Podcast
Questions and Answers
What is included in a rapid first impression observation of a patient?
What is included in a rapid first impression observation of a patient?
How can paramedics determine if a patient's condition is urgent?
How can paramedics determine if a patient's condition is urgent?
Which component is NOT part of the rapid first impression assessment?
Which component is NOT part of the rapid first impression assessment?
In assessing circulation, paramedics primarily evaluate which aspect?
In assessing circulation, paramedics primarily evaluate which aspect?
Signup and view all the answers
What does a paramedic observe to gather rapid first impressions?
What does a paramedic observe to gather rapid first impressions?
Signup and view all the answers
What does an alert mental status in a patient indicate?
What does an alert mental status in a patient indicate?
Signup and view all the answers
Which factor is typically associated with changes in a patient's mental state?
Which factor is typically associated with changes in a patient's mental state?
Signup and view all the answers
What is an indication of a patient's urgent condition based on their mental status?
What is an indication of a patient's urgent condition based on their mental status?
Signup and view all the answers
What should be observed to assess the mental status of a patient in a rapid first impression?
What should be observed to assess the mental status of a patient in a rapid first impression?
Signup and view all the answers
Changes in mental state can result from what kind of brain conditions?
Changes in mental state can result from what kind of brain conditions?
Signup and view all the answers
Changes in mental state are often associated with inadequate ______ of the brain.
Changes in mental state are often associated with inadequate ______ of the brain.
Signup and view all the answers
If the patient is alert, the situation is considered ______.
If the patient is alert, the situation is considered ______.
Signup and view all the answers
An immediate response to your introduction indicates that the patient is ______.
An immediate response to your introduction indicates that the patient is ______.
Signup and view all the answers
Hypoxia or ______ can lead to changes in mental state.
Hypoxia or ______ can lead to changes in mental state.
Signup and view all the answers
Other than alert, any other mental status indicates a ______ situation.
Other than alert, any other mental status indicates a ______ situation.
Signup and view all the answers
What body position is considered normal for infants in a rapid first impression assessment?
What body position is considered normal for infants in a rapid first impression assessment?
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?
Which of the following conditions in an adult would be classified as abnormal and urgent based on rapid first impression?
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?
In the context of a rapid first impression, a patient described as 'stiff' would imply what kind of urgency?
Signup and view all the answers
What does the term 'normal for age' refer to in the context of rapid first impression observations?
What does the term 'normal for age' refer to in the context of rapid first impression observations?
Signup and view all the answers
Which scenario represents a non-urgent condition in a rapid first impression assessment?
Which scenario represents a non-urgent condition in a rapid first impression assessment?
Signup and view all the answers
Infants lying with flexed arms and legs is considered ______ for age.
Infants lying with flexed arms and legs is considered ______ for age.
Signup and view all the answers
A patient who is floppy, stiff, or unable to sit is classified as ______.
A patient who is floppy, stiff, or unable to sit is classified as ______.
Signup and view all the answers
Adults sitting comfortably is an example of a ______ body position.
Adults sitting comfortably is an example of a ______ body position.
Signup and view all the answers
Rapid first impressions involve observing muscle tone and ______ position.
Rapid first impressions involve observing muscle tone and ______ position.
Signup and view all the answers
When assessing a patient, abnormal findings indicate a ______ response is required.
When assessing a patient, abnormal findings indicate a ______ response is required.
Signup and view all the answers
What is an indicator that a patient may be experiencing respiratory distress?
What is an indicator that a patient may be experiencing respiratory distress?
Signup and view all the answers
Which observation would suggest that a patient is making an extra effort to breathe?
Which observation would suggest that a patient is making an extra effort to breathe?
Signup and view all the answers
In a rapid first impression assessment, what should be noted regarding the patient's breathing?
In a rapid first impression assessment, what should be noted regarding the patient's breathing?
Signup and view all the answers
Which factor is least likely to be assessed when observing a patient's breathing?
Which factor is least likely to be assessed when observing a patient's breathing?
Signup and view all the answers
What would indicate a lack of adequate air exchange in a patient?
What would indicate a lack of adequate air exchange in a patient?
Signup and view all the answers
Observe and listen for ______ during the rapid first impression assessment.
Observe and listen for ______ during the rapid first impression assessment.
Signup and view all the answers
The movement of the ______ can indicate the effort a patient is making to breathe.
The movement of the ______ can indicate the effort a patient is making to breathe.
Signup and view all the answers
Are there audible ______ associated with breathing?
Are there audible ______ associated with breathing?
Signup and view all the answers
Does the patient appear to be making extra ______ in order to move air in or out?
Does the patient appear to be making extra ______ in order to move air in or out?
Signup and view all the answers
Assessing for any movement in the ______ is crucial during the rapid first impression.
Assessing for any movement in the ______ is crucial during the rapid first impression.
Signup and view all the answers
What observation indicates a non-urgent condition during a rapid first impression assessment?
