Initial Evaluation of Patient, First Aid, and CPR PDF

Initial evaluation of the patient, First aid and CPR  The initial patient assessment, also referred to as the primary survey, is a critical component of prehospital care. When assessing a patient, the prehospital care provider must be able to quickly and accurately determine if a patient i...

Initial evaluation of the patient, First aid and CPR  The initial patient assessment, also referred to as the primary survey, is a critical component of prehospital care. When assessing a patient, the prehospital care provider must be able to quickly and accurately determine if a patient is "sick" or not. Evaluation is an essential part of quality improvement and when done well it can help solve problems, inform decision making and build knowledge. Its key purpose is to help us to develop a deeper understanding of how best to improve health care. What is an Initial Evaluation Patient? An initial evaluation medical is a comprehensive assessment that is conducted by a healthcare professional. It serves as a starting point to gather information about your medical history, current health status, and any specific concerns or symptoms you may have. This evaluation helps the healthcare provider understand your unique needs and develop an appropriate treatment plan. During the initial evaluation medical, you will typically meet with a healthcare provider, such as a doctor or nurse, who will ask you a series of questions and perform various examinations. This may include: Taking your medical history Checking your vital signs, such as blood pressure and heart rate Conducting a physical examination Ordering laboratory tests or diagnostic imaging, if necessary Why is an Initial Evaluation of Patient Important? The initial evaluation medical is an essential step in your healthcare journey for several reasons: 1.Establishing a baseline: The evaluation helps establish a baseline for your health status. By gathering information about your medical history and conducting examinations, the healthcare provider can identify any existing health issues, detect potential risks, and track changes in your health over time. 2.Identifying underlying conditions: The evaluation can help identify any underlying conditions or risk factors that may contribute to your current symptoms or concerns. This information is crucial for accurate diagnosis and appropriate treatment planning. 3.Developing a personalized treatment plan: Based on the information gathered during the evaluation, the healthcare provider can develop a personalized treatment plan tailored to your specific needs. This may include medication, lifestyle modifications, therapy, or referrals to specialists. 4.Building a strong patient-provider relationship: The initial evaluation medical allows you to establish a relationship with your healthcare provider. This relationship is vital for effective communication, trust, and collaboration in managing your healthcare. What is Included in an Initial Evaluation of Pateints? The components of an initial evaluation medical can vary, but here are some common elements that may be included: Medical History Your healthcare provider will ask you about your medical history, including any past illnesses, surgeries, allergies, medications, and family history of diseases. This information helps provide insights into your overall health and any potential risk factors. Physical Examination A physical examination involves assessing various aspects of your body, such as your heart, lungs, abdomen, and musculoskeletal system. The healthcare provider may use tools like a stethoscope, blood pressure cuff, and reflex hammer to gather information about your overall health. Vital Signs Checking your vital signs is an important part of the initial evaluation medical. This includes measuring your blood pressure, heart rate, temperature, and respiratory rate. These measurements help provide a baseline for your health status and can indicate any abnormalities that may require further investigation. Laboratory Tests Depending on your specific needs and concerns, the healthcare provider may order laboratory tests, such as blood tests or urine tests. These tests can provide valuable information about your organ function, blood cell counts, hormone levels, and more. Diagnostic Imaging In some cases, the healthcare provider may order diagnostic imaging tests, such as X-rays, CT scans, or MRI scans. These tests help visualize the internal structures of your body and can aid in the diagnosis of certain conditions or injuries. Referrals If necessary, the healthcare provider may refer you to other specialists or healthcare professionals for further evaluation or treatment. This ensures that you receive the most appropriate care for your specific needs. Initial Evaluation and Approach to the Patient with Hypertension Prognosis- prediction about how something(will develop Patient/Client Management Model Components of the Initial Process Evaluation Examination/evaluation Reason for referralParticipation Explain medical and health conditions that are pertinent to patient’s current problems Participation Determine restrictions in participation in work or personal roles Activities Measure patient performance on the activities that the individual needs to perform to overcome or prevent participation restrictions Impairments Identify and measure the impairments that contribute to the observed functional activities Diagnosis Assessment Establish a diagnosis and justify necessity of physical therapy intervention Prognosis Goals/plan of care Develop a set of goals in consultation with the patient Intervention Plan of care Plan an intervention strategy that will help the patient achieve the goals Process Used to Evaluate a Patient and Develop a Plan for Intervention Main Sections of Initial Evaluation Questions the Physical Therapist Asks Reason for referral What is the primary health condition? What other medical conditions may affect the primary health condition? What