Podcast
Questions and Answers
What is the recommended timeframe for completing the primary survey in patient assessment?
What is the recommended timeframe for completing the primary survey in patient assessment?
- As long as necessary to gather all information
- Within 15-30 seconds
- Within 5-10 minutes
- Within 60-90 seconds (correct)
Which of the following is the correct order of steps in the <C>ABCDE
approach to initial patient assessment?
Which of the following is the correct order of steps in the <C>ABCDE
approach to initial patient assessment?
- Airway, Breathing, Catastrophic haemorrhage, Circulation, Disability, Exposure
- Breathing, Airway, Circulation, Disability, Exposure, Catastrophic haemorrhage
- Catastrophic haemorrhage, Airway, Breathing, Circulation, Disability, Exposure (correct)
- Airway, Breathing, Circulation, Disability, Exposure, Catastrophic haemorrhage
What does the 'A' stand for in the AVPU scale used to assess a patient's level of consciousness?
What does the 'A' stand for in the AVPU scale used to assess a patient's level of consciousness?
- Alert (correct)
- Agitated
- Aphasic
- Ambulatory
Which of the following best describes 'catastrophic haemorrhage'?
Which of the following best describes 'catastrophic haemorrhage'?
Why is it important to avoid unnecessary movement of the head and neck in patients who have suffered traumatic injuries?
Why is it important to avoid unnecessary movement of the head and neck in patients who have suffered traumatic injuries?
During the assessment of a patient's airway, what are the three key actions that should be performed?
During the assessment of a patient's airway, what are the three key actions that should be performed?
Which of the following is NOT typically assessed during the 'Disability' component of the primary survey?
Which of the following is NOT typically assessed during the 'Disability' component of the primary survey?
What does the acronym 'SAMPLE' stand for when taking a patient history?
What does the acronym 'SAMPLE' stand for when taking a patient history?
What is the significance of identifying a non-blanching rash during the 'Exposure' component of the primary survey?
What is the significance of identifying a non-blanching rash during the 'Exposure' component of the primary survey?
During reassessment, what illustrates the dynamic nature of a patient's clinical condition?
During reassessment, what illustrates the dynamic nature of a patient's clinical condition?
What is the initial and immediate assessment of the patient and their current location called?
What is the initial and immediate assessment of the patient and their current location called?
In the context of patient assessment, what does the acronym SOCRATES help to organize?
In the context of patient assessment, what does the acronym SOCRATES help to organize?
Which of the following is a key consideration during the 'Exposure' stage of patient assessment to maintain patient privacy?
Which of the following is a key consideration during the 'Exposure' stage of patient assessment to maintain patient privacy?
What should clinicians do if they identify gurgling sounds while assessing the patient's airway?
What should clinicians do if they identify gurgling sounds while assessing the patient's airway?
When assessing a patient's circulation, which of the following actions should be performed to evaluate cardiac output in addition to pulse assessment?
When assessing a patient's circulation, which of the following actions should be performed to evaluate cardiac output in addition to pulse assessment?
During the 'head-to-toe' assessment, what specific observation is mentioned as potentially indicative of a diabetic patient?
During the 'head-to-toe' assessment, what specific observation is mentioned as potentially indicative of a diabetic patient?
A trauma patient has a respiratory rate of 10 breaths per minute, oxygen saturation on air of 93%, is on room air, systolic blood pressure of 108 mmHg, heart rate of 110 beats per minute, is alert, and has a temperature of 38.1°C. Using the NEWS2 chart, what is this patient's total score?
A trauma patient has a respiratory rate of 10 breaths per minute, oxygen saturation on air of 93%, is on room air, systolic blood pressure of 108 mmHg, heart rate of 110 beats per minute, is alert, and has a temperature of 38.1°C. Using the NEWS2 chart, what is this patient's total score?
A patient is found unresponsive. You shake the patient's shoulders gently, but they do not respond. According to the AVPU scale, how would you document this patient's level of consciousness?
A patient is found unresponsive. You shake the patient's shoulders gently, but they do not respond. According to the AVPU scale, how would you document this patient's level of consciousness?
During a 'head-to-toe' assessment, you note bulging veins in the neck. Which of the following conditions might this finding indicate?
During a 'head-to-toe' assessment, you note bulging veins in the neck. Which of the following conditions might this finding indicate?
A patient is prescribed Drug X by their physician. During history taking, the patient mentions they also take Drug Y, prescribed to their spouse, for similar symptoms. They also use a herbal supplement bought online. What is the MOST appropriate action?
A patient is prescribed Drug X by their physician. During history taking, the patient mentions they also take Drug Y, prescribed to their spouse, for similar symptoms. They also use a herbal supplement bought online. What is the MOST appropriate action?