What observation indicates a non-urgent condition during a rapid first impression assessment?
Signup and view all the answers
Which condition should prompt an urgent response based on chest wall movement?
Which condition should prompt an urgent response based on chest wall movement?
Signup and view all the answers
What does no chest wall movement indicate during a rapid first impression assessment?
What does no chest wall movement indicate during a rapid first impression assessment?
Signup and view all the answers
Which statement correctly reflects a sign that indicates an urgent health condition?
Which statement correctly reflects a sign that indicates an urgent health condition?
Signup and view all the answers
What can excessive effort in chest wall movement suggest about a patient's condition?
What can excessive effort in chest wall movement suggest about a patient's condition?
Signup and view all the answers
What does a lack of chest wall movement most directly indicate about a patient's condition?
What does a lack of chest wall movement most directly indicate about a patient's condition?
Signup and view all the answers
What immediate action should be taken if it is observed that the chest wall is not rising?
What immediate action should be taken if it is observed that the chest wall is not rising?
Signup and view all the answers
Which of these statements about the rapid first impression assessment is true?
Which of these statements about the rapid first impression assessment is true?
Signup and view all the answers
Why is immediate transport necessary when oxygen exchange cannot take place?
Why is immediate transport necessary when oxygen exchange cannot take place?
Signup and view all the answers
What sign indicates that a patient may be experiencing respiratory distress?
What sign indicates that a patient may be experiencing respiratory distress?
Signup and view all the answers
If the chest wall is not rising, adequate ______ is not occurring.
If the chest wall is not rising, adequate ______ is not occurring.
Signup and view all the answers
Oxygen exchange cannot take place, so you need to ventilate the patient with a ______ and supplemental oxygen.
Oxygen exchange cannot take place, so you need to ventilate the patient with a ______ and supplemental oxygen.
Signup and view all the answers
If the chest wall is not moving, you will already have observed a problem with the patient’s ______.
If the chest wall is not moving, you will already have observed a problem with the patient’s ______.
Signup and view all the answers
You need to ______ the patient immediately if there is inadequate breathing.
You need to ______ the patient immediately if there is inadequate breathing.
Signup and view all the answers
The lack of chest wall ______ most directly indicates a problem with the patient's condition.
The lack of chest wall ______ most directly indicates a problem with the patient's condition.
Signup and view all the answers
What skin color observation indicates a non-urgent condition during a rapid first impression assessment?
What skin color observation indicates a non-urgent condition during a rapid first impression assessment?
Signup and view all the answers
In individuals with darker skin tones, which areas should be assessed for circulation?
In individuals with darker skin tones, which areas should be assessed for circulation?
Signup and view all the answers
What does a pale, bluish, or mottled color in skin indicate during a rapid first impression assessment?
What does a pale, bluish, or mottled color in skin indicate during a rapid first impression assessment?
Signup and view all the answers
Which observation regarding skin tone suggests that oxygen delivery may be ineffective?
Which observation regarding skin tone suggests that oxygen delivery may be ineffective?
Signup and view all the answers
When observing skin color, which of the following conditions should raise immediate concern?
When observing skin color, which of the following conditions should raise immediate concern?
Signup and view all the answers
The skin tone gives you the first clue about how effectively ______ is being delivered throughout the body.
The skin tone gives you the first clue about how effectively ______ is being delivered throughout the body.
Signup and view all the answers
Pale, bluish or mottled color indicates a ______ condition.
Pale, bluish or mottled color indicates a ______ condition.
Signup and view all the answers
In people with dark skin tones, look at the lips, tongue, palms or ______.
In people with dark skin tones, look at the lips, tongue, palms or ______.
Signup and view all the answers
When you see anything other than pink, think high concentration ______ and transport.
When you see anything other than pink, think high concentration ______ and transport.
Signup and view all the answers
Pink tones indicate a ______ condition.
Pink tones indicate a ______ condition.
Signup and view all the answers
What should be prioritized for a patient with an urgent condition?
What should be prioritized for a patient with an urgent condition?
Signup and view all the answers
Which aspect of patient assessment continues throughout transport for urgent conditions?
Which aspect of patient assessment continues throughout transport for urgent conditions?
Signup and view all the answers
Why is time considered critical for patients in urgent conditions?
Why is time considered critical for patients in urgent conditions?
Signup and view all the answers
What is the best clinical decision for any patient with an urgent condition?
What is the best clinical decision for any patient with an urgent condition?
Signup and view all the answers
Which condition is likely to necessitate care that is not available in a pre-hospital setting?
Which condition is likely to necessitate care that is not available in a pre-hospital setting?
Signup and view all the answers
A person with an urgent condition requires immediate intervention to support Airway, Breathing and/or ______.
A person with an urgent condition requires immediate intervention to support Airway, Breathing and/or ______.
Signup and view all the answers
Immediate intervention and Rapid transport are the ______.