was the individual’s prior level of functioning? What is the individual’s current life situation—home environment, work, social support? How is the current condition affecting the individual’s life and life roles? Activities What specific activities (or functional skills) does the individual need to learn (or re-learn) to be able to accomplish his or her life roles? How does inadequate performance in specific activities prevent the individual from fulfilling life roles? Impairments How are/why are the individual’s movements dysfunctional? What neuromuscular, sensorimotor, or cardiovascular mechanisms are inadequate (e.g., range of motion, strength, sensation, pulmonary function)? Assessment What is the patient’s diagnosis, or can the current diagnosis be modified? What is the justification for physiotherapy intervention? What are the causal links between activity limitations and participation restrictions? Between impairments and activity limitations? Between health condition and impairments? Goals What goals have the therapist and patient agreed on? What level of participation does the patient need/want to achieve? What activities will be used to benchmark the patient’s progress toward accomplishing the overall goals? Are there any impairment goals that are critical to be achieved? Plan of care What musculoskeletal, neuromotor, and physiologic resources must be enhanced to enable the individual to relearn the specified functional skills? What sequence of tasks will optimally challenge the patient? What should be done to promote tissue healing or prevent damage? The observations should be as follows: 1. Conscious state: If help is going to be delayed, check the conscious state every few minutes and note any changes. Use the ‘AVPU’ code: A Alert Is the patient alert and responding to you? V Voice Does the patient respond to your voice? P Painful Does the patient respond to a painful stimulus? U Unresponsive Is the patient unresponsive?  2. Airway: ensure that it is clear and open and that the patient does not have any secretions that might obstruct breathing. 3. Breathing: Check for normal breathing – note the rate and rhythm for any changes. Check whether the breathing is deep or shallow, quiet or noisy, and whether there are any abnormal sounds such as wheezing on breathing out. This is especially important with the unconscious patient because any change may be a warning of deterioration. 4. Skin: Look at the skin and note the colour (whether tinged with blue), and feel whether it is hot (with fever) or cold and clammy (as in shock). First aid, the recovery position, and CPR First aid is vital for saving lives. A person can carry out first aid after a life-threatening incident or injury before the arrival of emergency services. The aims of first aid are to preserve life, prevent harm, and promote recovery. In first aid, ABC stands for airway, breathing, and circulation. The recovery position helps minimize further injury. CPR stands for cardiopulmonary resuscitation. It helps maintain the flow of oxygenated blood. While doing chest compressions, you may hear cracks. This is normal. What is first aid? First aid is an emergency measure, generally consisting of simple, often life-saving techniques that most people can train to perform with minimal equipment and no previous medical experience. First aid is a combination of simple procedures and common sense. Aims of first aid The aims of first aid are: To preserve life: Saving lives is the main aim of first aid. To prevent further harm: The person who has experienced the injury must be kept stable, and their condition must not deteriorate before medical services arrive. This may include moving the individual away from harm, applying first aid techniques, keeping them warm and dry, and applying pressure to wounds to stop any bleeding. Promote recovery: Taking steps to promote recovery may include applying a bandage to a wound. How to practice first aid? The most common term referred to in first aid is ABC. This stands for airway, breathing, and circulation. A fourth step will appear in the emergency procedures for some facilities. Airway: Make sure the airway is clear. Choking, which results from the obstruction of airways, can be fatal. Breathing: Once the airways are confirmed to be clear, determine whether the person can breathe, and, if necessary, provide rescue breathing. Circulation: If the person involved in the emergency situation is not breathing, the first aider should go straight for chest compressions and rescue breathing. The chest compressions will promote circulation. This saves valuable time. In emergencies that are not life-threatening, the first aider needs to check the pulse. Deadly bleeding or defibrillation: Some organizations consider dressing severe wounds or applying defibrillation to the heart a separate fourth stage, while others include this as part of the circulation step. It is important to use a primary survey to make sure the scene is clear of threats before stepping in to help: Danger: Check for dangers to the injured person and yourself. If there is danger, can it be cleared, or can the individual be moved away from further harm? If there is nothing you can do, stand clear, and call for professional help. Response: Once it is clear that all danger has ceased, check if the patient is conscious and alert, ask questions, and see if you get a response. It is also important to find out whether they respond to your touch and are aware of their pain. Airway: Check whether the airway is clear and, if not, try to clear it. Have the injured person lying on their back, and then place one hand on the forehead and two fingers from the other hand on the chin. Gently tilt the head back while slightly raising the chin upwards. Any obstructions need to be removed from the mouth, including dentures. Only insert fingers into the mouth of the injured individual if an obstruction is present. Breathing: Is the individual breathing effectively? The first aider should examine the chest for movement and the mouth for signs of breathing. Afterward, get close to the person to see if air can be felt on the cheek from breathing.  