Which of the following BEST describes the primary mechanism by which airway edema, in the setting of anaphylaxis, leads to respiratory distress?
Which of the following BEST describes the primary mechanism by which airway edema, in the setting of anaphylaxis, leads to respiratory distress?
What is the MOST accurate description of the difference between a partial and complete airway obstruction?
What is the MOST accurate description of the difference between a partial and complete airway obstruction?
A patient presents with dysphagia, what underlying condition should MOST concern the paramedic?
A patient presents with dysphagia, what underlying condition should MOST concern the paramedic?
What role does the epiglottis play in protecting the airway during swallowing?
What role does the epiglottis play in protecting the airway during swallowing?
What is the MOST common infectious cause of epiglottitis?
What is the MOST common infectious cause of epiglottitis?
A patient presents with fever, sore throat, difficulty swallowing, and is drooling, what should the paramedic suspect?
A patient presents with fever, sore throat, difficulty swallowing, and is drooling, what should the paramedic suspect?
Which patient population is MOST commonly affected by Croup?
Which patient population is MOST commonly affected by Croup?
A child presents with a barking cough and inspiratory stridor, what is the MOST likely cause?
A child presents with a barking cough and inspiratory stridor, what is the MOST likely cause?
What is the MOST accurate description of a peritonsillar abscess?
What is the MOST accurate description of a peritonsillar abscess?
What is the immediate treatment for partial airway obstruction with stridor in a patient who is well oxygenated?
What is the immediate treatment for partial airway obstruction with stridor in a patient who is well oxygenated?
What is the correct anatomical location for performing back blows to relieve airway obstruction?
What is the correct anatomical location for performing back blows to relieve airway obstruction?
How do positive pressure ventilations help in cases of foreign body obstruction of the airway?
How do positive pressure ventilations help in cases of foreign body obstruction of the airway?
In what situation is the use of Magill forceps and a laryngoscope MOST appropriate for airway clearance?
In what situation is the use of Magill forceps and a laryngoscope MOST appropriate for airway clearance?
What is the NEXT step after foreign body airway obstruction is relieved?
What is the NEXT step after foreign body airway obstruction is relieved?
What does a hoarse voice indicate in a patient status post airway obstruction?
What does a hoarse voice indicate in a patient status post airway obstruction?
Which of the following best describes the long-term management of a patient that has a foreign body removed from their airway?
Which of the following best describes the long-term management of a patient that has a foreign body removed from their airway?
A construction worker falls from scaffolding and lands on his neck. He is conscious, but struggling to breath. You see no external obstructions in the airway. What is the MOST likely cause?
A construction worker falls from scaffolding and lands on his neck. He is conscious, but struggling to breath. You see no external obstructions in the airway. What is the MOST likely cause?
Why is it important to transport and admit a patient to the hospital even if they are able to sit up and talk after a choking incident?
Why is it important to transport and admit a patient to the hospital even if they are able to sit up and talk after a choking incident?
Which of the following is the MOST common cause of airway obstruction listed?
Which of the following is the MOST common cause of airway obstruction listed?
Which of the following is the MOST LIKELY reason the elderly are at a higher risk for choking events?
Which of the following is the MOST LIKELY reason the elderly are at a higher risk for choking events?
A 78-year-old male in a cafe is having difficulty breathing, and is cyanosed, what is the MOST likely provisional diagnosis?
A 78-year-old male in a cafe is having difficulty breathing, and is cyanosed, what is the MOST likely provisional diagnosis?
All of the following are TRUE regarding the differences in anaphylaxis vs mechanical airway obstruction EXCEPT?
All of the following are TRUE regarding the differences in anaphylaxis vs mechanical airway obstruction EXCEPT?
A patient who is in severe respiratory distress has a complete obstruction that cannot be relieved in field but oxygen saturation is 99% on room air. What is the MOST LIKELY reason this patient has a normal SpO2 if the obstruction cannot be relieved?
A patient who is in severe respiratory distress has a complete obstruction that cannot be relieved in field but oxygen saturation is 99% on room air. What is the MOST LIKELY reason this patient has a normal SpO2 if the obstruction cannot be relieved?
You are transporting a patient status post foreign body removal at a cafe. En route, the patient has a tonic clonic seizure, and is post ictal and has snoring respirations. Which of the following is the BEST course of action?
You are transporting a patient status post foreign body removal at a cafe. En route, the patient has a tonic clonic seizure, and is post ictal and has snoring respirations. Which of the following is the BEST course of action?
What is the correct sequence of events in a normal swallow?
What is the correct sequence of events in a normal swallow?
What is the MOST accurate reason for managing patients with an impaired conscious level in a lateral position?
What is the MOST accurate reason for managing patients with an impaired conscious level in a lateral position?