Immediate intervention and Rapid transport are the ______.
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.
Supporting the ABCs while transporting is the best clinical ______ to be made for any patient with an urgent condition.
Signup and view all the answers
In doing the initial assessment, the nature of the ______ may become clearer and further treatment may be indicated.
In doing the initial assessment, the nature of the ______ may become clearer and further treatment may be indicated.
Signup and view all the answers
The patient needs care not available in the pre-hospital ______.
The patient needs care not available in the pre-hospital ______.
Signup and view all the answers
What should be prioritized over completing a focused history or initial assessment during urgent situations?
What should be prioritized over completing a focused history or initial assessment during urgent situations?
Signup and view all the answers
Why is it acceptable to delay additional physical exams during transport?
Why is it acceptable to delay additional physical exams during transport?
Signup and view all the answers
During a rapid first impression, how should paramedics communicate with the patient?
During a rapid first impression, how should paramedics communicate with the patient?
Signup and view all the answers
What is the primary goal during a rapid first impression assessment?
What is the primary goal during a rapid first impression assessment?
Signup and view all the answers
What approach should a paramedic take when they encounter an urgent situation during initial assessment?
What approach should a paramedic take when they encounter an urgent situation during initial assessment?
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.
It is always more important to be moving to definitive care than it is to complete the focused ______ or initial assessment.
Signup and view all the answers
Additional physical exam and ______ taking (if not essential) are delayed until after transport has begun.
Additional physical exam and ______ taking (if not essential) are delayed until after transport has begun.
Signup and view all the answers
Briefly explain ______ to patients and begin transport.
Briefly explain ______ to patients and begin transport.
Signup and view all the answers
Rapid first impressions involve observing muscle ______ and body position.
Rapid first impressions involve observing muscle ______ and body position.
Signup and view all the answers
You need to transport the patient immediately if there is ______ breathing.
You need to transport the patient immediately if there is ______ breathing.
Signup and view all the answers
What is the first priority in treating an unresponsive patient?
What is the first priority in treating an unresponsive patient?
Signup and view all the answers
Why is rapid transport essential for an unresponsive patient?
Why is rapid transport essential for an unresponsive patient?
Signup and view all the answers
What treatment should be administered to a patient with severe trauma immediately?
What treatment should be administered to a patient with severe trauma immediately?
Signup and view all the answers
Which action should follow the opening of an airway in a severely traumatized patient?
Which action should follow the opening of an airway in a severely traumatized patient?
Signup and view all the answers
What is a critical component of airway management in an unresponsive child?
What is a critical component of airway management in an unresponsive child?
Signup and view all the answers
A patient presenting as unresponsive needs immediate ______ and rapid transport.
A patient presenting as unresponsive needs immediate ______ and rapid transport.
Signup and view all the answers
Treatment of the unresponsive child begins with strict attention to maintaining an open ______.
Treatment of the unresponsive child begins with strict attention to maintaining an open ______.
Signup and view all the answers
A patient with severe trauma should be treated with immobilization and modified jaw ______, if needed.
A patient with severe trauma should be treated with immobilization and modified jaw ______, if needed.
Signup and view all the answers
Once the airway is opened, ______ must be started.
Once the airway is opened, ______ must be started.
Signup and view all the answers
The unresponsive patient cannot afford ______ delays.
The unresponsive patient cannot afford ______ delays.
Signup and view all the answers
What is the primary goal when assessing a non-urgent patient?
What is the primary goal when assessing a non-urgent patient?
Signup and view all the answers
Which method is appropriate for conducting the initial assessment of a non-urgent patient?
Which method is appropriate for conducting the initial assessment of a non-urgent patient?
Signup and view all the answers
What approach should be taken to mitigate patient agitation during an assessment?
What approach should be taken to mitigate patient agitation during an assessment?
Signup and view all the answers
When dealing with a non-urgent patient, what is important to consider during the assessment?
When dealing with a non-urgent patient, what is important to consider during the assessment?
Signup and view all the answers
How should the focused history be approached in a non-urgent situation?
How should the focused history be approached in a non-urgent situation?
Signup and view all the answers
In treating critically ill patients, which approach should be utilized to assess and manage their condition?
In treating critically ill patients, which approach should be utilized to assess and manage their condition?
Signup and view all the answers
What is the primary aim of the initial treatment when caring for deteriorating patients?
What is the primary aim of the initial treatment when caring for deteriorating patients?
Signup and view all the answers
Which of the following statements best describes the significance of regular reassessment in patient management?
Which of the following statements best describes the significance of regular reassessment in patient management?
Signup and view all the answers
When should additional help be sought in the care of a critically ill patient?
When should additional help be sought in the care of a critically ill patient?
Signup and view all the answers
What is a critical aspect to remember about the effects of treatments administered to critically ill patients?
What is a critical aspect to remember about the effects of treatments administered to critically ill patients?
Signup and view all the answers
What indicates that a patient is likely to be critically ill during the initial assessment?
