Overall Assessment Approach PDF

Summary

This document outlines an overall assessment approach, covering various aspects like narrative writing styles, scene assessment, initial assessment, and considerations for different patient groups (pediatric and geriatric). It details crucial elements of a medical assessment, including vital signs, responses to trauma & different causes of delirium; It also discusses various types of elder maltreatment.

Full Transcript

Narrative writing styles: - - - - - - - - - - - - Scene assessment is comprised of: 1. 2. 3. 4. 5. 6. Initial assessment: 1. 2. 3. 4. 5. 6. 7. The **initial assessment** is the most time-intensive portion of the assessment process and should be com...

Narrative writing styles: - - - - - - - - - - - - Scene assessment is comprised of: 1. 2. 3. 4. 5. 6. Initial assessment: 1. 2. 3. 4. 5. 6. 7. The **initial assessment** is the most time-intensive portion of the assessment process and should be completed in the first 60-90 seconds GCS score predictions: 15 = no neurological disabilities 13-14 = mild dysfunction 9-12 = moderate to severe dysfunction 3-8 = severe dysfunction Current health status elements: - - - - - - - - Three (3) mechanisms that produce ABD pain: 1. a. b. 2. c. d. 3. e. *Tilt-test*: Positive results - - - The rapid trauma assessment is used between the initial assessment and the focused physical examination Mental status evaluation: COASTMAP **C** - Consciousness **O** - Orientation **A** - Activity **S** - Speech **T** - Thoughts **M** - Memory **A** - Affect **P** - Perception Ongoing assessment elements: - - - - **Drug** - Any substance or mixture of substances manufactured, sold, or represented for use in: 1. 2. 3. Health Products and Food Branch (HPFB) is the branch of government that approves medication in Canada. Medication names: 1. a. 2. b. 3. c. Sources of medicine: 1. 2. 3. 4. Scheduled drugs: **Schedule I** - narcotics such as opium, heroin, morphine, and cocaine **Schedule II** - cannabis and cannabis resin **Schedule III** - stimulants such as amphetamines, and hallucinogens such as LCD **Schedule IV** - anabolic steroids, barbituates, benzodiazepineines **Schedule V** - Repealed **Schedule VI** - precursors that can be used to create other scheduled drugs **Schedule VII** - Repealed **Schedule VIII ​​**- Repealed **Schedule IX** - devices that can be used to create tablets or capsules 9 years is the average time it takes for a drug to be developed, tested, and approved New drugs must be tested in two (2) animal species before it may enter clinical trials Clinical trial phases: 1. a. 2. b. c. 3. d. e. 4. f. g. Pediatric assessment triangle: - - - Pediatric appearance features: **T** - Tone **I** - Interactiveness **C** - Consolability **L** - Look or gaze **S** - Speech or cry Stridor - obstruction at the level of the glottis - Grunting - obstruction in the lower airway and is a form of auto-PEEP - Wheezing - Constricted or blocked small airways - Pallor - initial sign of poor circulation, anemia or hypoxia Mottling - vasomotor instability in the capillary beds. It can also be a normal response to a cold environment Cyanosis - blue or purple discolouration of the skin and mucous membranes indicating poor perfusion or poor oxygenation Acrocyanosis - blue hands or feet in an infant less than 2 months old and is a normal finding when the infant is cold How to use a browslow tape: 1. 2. a. 3. 4. Skin CTC: - - - Children aged 1 - 10 minimum BP = 70 + (age x 2) Pediatric Resp rates: **Age** **Resp rate** **HR** **SBP** **DBP** ---------------------------- --------------- ---------- ----------- --------- Neonate (0 - 1 month) 30 - 60 90 - 160 67 - 84 35-53 Infant (1 month - 1 year) 30 - 53 90 - 160 72 - 104 37 - 56 Toddler (1 year - 2 years) 22 - 37 80 - 120 86 - 106 42 - 63 Preschool (3 - 5 years) 20 - 28 65 - 100 89 - 112 46 - 72 School-aged (6 - 12 years) 18 - 25 58 - 90 97 - 120 57 - 80 Adolescent (12 - 15) 12 - 20 50 - 90 110 - 131 64 - 83 Geriatric assessment tool: GEMS diamond **G** - Geriatric pt **E** - Environmental **M** - Medical assessment **S** - Social assessment PE triad: 1. 2. 3. Causes of delirium: **D** - Drugs or toxins **E** - Emotional/ electrolytes **L** - Low PaO2 **I** - Infection **R** - Retention of stool or urine **I** - Ictal state (seizures) **U** - Undernutrition or underhydration **M** - Metabolism **S** - Subdural hematoma Type of elder maltreatment: 1. 2. 3. 4. 5.

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