You are called to a kindergarten classroom where a 4 year old patient is reported to be choking after swallowing a small toy. Upon arrival, the child remains cyanotic, unresponsive, and ineffective abdominal thrusts have failed to yield any improvement. What crucial but easily over-looked modification should be made at this stage?
You are called to a kindergarten classroom where a 4 year old patient is reported to be choking after swallowing a small toy. Upon arrival, the child remains cyanotic, unresponsive, and ineffective abdominal thrusts have failed to yield any improvement. What crucial but easily over-looked modification should be made at this stage?
What is a potential complication associated with the sharp back blows given while managing a patient's airway?
What is a potential complication associated with the sharp back blows given while managing a patient's airway?
Patients with suspected epiglottitis should be managed with as little intervention as possible in the pre-hospital setting.
Patients with suspected epiglottitis should be managed with as little intervention as possible in the pre-hospital setting.
Complete obstruction can occur with a mechanical obstruction above the vocal cords, but an incomplete obstruction with stridor is far more likely?
Complete obstruction can occur with a mechanical obstruction above the vocal cords, but an incomplete obstruction with stridor is far more likely?
What is true regarding patients with known anaphylaxis?
What is true regarding patients with known anaphylaxis?
What finding is most reliable in distinguishing upper airway obstruction from lower airway disorders?
What finding is most reliable in distinguishing upper airway obstruction from lower airway disorders?
What describes best why a conscious patient is speaking freely status post foreign body airway obstruction event?
What describes best why a conscious patient is speaking freely status post foreign body airway obstruction event?
Of the following, which is the best strategy for managing a conscious patient with respiratory distress from suspected airway obstruction?
Of the following, which is the best strategy for managing a conscious patient with respiratory distress from suspected airway obstruction?
How is the severity of the airway obstruction commonly assessed?
How is the severity of the airway obstruction commonly assessed?
In the setting of airway obstruction, which is the most common complication due to overzealous rescue attempts?
In the setting of airway obstruction, which is the most common complication due to overzealous rescue attempts?
What is the primary aim in treatment of a suspected airway obstruction?
What is the primary aim in treatment of a suspected airway obstruction?
An elderly patient experiences syncope, exhibiting agonal gasps shortly after. There is a strong smell of almonds and a witness reports the patient was eating cherries when the incident occurred. The paramedic should initially consider:
An elderly patient experiences syncope, exhibiting agonal gasps shortly after. There is a strong smell of almonds and a witness reports the patient was eating cherries when the incident occurred. The paramedic should initially consider:
What is the best and most accurate way to determine difficulty or ease of intubation success?
What is the best and most accurate way to determine difficulty or ease of intubation success?
What are the three specific locations swelling can occur, depending on pathology?
What are the three specific locations swelling can occur, depending on pathology?
Flashcards
What is a primary survey?
What is a primary survey?
A rapid patient assessment and management process, usually completed within 60-90 seconds.
What is general impression?
What is general impression?
First and immediate assessment of the patient and their surroundings to determine illness/injury severity.
What is catastrophic haemorrhage?
What is catastrophic haemorrhage?
Bleeding that poses an immediate threat to life due to rapid blood loss.
Airway Assessment
Airway Assessment
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Breathing Assessment
Breathing Assessment
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Circulation Assessment
Circulation Assessment
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What is the AVPU scale?
What is the AVPU scale?
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Exposure Assessment
Exposure Assessment
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What does SAMPLE stand for?
What does SAMPLE stand for?
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What does SOCRATES stand for?
What does SOCRATES stand for?
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What does reassessment involve?
What does reassessment involve?
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What is 'Head-to-toe' assessment?
What is 'Head-to-toe' assessment?
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What is National Early Warning Score (NEWS)?
What is National Early Warning Score (NEWS)?
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Face Assessment
Face Assessment
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Scalp examination
Scalp examination
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Extremities Assessment
Extremities Assessment
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Identify vital signs to reassess.
Identify vital signs to reassess.