What indicates that a patient is likely to be critically ill during the initial assessment?
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?
During a rapid first impression assessment, what should be the immediate response if a patient shows occasional gasping breaths?
Signup and view all the answers
When a patient speaks only in short sentences, what does this likely indicate?
When a patient speaks only in short sentences, what does this likely indicate?
Signup and view all the answers
What is the purpose of establishing a response and introducing yourself to a patient?
What is the purpose of establishing a response and introducing yourself to a patient?
Signup and view all the answers
Why is monitoring vital signs important in critically ill patients?
Why is monitoring vital signs important in critically ill patients?
Signup and view all the answers
What is a sign that a patient is experiencing respiratory distress during the rapid assessment?
What is a sign that a patient is experiencing respiratory distress during the rapid assessment?
Signup and view all the answers
During the rapid first impression, ensure you have appropriate help coming if ______.
During the rapid first impression, ensure you have appropriate help coming if ______.
Signup and view all the answers
If the patient is unconscious and unresponsive, start ______ immediately.
If the patient is unconscious and unresponsive, start ______ immediately.
Signup and view all the answers
If a patient responds by talking normally, they have a patent ______.
If a patient responds by talking normally, they have a patent ______.
Signup and view all the answers
Monitor vital signs early in all critically ill patients, including ______ oximetry.
Monitor vital signs early in all critically ill patients, including ______ oximetry.
Signup and view all the answers
Occasional gasps are NOT normal and are a sign of ______ arrest.
Occasional gasps are NOT normal and are a sign of ______ arrest.
Signup and view all the answers
A rapid first impression assessment should take no more than ______ seconds.
A rapid first impression assessment should take no more than ______ seconds.
Signup and view all the answers
A patient who appears to be unconscious and does not respond is likely to be critically ill.
A patient who appears to be unconscious and does not respond is likely to be critically ill.
Signup and view all the answers
If a patient speaks only in short sentences, they are guaranteed to have a patent airway.
If a patient speaks only in short sentences, they are guaranteed to have a patent airway.
Signup and view all the answers
The first step in assessing a critically ill patient involves ensuring personal safety and wearing appropriate PPE.
The first step in assessing a critically ill patient involves ensuring personal safety and wearing appropriate PPE.
Signup and view all the answers
Occasional gasps during breathing can be considered normal and do not require immediate action.
Occasional gasps during breathing can be considered normal and do not require immediate action.
Signup and view all the answers
Monitoring vital signs should be initiated as soon as possible for all critically ill patients.
Monitoring vital signs should be initiated as soon as possible for all critically ill patients.
Signup and view all the answers
A rapid first impression assessment should take more than 30 seconds to ensure accuracy.
A rapid first impression assessment should take more than 30 seconds to ensure accuracy.
Signup and view all the answers
What does complete airway obstruction signify in terms of breath sounds?
What does complete airway obstruction signify in terms of breath sounds?
Signup and view all the answers
Which of the following is a late sign of airway obstruction?
Which of the following is a late sign of airway obstruction?
Signup and view all the answers
What is commonly required for airway clearance in most cases of airway obstruction?
What is commonly required for airway clearance in most cases of airway obstruction?
Signup and view all the answers
In which situation is airway obstruction most likely to occur?
In which situation is airway obstruction most likely to occur?
Signup and view all the answers
What indicates a partial airway obstruction?
What indicates a partial airway obstruction?
Signup and view all the answers
Airway obstruction causes paradoxical chest movement and ______ movements.
Airway obstruction causes paradoxical chest movement and ______ movements.
Signup and view all the answers
In complete airway obstruction, there are no breath sounds at the ______ or nose.
In complete airway obstruction, there are no breath sounds at the ______ or nose.
Signup and view all the answers
Central cyanosis is a late sign of ______ obstruction.
Central cyanosis is a late sign of ______ obstruction.
Signup and view all the answers
In most cases, only simple methods of airway ______ are required.
In most cases, only simple methods of airway ______ are required.
Signup and view all the answers
Tracheal intubation by an ALS paramedic may be required when these ______.
Tracheal intubation by an ALS paramedic may be required when these ______.
Signup and view all the answers
Signs of airway obstruction include paradoxical chest and abdominal movements.
Signs of airway obstruction include paradoxical chest and abdominal movements.
Signup and view all the answers
Complete airway obstruction allows for audible breath sounds at the mouth or nose.
Complete airway obstruction allows for audible breath sounds at the mouth or nose.
Signup and view all the answers
Central cyanosis is an early sign of airway obstruction.
Central cyanosis is an early sign of airway obstruction.
Signup and view all the answers
In most airway obstruction cases, complex surgical interventions are required for clearance.
In most airway obstruction cases, complex surgical interventions are required for clearance.
Signup and view all the answers
Depressed consciousness can contribute to airway obstruction in critically ill patients.
