EMT Course 1 > Chapter 10 > Flashcards

Chapter 10 Flashcards

Patient Assessment (65 cards)

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1
Q

Scene Size-Up (Patient Assessment 1)

A
  • Ensure Scene Safety
  • Determine Mechanism of injury/nature of illness
  • Take standard precautions
  • Consider addition/specialized resources
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2
Q

Primary Assessment (Patient Assessment 2)

A

(Identify and control life-threatening external hemorrhage before assessing the airway)

  • Form general Impression
  • Assess level of consciousness
  • Assess the airway: identify and treat life threats
  • Assess breathing: identify and treat life threats
  • Assess Circulation: identify and treat life threats
  • Perform Primary Assessment
  • Determine Priority of patient care and transport
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3
Q

History Taking (Patient Assessment 3)

A

Investigate the chief complaint (history of presnt illness) Obtain SAMPLE history

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4
Q

Secondary Assessment MEDICAL / TRAUMA
(Patient Assessment 4)

A

Systematically assess the patient
- Secondary assessment and/or focused assessment
Assess vital signs using the appropriate monitoring device

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5
Q

Reassessment (Patient Assessment 5)

A
  • Repeat primary assessment
  • Reassess vital signs
  • Reassess the chief complaint
  • Recheck interventions
  • Identify and treat changes in the patient’s condition
  • Reassess the patient
    • Unstable patient: every 5 min
    • Stable patient: every 15 min
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6
Q

What does LOC mean?

A

Level Of Consciousness

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7
Q

AVPU scale

A

Tests the patient’s responsiveness
A - Awake and alert: eyes open / track objects, aware of you, responsive to the environment, follows commands

V - Responsive to verbal stimuli: Patient not alert or awake, Eyes do not open spontaneously, eyes open when spoken to, able to respond by moaning or moving…

P - Responsive to Pain: No response to questions, moves or cries in response to painful stimulus

U - Unresponsive: No spontaneous response to verbal or painful stimuli, usually no cough or gag reflex

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8
Q

(CAB) Sequence

A

C - Circulation
A - Airway
B - Breathing

(If life threating bleeding)

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9
Q

(ABC) Sequence

A

A - Airway
B - Breathing
C - Circulation

(If cardiac arrest, ABC’s should be assessed simultaneously (for speed))

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10
Q

Where to check for pulse over 1-year (Conscious & Unconscious) under 1 year

A

Responsive patients - Radial pulse

Unresponsive patients - Carotid pulse

Under 1 year (infant) - Brachial pulse
If supine raise arm over head then palpate

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11
Q

Manual Ventilation Rate

A

10 - 12 breaths a min
12 - 20 breaths per min for infant or child

monitor pulse every 2 min

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12
Q

Skin Moisture

A

When skin is slightly moist it is defined as clammy, damp, moist

When skin is bathed in sweat it is called wet or diaphretic

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13
Q

(CRT)

A

Capillary refill time (should be within 2 seconds)

Test use thumb and press on patient’s nail

To assess on newborns and young infants press on forehead chin or sternum

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14
Q

DCAP-BTLS

A

Deformities
Contusions
Abrasions
Punctures/Penetrations

Burns
Tenderness
Lacerations
Swelling

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15
Q

How often to reassess vital signs

A

If stable every 15 min

If unstable every 5 min

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16
Q

OPQRST

A

O – Onset - Where were you when symptoms began?

P – Provocation/Palliation - Does anything make the symptoms better or worse? How are you most comfortable?

Q – Quality - What does the symptom feel like? Is it sharp, dull, crushing, tearing? Does it come in waves?

R – Region/Radiation - Where do you feel the symptom? Does it move anywhere?

S – Severity - On a scale of 0 - 10, how would you rate your symptom?

T – Timing - How long have you had the symptom? When did it start?

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17
Q

SAMPLE

A

S - Signs and Symptoms
A - Allergies
M - Medications
P - Pertinent past medical history
L - Last oral intake / Last Menstual period
E - Event leading up to the injury or illness

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18
Q

What to get when assessing breathing?

A
  • Respiratory Rate
  • Rhythm: regular or irregular
  • Quality of breathing
  • Depth of breathing (tital volume)
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19
Q

Normal respiratory rate (all ages)

A

Adults 12 - 20 breaths/min
Adolescents (13-18) 12-16 breaths/min
School-aged (6-12) 18-30 breaths/min
Toddlers (1-3) 22-34 breaths/min
Infants 30-60 breaths/min

Count over 30 seconds then x2
count at each peak chest rise

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20
Q

Normal Pulse Rates

A

Adults (and children older than 10) - 60-100
2-10 year olds - 60-140
Infants and toddlers (3months to 2 years) - (100-190)
Infants (up to 3 months) - 85-205

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21
Q

Normal Blood Pressures (Systolic)

A

SYSTOLIC Pressures

Adults 90 - 120
Adolescent (15) 110 - 131
Child (7) 97 - 115
Child (2) 86 - 106
Infant (1-12months) 72 - 104
Neonate (96hours) 67 - 84

Systolic is the maximum pressure that arteries are subjected to and diastolic is minimum pressure
measured in millimeters of mercury

