure for mortality risk in patients.

Importance of GCS

Facilitates effective communication among medical professionals regarding patient status.
Aids in determining the need for urgent interventions based on consciousness levels.
Supports decision-making processes for the ongoing care of patients with brain impairments.
Total score is out of 15. Minimum score is 3.
Always good to point out where points have been lost in a handover.

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