Patient Assessment Techniques

Patient Assessment

• Scene Size Up: Assess the scene for safety, number of patients, mechanism of injury (MOI) / nature of illness (NOI), and potential spinal injuries (C-spine). Secure the scene and ensure personnel safety.

• Primary Assessment: A rapid initial evaluation of the patient's condition, prioritizing life-threatening issues;

  • General Impression: Observe the patient's appearance and behavior.
  • AVPU: Alert, Verbal, Pain, Unresponsive (used to quickly assess responsiveness)
  • Chief Complaint (C/C): Determine the patient's primary concern.
  • Life Threats: Identify and address any immediate concerns (e.g., airway obstruction, severe bleeding).
  • Consent: Obtain appropriate consent for treatment.
  • Expose (necessary): Remove clothing for a comprehensive assessment, if safe and possible.
  • Transport Priority: Determine the appropriate transport category and speed based on needs:
    • Rapid Transport (life-threatening)
    • Prompt Transport (generally needed, as needed)
    • Regular Transport (no immediate life-threatening issues, obeying traffic laws).

• Focused History and Physical Exam: Collect detailed information about the patient's past health, taking into account the MOI/NOI, followed by a thorough examination.

• Detailed Physical Exam: Follow up on the focused exam with a further detailed examination of the patient.

ABCs

• Airway: Evaluate airway patency (open and clear). If open, maintain with head tilt-chin lift. If obstructed, clear with suction and use an OPA/NPA.

• Breathing: Assess respirations—rate (12-20), rhythm (regular/irregular), and quality (labored, constricted, wheezing). Monitor SpO2 (target 95-100%). Administer supplemental oxygen as needed (nasal cannula, non-rebreather, BVM-most to least).

• Circulation: Check pulse rate (adult 60-100, child 70-150, infant 100-160), rhythm (regular/irregular/irregularly irregular), quality (strong, weak, thready, bounding). Assess capillary refill (2-3 seconds). Monitor blood glucose (70-130), skin condition (pink, warm, dry), and blood pressure (100-120/60-80).

Assessment Tools

• OPQRST: Used for pain assessment: Onset, Provocation, Quality, Region/Radiation, Severity, and Timing.

• DCAP-BTLS: Useful for identifying injuries: Deformities, Contusions, Abrasions, Punctures, Burns, Tenderness, Lacerations, Swelling.

• SAMPLE: A useful method of gathering history: Signs and Symptoms, Allergies, Medications, Past pertinent medical history, Last oral intake, Events leading up to the injury.

Additional Notes

• BSI: Standard precautions for infection control/prevention.
• MOI/NOI: Mechanism of injury/nature of illness - crucial for understanding the patient's condition and directing treatment.
• C-spine precautions: If any possibility of spinal injury, immobilize the patient's head until spinal board is in place.

This quiz covers essential patient assessment techniques including scene size up and primary assessment. It emphasizes the importance of quickly identifying life-threatening issues and effectively communicating with the patient. Test your knowledge on prioritizing transport and obtaining consent during emergencies.