How do you to assess a patients consciousness?
A - alert - eyes open?
V - voice - “can you hear me?”
P - pain - trapezius squeeze
U - unresponsive - no response to voice/pain
Taking temperature
Human body is stable at 37
Taken in the ear as reflects bodies core temperature
Use single disposable ear probe
Child -1 pull ear back / 1+ pull ear up
Reassess to identify change
If hearing aid is worn temp will change for 30 minutes
How would you assess a patients pain?
Site- location
Onset - when it started
Character - description
Radiates - has it spread
Associated signs and symptoms - pallor, sweating, breathlessness
Timescale - how long it has lasted
Exacerbating factors - when does it get worse ie moving
Severity - on a scale of 1-10
What three components make up a secondary survey?
History, examination and observations
Secondary survey
History
SAMPLE
Signs/symptoms - SOCRATES and SoB, dizziness, ask questions
Allergies - sensitive to medication
Medication - any clues/ recreational drugs
Past medical history - any known conditions?
last meal (in/out) - nausea, vomiting, fluid intake
Events - what lead to the patient calling?
What is the difference between a sign and a symptom?
A sign is OBJECTIVE evidence (observed by others)
A symptom is SUBJECTIVE evidence (only felt by the person experiencing it
Secondary survey
Examination
Gain consent
. ECG (ride your green bike)
. Visually check pupils
. Rate rhythm and depth of breathing - pulse and auscultate left and right
Secondary survey
Observation
Consent and explanation
Need to be repeating and continue to monitor
Inspecting trauma, rashes etc
Palpate anatomical landmarks and auscultate
Blood glucose level
FAST - stroke
Peak flow
Pulse points
Carotid - neck, carotid artery
Branchial -crooked of elbow
Radial - radial side of wrist
Ulnar - ulnar side of wrist
Femoral - crease between leg and groin
Popliteal - behind the knee cap
Posterior tibial - in the ankle
Dorsal is pedis - top of the foot
Assessing pulse
Can use a capillary refill
Rate, rhythm and volume
Skin temp, tone and colour
Normal adult 60-100
-60 - bradycardia
100+ - tachycardia
Assess patients rate of deterioration
Using NEWS 2
National early warning score
Ideal want a score of 0