Depressed consciousness can contribute to airway obstruction in critically ill patients.
Signup and view all the answers
Which of the following conditions necessitates immediate treatment during the assessment of breathing?
Which of the following conditions necessitates immediate treatment during the assessment of breathing?
Signup and view all the answers
What is the normal range for respiratory rate in adults?
What is the normal range for respiratory rate in adults?
Signup and view all the answers
What does a decrease in breath sounds during auscultation typically suggest?
What does a decrease in breath sounds during auscultation typically suggest?
Signup and view all the answers
What finding during a breathing assessment would indicate that the trachea has deviated?
What finding during a breathing assessment would indicate that the trachea has deviated?
Signup and view all the answers
Which of the following indicates that a patient's breathing may be inadequate?
Which of the following indicates that a patient's breathing may be inadequate?
Signup and view all the answers
What respiratory sign could indicate a significant airway obstruction?
What respiratory sign could indicate a significant airway obstruction?
Signup and view all the answers
Which action should be taken if a patient's breathing is assessed as absent or inadequate?
Which action should be taken if a patient's breathing is assessed as absent or inadequate?
Signup and view all the answers
What assessment might indicate that a patient is experiencing an immediate breathing emergency?
What assessment might indicate that a patient is experiencing an immediate breathing emergency?
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 _____.
During the immediate assessment of breathing, it is vital to assess and treat immediately life-threatening conditions, such as acute severe _____.
Signup and view all the answers
Look, listen and feel for the general signs of respiratory _____ such as sweating and central cyanosis.
Look, listen and feel for the general signs of respiratory _____ such as sweating and central cyanosis.
Signup and view all the answers
A normal respiratory rate is between 12 - _____ breaths per minute.
A normal respiratory rate is between 12 - _____ breaths per minute.
Signup and view all the answers
____ breathing suggests partial airway obstruction, often accompanied by stridor.
____ breathing suggests partial airway obstruction, often accompanied by stridor.
Signup and view all the answers
Check the position of the trachea in the suprasternal notch as deviation to one side indicates a _____ shift.
Check the position of the trachea in the suprasternal notch as deviation to one side indicates a _____ shift.
Signup and view all the answers
Use bag valve mask ventilation to improve _____ if a patient’s depth or rate of breathing is inadequate.
Use bag valve mask ventilation to improve _____ if a patient’s depth or rate of breathing is inadequate.
Signup and view all the answers
Listen to the patient's breath sounds noting rattling airway noises which indicate the presence of airway _____.
Listen to the patient's breath sounds noting rattling airway noises which indicate the presence of airway _____.
Signup and view all the answers
Specific treatment of breathing problems depends on the _____ underlying the condition.
Specific treatment of breathing problems depends on the _____ underlying the condition.
Signup and view all the answers
What is a normal respiratory rate for an adult?
What is a normal respiratory rate for an adult?
Signup and view all the answers
An increase in respiratory rate to over 24 breaths per minute is a marker of health.
An increase in respiratory rate to over 24 breaths per minute is a marker of health.
Signup and view all the answers
List two signs that may indicate respiratory distress.
List two signs that may indicate respiratory distress.
Signup and view all the answers
Rattling airway noises usually indicate the presence of ______.
Rattling airway noises usually indicate the presence of ______.
Signup and view all the answers
Match the following terms with their descriptions:
Match the following terms with their descriptions:
Signup and view all the answers
Which of the following conditions requires immediate oxygen administration?
Which of the following conditions requires immediate oxygen administration?
Signup and view all the answers
Chest deformity does not affect a patient's ability to breathe normally.
Chest deformity does not affect a patient's ability to breathe normally.
Signup and view all the answers
What is the purpose of using a bag valve mask ventilation?
What is the purpose of using a bag valve mask ventilation?
Signup and view all the answers
Which sign would indicate the worst outcome in evaluating a patient's circulation?
Which sign would indicate the worst outcome in evaluating a patient's circulation?
Signup and view all the answers
What does a low diastolic blood pressure typically suggest?
What does a low diastolic blood pressure typically suggest?
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?
When assessing for hypovolaemia, which type of pulse presence is crucial if a patient has a blood pressure of greater than 70 systolic?
Signup and view all the answers
Which observation during a circulation assessment indicates potential compensatory mechanisms at play?
Which observation during a circulation assessment indicates potential compensatory mechanisms at play?
Signup and view all the answers
What is an immediate treatment step that should be taken for patients experiencing cardiovascular collapse?
What is an immediate treatment step that should be taken for patients experiencing cardiovascular collapse?
Signup and view all the answers
Which of the following findings would NOT be considered a sign of reduced cardiac output?
Which of the following findings would NOT be considered a sign of reduced cardiac output?
Signup and view all the answers
What does a narrowed pulse pressure indicate?
What does a narrowed pulse pressure indicate?
Signup and view all the answers
In trauma patients, which action is critical to quickly identify a life-threatening condition?