The first aider then needs to carry out a secondary survey, checking for deformities, open wounds, medic alert tags, and swellings. If the injured person is breathing safely, carry out a rapid whole-body check for the following: open wounds deformities medical alert tags advising of underlying conditions swellings This is known as a secondary survey. As soon as this has been completed, place the individual in a recovery position. At this point, the first aider should call for an ambulance. Recovery position Even if the individual is breathing but is unconscious, there is still a significant risk of airway obstruction. The recovery position reduces the risk to the patient. A first aider should do the following: If the individual is wearing glasses, remove them. Kneel next to the person, and place the arm nearest to you at a right angle to the body. Bring the other arm across the chest. Hold the back of your hand against their nearest cheek. With your other hand, hold the thigh furthest from you and pull up the knee. Make sure the foot is flat on the ground. Slowly pull down on the raised knee, and roll the body over towards you. Move the upper leg slightly, so that the hip and knee are bent at right angles. This makes sure that they do not roll onto their face. Gently tilt the head back so that the airway is kept open. Cardio-pulmonary resuscitation (CPR) If the person is not breathing, the first aider will need to perform CPR. It is unlikely that CPR will start a heart. Its purpose is to maintain the flow of oxygenated blood to the brain and heart, preventing or at least delaying tissue death. CPR can extend the brief window of time during which successful resuscitation can take place without permanent brain damage. There are two main steps in CPR: Applying chest compressions and then providing breaths. Apply 30 chest compressions: The first aider should kneel next to the person who is injured. They should be lying on their back. For adults, place the heel of one hand in the middle of the chest. Place your other hand on top of the first hand and interlace the fingers. Push the chest down about 1.5 to 2 inches. If the person is a child aged between 1 and 8 years, compress to a maximum of 1.5 inches with one hand. Let go, and wait for the chest to come back up completely before repeating. Your elbows must remain straight throughout. Push the breastbone up and down to a depth of about 5 cm about 30 times, at a pulse rate of 100 beats per minute. Provide two breaths: Make sure the airway is open, and pinch the nose so it closes. Gently raise the chin upwards with two fingers of your other hand. Take a deep breath, seal your mouth over that of the person with the injury, and exhale into the airway. You should see the chest rise and fall. To get another breath, lift your head and breathe in deeply. Perform steps 1, 2, 3, and 4 again.  Repeat the 30 chest compressions followed by the two breaths about five times, and then check for normal breathing. If they are not breathing normally, carry on performing CPR. If breathing restarts as normal, stay with the injured person until help arrives. Chest compressions alone can be lifesavers – the crucial factor is time. Make sure you respond quickly. It is important not to let your hands bounce when performing chest compressions. Make sure the heel of your hand is touching the chest throughout chest compressions. You might hear some pops and snaps during chest compressions. These are normal, so do not stop.  Before you begin Before starting CPR, check: Is the environment safe for the person? Is the person conscious or unconscious? If the person appears unconscious, tap or shake his or her shoulder and ask loudly, "Are you OK?" If the person doesn't respond and you're with another person who can help, have one person call the local emergency number. Have the other person begin CPR. If you are alone and have immediate access to a telephone, call your local emergency number before beginning CPR. As soon as an AED is available, deliver one shock if instructed by the device, then begin CPR. AED - automated external defibrillator Remember to spell C-A-B The American Heart Association uses the letters C-A-B to help people remember the order to perform the steps of CPR. C: compressions A: airway B: breathing Chest compressions To perform chest compressions, kneel next to the person's neck and shoulders. Place the heel of one hand over the center of the person's chest and your other hand on top of the first hand. Keep your elbows straight and position your shoulders directly above your hands. Using your upper body weight, push straight down on the chest about 2 inches (5 centimeters), but not more than 2.4 inches (6 centimeters). Push hard at a rate of 100 to 120 compressions a minute. If you haven't been trained in CPR, continue chest compressions until there are signs of movement or until emergency medical personnel take over. If you have been trained in CPR, go on to opening the airway and rescue breathing. Airway: Open the airway If you're trained in CPR and you've performed 30 chest compressions, open the person's airway using the head-tilt, chin-lift maneuver. Put your palm on the person's forehead and gently tilt the head back. Then with the other hand, gently lift the chin forward to open the airway.  Rescue breathing Open the airway using the head- tilt, chin-lift maneuver. Pinch the nostrils shut for mouth-to-mouth breathing and cover the person's mouth with yours, making a seal. Give the first rescue breath, lasting one second, and watch to see if the chest rises. If it rises, give the second breath. If the chest doesn't rise, repeat the head-tilt, chin-lift maneuver first and then give the second breath. Be careful not to provide too many breaths or to breathe with too much force. After two breaths, immediately restart chest compressions to restore blood flow. Thank you