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Respiratory Distress Causes
Respiratory Distress Causes
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Airway Obstruction
Airway Obstruction
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Inability to ventilate
Inability to ventilate
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Inability to externally respirate
Inability to externally respirate
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Inability to internally respirate
Inability to internally respirate
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Dysphagia
Dysphagia
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Epiglottitis
Epiglottitis
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Croup
Croup
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Peritonsillar Abscess
Peritonsillar Abscess
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Airway Oedema
Airway Oedema
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Asthma Symptoms
Asthma Symptoms
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Gas Trapping
Gas Trapping
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Airway Remodelling
Airway Remodelling
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Inflammatory Cell Infiltration
Inflammatory Cell Infiltration
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Dynamic Hyperinflation
Dynamic Hyperinflation
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Asthma pathway
Asthma pathway
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PASSRESPS
PASSRESPS
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Asthma Management
Asthma Management
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Asthma and Beta-agonists
Asthma and Beta-agonists
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Combined asthma therapies
Combined asthma therapies
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Heliox
Heliox
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Study Notes
Patient Assessment Process
- Patient assessment involves a systematic approach to evaluate a patient's condition
- The chapter focuses on the order of the assessment process
Primary Survey
- It is a swift assessment and management process, completed within 60–90 seconds
- Steps should be addressed in order
- Check for life-threatening haemorrhage before checking the airway, especially in trauma patients
- In trauma cases avoid unnecessary head and neck movement to protect the cervical spine
Components of primary survey: <C>ABCDE
- <C> Catastrophic haemorrhage: Identify and control life-threatening bleeding
- A: Airway: Assess and maintain airway patency
- B: Breathing: Evaluate breathing effectiveness
- C: Circulation: Assess circulation status
- D: Disability: Assess level of consciousness
- E: Exposure: Expose the patient to identify injuries
Assessing Airway
- Look for signs of airway obstruction
- Listen for noisy or absent breathing sounds
- Feel for air movement
Breathing Assessment
- Adopt a look, listen, and feel approach
- Determine if the patient is breathing
- Determine adequacy of breathing through rate and depth of chest movement.
Circulation Assessment
- Assess circulation by observing the colour of the patient's limbs
- Palpate for a pulse to determine heart rate and cardiac output effectiveness
Disability Assessment
- Disability assessment entails evaluating the patient’s level of consciousness using the AVPU
- Assess pupils and blood sugar
AVPU Scale:
- A: Alert – The patient is awake and responsive
- V: Responds to Verbal stimulus – The patient responds to voice
- P: Responds to Pain – The patient responds to painful stimulus
- U: Unresponsive – The patient does not respond to any stimulus
Exposure
- Perform a quick 'head-to-toe' assessment to identify obvious injuries
- Be mindful when working out of hospital to maintain patient privacy and prevent heat loss, especially in trauma
History Taking
- Ascertain the presenting complaint i.e. the main reason for calling for help
SAMPLE History:
- S: Signs and Symptoms of the presenting complaint
- A: Allergies, especially to medications and food
- M: Medications, including dosage and frequency
- P: Past medical history, including illnesses and surgeries
- L: Last oral intake
- E: Events leading to the current illness or injury
SOCRATES acronym for assessing signs and symptoms specifically:
- S: Site of the symptom
- O: Onset of the symptom
- C: Character of the symptom
- R: Radiation of the symptom
- A: Associations with other signs and symptoms
- T: Timing of the symptom
- E: Exacerbating/relieving factors
- S: Severity of the symptom
Secondary Survey
- A more detailed assessment based on findings from the primary survey and history
Reassessing Vital Signs
- Minimum set of observations include respiratory rate, oxygen saturations, pulse rate, blood pressure, level of consciousness, blood sugar, temperature
National Early Warning Score (NEWS2)
- NEWS2 aims to improve: assessment of acute illness, detection of clinical deterioration and initiation of a timely and competent clinical response
- NEWS2 is not suitable for use with children under 16 years or pregnant women
Head-to-toe Assessment
- A rapid comprehensive full-body assessment to identify signs of injury or illness
- Not always appropriate, but consider in cases of multiple injuries or when the patient is collapsed and has limited or non-existent medical history
Head-to-toe Procedure:
- Look at the face for injuries, fluid leakage, and deformities
- Inspect the area around the eyes for injuries
- Check the eyes for redness and contact lenses
- Assess the pupils using a pen torch
- Look behind the ears for bruising or fluid/blood
- Look for bruising, lacerations and deformity around the head and then gently feel for tenderness and depressions of the skull
- Feel the cheekbones for tenderness, symmetry and instability
- Feel the maxilla (below the nose)
- Check the nose for blood and fluid
- Feel the jaw
- Assess the mouth and nose for cyanosis, foreign objects, bleeding, lacerations, and deformities
- Smell the patient's breath for specific odours
- Look at the neck and note any lacerations, bruises and/or deformity
- Look for bulging veins in the neck and feel the trachea
- Feel the back of the neck for tenderness and deformity
- Look at the chest for any obvious injury and watch the chest rise and fall
- Gently feel the ribs, ensuring they are intact and identifying if they are tender
- Listen for breath sounds
- Roll the patient and listen to the back of the chest, also look for injuries and feel for deformities and tenderness
- Check the abdomen and pelvis for obvious injury and gently feel the abdomen
- Look at the pelvis for signs of injury, then gently feel the iliac crests for signs of instability, tenderness or crepitus
- Check the extremities for lacerations, bruises, swelling, deformities, and the presence of medical bracelets
Reassessment:
- Monitor dynamic changes in patient's clinical condition
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