In trauma patients, which action is critical to quickly identify a life-threatening condition?
Signup and view all the answers
In almost all medical and traumatic emergencies consider hypovolaemia to be the likeliest cause of ______ until proven otherwise.
In almost all medical and traumatic emergencies consider hypovolaemia to be the likeliest cause of ______ until proven otherwise.
Signup and view all the answers
Blood pressure may be normal even if the patient is in ______.
Blood pressure may be normal even if the patient is in ______.
Signup and view all the answers
BP Systolic: The pressure exerted against the arterial walls when the heart ______.
BP Systolic: The pressure exerted against the arterial walls when the heart ______.
Signup and view all the answers
Look thoroughly for external ______ (obvious external and concealed).
Look thoroughly for external ______ (obvious external and concealed).
Signup and view all the answers
Low Diastolic BP suggests arterial ______.
Low Diastolic BP suggests arterial ______.
Signup and view all the answers
Narrowed pulse pressure suggests arterial ______.
Narrowed pulse pressure suggests arterial ______.
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.
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.
Signup and view all the answers
Seek signs of conditions that are immediately life threatening and treat them ______.
Seek signs of conditions that are immediately life threatening and treat them ______.
Signup and view all the answers
What is the primary aim when assessing circulation in an emergency situation?
What is the primary aim when assessing circulation in an emergency situation?
Signup and view all the answers
A normal blood pressure reading guarantees that the patient is not in shock.
A normal blood pressure reading guarantees that the patient is not in shock.
Signup and view all the answers
What does a narrowed pulse pressure indicate?
What does a narrowed pulse pressure indicate?
Signup and view all the answers
In cases of shock, hypovolaemia is often considered the likeliest cause until _______.
In cases of shock, hypovolaemia is often considered the likeliest cause until _______.
Signup and view all the answers
Match the type of pulse with the corresponding systolic blood pressure range it implies:
Match the type of pulse with the corresponding systolic blood pressure range it implies:
Signup and view all the answers
Which observation is NOT associated with assessing the circulatory state of a patient?
Which observation is NOT associated with assessing the circulatory state of a patient?
Signup and view all the answers
Looking for signs of concealed bleeding is essential in trauma and post-surgery patients.
Looking for signs of concealed bleeding is essential in trauma and post-surgery patients.
Signup and view all the answers
The diastolic blood pressure measures the pressure against the arterial walls when the heart is in a ______ state.
The diastolic blood pressure measures the pressure against the arterial walls when the heart is in a ______ state.
Signup and view all the answers
What is a common cause of unconsciousness in patients?
What is a common cause of unconsciousness in patients?
Signup and view all the answers
Which action is essential to assess a patient's level of consciousness?
Which action is essential to assess a patient's level of consciousness?
Signup and view all the answers
What is the normal blood glucose level that should be assessed to exclude hypoglycaemia?
What is the normal blood glucose level that should be assessed to exclude hypoglycaemia?
Signup and view all the answers
When should an antagonist medication be administered?
When should an antagonist medication be administered?
Signup and view all the answers
Which of the following observations about pupils indicates a possible problem?
Which of the following observations about pupils indicates a possible problem?
Signup and view all the answers
Which condition is NOT a common cause of unconsciousness?
Which condition is NOT a common cause of unconsciousness?
Signup and view all the answers
Hypoglycaemia is defined as a blood glucose level greater than 4.0 mmol/l.
Hypoglycaemia is defined as a blood glucose level greater than 4.0 mmol/l.
Signup and view all the answers
What is the normal range for tympanic temperature in degrees Celsius?
What is the normal range for tympanic temperature in degrees Celsius?
Signup and view all the answers
The ______ scale is used to make a rapid assessment of the patient’s conscious state.
The ______ scale is used to make a rapid assessment of the patient’s conscious state.
Signup and view all the answers
Match the cause of unconsciousness with its related action or management:
Match the cause of unconsciousness with its related action or management:
Signup and view all the answers
What is primarily necessary for a thorough examination according to the ABCDE approach?
What is primarily necessary for a thorough examination according to the ABCDE approach?
Signup and view all the answers
Which of the following should be a priority when exposing a patient for examination?
Which of the following should be a priority when exposing a patient for examination?
Signup and view all the answers
What should be minimized to ensure patient comfort during exposure?
What should be minimized to ensure patient comfort during exposure?
Signup and view all the answers
In the ABCDE approach, what areas of the body should be examined?
In the ABCDE approach, what areas of the body should be examined?
Signup and view all the answers
Which of the following is NOT a component of the examination process according to the ABCDE approach?
Which of the following is NOT a component of the examination process according to the ABCDE approach?
Signup and view all the answers
What should be done to respect a patient's dignity during an examination?
What should be done to respect a patient's dignity during an examination?
Signup and view all the answers
Minimizing heat loss during examination is not important.
Minimizing heat loss during examination is not important.