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22
Q

Glasgow Coma Score (GCS)

A

Eyes Opening
- Spontaneous (4)
- In response to sound (3)
- In response to pressure (2)
- None (1)

Best Verbal Response
- Oriented Conversation (5)
- Confused Conversation (4)
- Inappropriate words (3)
- Incomprehensible sounds (2)
- None (1)

Best Motor Response
- Obeys Commands (6)
- Localizes to pressure (5)
- Withdraws from pressure (4)
- Abnormal flexion (3)
- Abnormal extension (2)
- None (1)

Score 13-15 mild dysfunction
Score 9-12 moderate dysfunction
Score 8 or less Severe dysfunction

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23
Q

PEARRL (pupils)

A

Pupils
Equal
And
Round
Regular in size
React in Light

PEARRL

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24
Q

Sclera

A

White layer of eye

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25
Accessory Muscles
The secondary muscles of respiration. Neck and Sternum Muscles. Check pectoralis major muscles and abdominal muscles
26
Altered Mental Status
Change in the way person thinks or behaves that may signal a disease
27
Auscultate
To listen to sounds within an organ with a stethoscope
28
Bradycardia
A slow heart rate (Less than 60 beats/min)
29
Capnography
Noninvasive method to efficiently provide information on ventilatory status, circulation, and metabolism Measures the concentration of carbon dioxide in air over time
30
Conjunctiva
A delicate membrane that lines the eyelids and covers the exposed surface of the eye
31
Crepitus
A grating or grinding sensation caused by a fractured bone ends or joints rubbing together
31
Crackles (lungs)
A crackling rattling breath sound that signals fluid in the air spaces of lungs
32
Diaphoretic
Something that induces or relates to light or profuse sweating
33
Field Impression
Conclusion about the cause of the patients condition after considering the situation history and examination findings
34
Focused assessment
Based on chief complaint and focuses on body ONE body system or part performed on patients who have sustained nonsignificant MOIs or on responsive medical patients
35
General Impression
Overall initial impression that determines the priority for patient care
36
Golden Hour
Hour after injury occurs to definitive care (hospital) Also called golden period
37
Gaurding
Involuntary muscle contractions (spasm) of the abdominal wall Effort to protect inflamed abdomen
38
History Taking
A step within the patient assessment provides detail about chief complaint and signs and symptoms
39
Hypertension
Blood pressure that is higher than normal range Above Systolic of 140 mmHg
40
Hypotension
Blood pressure that is lower than normal range Below Systolic of 90 mmHg
41
Hypothermia
Body temperature that drops below 95
42
Incident command system
A multisytem incident where Chiefs... Report to incident commander
43
Jaundice
Yellow skin or sclera (white layer of eye) Caused by liver disease or dysfunction
44
(MAP)
Mean Arterial Pressure Average pressure in the circulatory system during one cardiac cycle 70-100mmHg DBP + 1/3 (SBP - DBP)
45
Orientation
Mental status of patient measured by memory of person name, place, time, date, event
46
Paradoxical Motion
Exact opposite of normal chest wall during breathing Expands when breathing out Shrinks when breathing in
47
Primary Assessment (Definition)
Finding life threats A step within the patient assessment that identifies and initiates treatment of potential life threats
48
Pertinent Negatives
Negative finding that warrent no care or intervention Can use this as clues
49
Pulse Oximetry
Assessment tool that measures blood oxygen of hemoglobin in capillary beds
50
Retractions
Movements in which the skin pulls in around the ribs during inspiration the chest muscles are pulling inward with each breath, indicating the body is struggling to get enough air, a serious sign of respiratory distress
51
Rhonchi
Coarse, low-pitched breath sounds Heard in patients with chronic mucus in the upper airway
52
Sign
Finding that can be seen, heard, felt, smelled, or measured
53
Sniffing Position
Upright position, head and chin are thrust slightly forward to keep airway open
54
Spontaneous Respirations
Breathing that occurs without assistance
55
Standard Precautions
Centers for Disease Control (CDC) Protective measures for exposure...
56
Stridor
Harsh, high-pitched lung sound generally caused by partial blockage or narrowing of upper airway.
57
Subcutaneous emphysema
Cracking sensation felt on palpation of skin. Presence of air in soft tissue
58
Tachycardia
Rapid heart rate More than 100 bpm
59
Tidal Volume
Amount of air (in mm) that is moved in or out of lungs during 1 breath
60
Triage
Establishing treatment according to severity of injury
61
Tripod Position
Upright position, patient leans forrward onto both arms on lap. Head and chin thrusted forward
62
2 - 3 word dyspnea
Patient can only talk 2-3 words at a time without pausing to take breath
63
Wheezing
High pitched whistle Suggests an obstruction of narrowing of the lower airways Asthma and Bronchiolitis
64
Indications for Spinal Immobilization
Blunt or penetration trauma: - pain or tenderness to neck or spine - Patient report of pain neck or back - Paralysis numbness tingling or legs or arms Blunt trauma with any of the following: - Altered mental status - Intoxication - Difficulty or inability to communicate
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