Signup and view all the answers
What body areas are particularly important to examine for proper exposure?
What body areas are particularly important to examine for proper exposure?
Signup and view all the answers
To properly examine a patient, full ______ of the body may be necessary.
To properly examine a patient, full ______ of the body may be necessary.
Signup and view all the answers
Match the following examination focuses with their significance:
Match the following examination focuses with their significance:
Signup and view all the answers
What is the primary objective when obtaining a chief complaint from a patient?
What is the primary objective when obtaining a chief complaint from a patient?
Signup and view all the answers
Why is it important to evaluate the circumstances surrounding a patient's chief complaint?
Why is it important to evaluate the circumstances surrounding a patient's chief complaint?
Signup and view all the answers
What aspect should be considered when assessing whether the mechanism of injury is high risk?
What aspect should be considered when assessing whether the mechanism of injury is high risk?
Signup and view all the answers
When obtaining a chief complaint, what should be the paramedic's initial focus?
When obtaining a chief complaint, what should be the paramedic's initial focus?
Signup and view all the answers
What is a crucial question to evaluate after determining the chief complaint?
What is a crucial question to evaluate after determining the chief complaint?
Signup and view all the answers
What is the first step in performing a focused history on a patient?
What is the first step in performing a focused history on a patient?
Signup and view all the answers
The mechanism of injury should always be evaluated to determine if it is a high risk for injury.
The mechanism of injury should always be evaluated to determine if it is a high risk for injury.
Signup and view all the answers
What is meant by 'evaluating the chief complaint' in a medical assessment?
What is meant by 'evaluating the chief complaint' in a medical assessment?
Signup and view all the answers
To effectively assess a patient's condition, one must first obtain the ______.
To effectively assess a patient's condition, one must first obtain the ______.
Signup and view all the answers
Match the following terms with their correct definitions:
Match the following terms with their correct definitions:
Signup and view all the answers
What is one of the main purposes of ongoing assessment in patient care?
What is one of the main purposes of ongoing assessment in patient care?
Signup and view all the answers
Which procedure is NOT part of the reassessment process?
Which procedure is NOT part of the reassessment process?
Signup and view all the answers
What is assessed to determine the effectiveness of treatment in a patient?
What is assessed to determine the effectiveness of treatment in a patient?
Signup and view all the answers
During reassessment, what should be performed after checking vital signs?
During reassessment, what should be performed after checking vital signs?
Signup and view all the answers
Why is it essential to identify missed injuries or conditions during reassessment?
Why is it essential to identify missed injuries or conditions during reassessment?
Signup and view all the answers
What is the primary purpose of ongoing assessment in patient care?
What is the primary purpose of ongoing assessment in patient care?
Signup and view all the answers
Ongoing assessments are performed solely on trauma patients.
Ongoing assessments are performed solely on trauma patients.
Signup and view all the answers
List one of the steps involved in the ongoing assessment procedure.
List one of the steps involved in the ongoing assessment procedure.
Signup and view all the answers
The ongoing assessment procedure includes repeating the initial assessment and checking ______.
The ongoing assessment procedure includes repeating the initial assessment and checking ______.
Signup and view all the answers
Match the steps of the ongoing assessment procedure to their descriptions:
Match the steps of the ongoing assessment procedure to their descriptions:
Signup and view all the answers
What should be the immediate action if a life-threatening condition is detected that cannot be alleviated?
What should be the immediate action if a life-threatening condition is detected that cannot be alleviated?
Signup and view all the answers
What is a consideration before transporting a patient in need of rapid evacuation?
What is a consideration before transporting a patient in need of rapid evacuation?
Signup and view all the answers
During a rapid evacuation process, which of the following is not a step you should take?
During a rapid evacuation process, which of the following is not a step you should take?
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?
Why is it crucial to transport a patient rapidly if your intervention fails to address their life-threatening condition?
Signup and view all the answers
What indication would prompt the need for a rapid evacuation of a patient?
What indication would prompt the need for a rapid evacuation of a patient?
Signup and view all the answers
Which condition requires rapid evacuation due to its potential severity?
Which condition requires rapid evacuation due to its potential severity?
Signup and view all the answers
What is a sign that a patient may be experiencing respiratory distress?
What is a sign that a patient may be experiencing respiratory distress?
Signup and view all the answers
Which of the following is NOT a criterion for rapid evacuation?
Which of the following is NOT a criterion for rapid evacuation?
Signup and view all the answers
How should a patient presenting with signs of anaphylaxis be classified?
How should a patient presenting with signs of anaphylaxis be classified?
Signup and view all the answers
Which scenario indicates a need for urgent medical attention in terms of circulation?
Which scenario indicates a need for urgent medical attention in terms of circulation?
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
Which of the following conditions indicates an urgent need for rapid evacuation? A) Uncontrolled bleeding B) Mild headache C) Slight dizziness D) Minor bruise
Signup and view all the answers
Severe allergic reactions (anaphylaxis) do not require urgent medical attention during a rapid evacuation.
Severe allergic reactions (anaphylaxis) do not require urgent medical attention during a rapid evacuation.
Signup and view all the answers
What is a sign that indicates a patient may be suffering from poisoning or overdose?
What is a sign that indicates a patient may be suffering from poisoning or overdose?
Signup and view all the answers
A high body temperature above ______°C is a criterion for rapid evacuation.
A high body temperature above ______°C is a criterion for rapid evacuation.
Signup and view all the answers
Match the emergency signs with their corresponding conditions:
Match the emergency signs with their corresponding conditions:
Signup and view all the answers
Signs of ______ can indicate a need for rapid evacuation due to severe body temperature issues.
Signs of ______ can indicate a need for rapid evacuation due to severe body temperature issues.
Signup and view all the answers
An ______ reaction, such as anaphylaxis, requires immediate attention during rapid evacuation.
An ______ reaction, such as anaphylaxis, requires immediate attention during rapid evacuation.
Signup and view all the answers
Uncontrolled ______ can be a critical sign that necessitates urgent evacuation.
Uncontrolled ______ can be a critical sign that necessitates urgent evacuation.
Signup and view all the answers
Inability to move any part of the body is a serious indicator of a ______ situation.
Inability to move any part of the body is a serious indicator of a ______ situation.
Signup and view all the answers
A high body temperature of over ______°C can be a criterion for rapid evacuation.
A high body temperature of over ______°C can be a criterion for rapid evacuation.
Signup and view all the answers
What is the primary purpose of the Glasgow Coma Scale?
What is the primary purpose of the Glasgow Coma Scale?
Signup and view all the answers
In what context is the Glasgow Coma Scale typically utilized?
In what context is the Glasgow Coma Scale typically utilized?
Signup and view all the answers
What aspect can the Glasgow Coma Scale help predict?
What aspect can the Glasgow Coma Scale help predict?
Signup and view all the answers
Which of the following is NOT a factor assessed by the Glasgow Coma Scale?
Which of the following is NOT a factor assessed by the Glasgow Coma Scale?
Signup and view all the answers
Which population is most commonly evaluated using the Glasgow Coma Scale?
Which population is most commonly evaluated using the Glasgow Coma Scale?
Signup and view all the answers
The Glasgow Coma Scale (GCS) is designed to assess the depth of impaired ______.
The Glasgow Coma Scale (GCS) is designed to assess the depth of impaired ______.
Signup and view all the answers
The GCS helps to measure acute and chronic brain ______ within a trauma scene.
The GCS helps to measure acute and chronic brain ______ within a trauma scene.
Signup and view all the answers
The Glasgow Coma Scale is also used to predict whether a victim is likely to ______.
The Glasgow Coma Scale is also used to predict whether a victim is likely to ______.
Signup and view all the answers
The GCS assesses ______ states and their duration.
The GCS assesses ______ states and their duration.
Signup and view all the answers
A higher GCS score indicates a better level of ______.
A higher GCS score indicates a better level of ______.
Signup and view all the answers
What is the total score range for the Glasgow Coma Scale?
What is the total score range for the Glasgow Coma Scale?
Signup and view all the answers
What is the minimum score a patient can achieve on the Glasgow Coma Scale?
What is the minimum score a patient can achieve on the Glasgow Coma Scale?
Signup and view all the answers
Which statement is important when passing on information regarding a patient’s Glasgow Coma Scale score?
Which statement is important when passing on information regarding a patient’s Glasgow Coma Scale score?
Signup and view all the answers
In the context of the Glasgow Coma Scale, what does a score of 15 indicate?
In the context of the Glasgow Coma Scale, what does a score of 15 indicate?
Signup and view all the answers
What is a critical aspect of handover information related to the Glasgow Coma Scale?
What is a critical aspect of handover information related to the Glasgow Coma Scale?
Signup and view all the answers
The maximum score on the Glasgow Coma Scale is 20.
The maximum score on the Glasgow Coma Scale is 20.
Signup and view all the answers
A minimum score of 3 on the Glasgow Coma Scale indicates a fully alert patient.
A minimum score of 3 on the Glasgow Coma Scale indicates a fully alert patient.
Signup and view all the answers
Identifying points lost during a handover can contribute to better patient care.
Identifying points lost during a handover can contribute to better patient care.
Signup and view all the answers
The Glasgow Coma Scale is typically used to assess a patient's respiratory rate.
The Glasgow Coma Scale is typically used to assess a patient's respiratory rate.
Signup and view all the answers
A total score on the Glasgow Coma Scale reflects a patient's overall neurological status.
A total score on the Glasgow Coma Scale reflects a patient's overall neurological status.
Signup and view all the answers
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:
- The patient's general appearance, which can indicate overall health and distress.
- Breathing assessment is essential; look for signs of respiratory distress or irregularities in breathing patterns.
- 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.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
