chapter 9 patient assessment

  1. patient assessment:

    a _____ is a subjective condition the patient feels and tells you about
    symptom
  2. patient assessment:

    a _____ is an objective condition you can observe or measure about the patient
    sign
  3. patient assessment:

    treatment EMTs provide is based on ____, not exact diagnosis
    symptoms
  4. patient assessment:


    the patient assessment is the ____ upon which all levels of EMT education are built and is the starting point for all patient care
    foundation
  5. scene size-up:

    ____ refers to your evaluation of the conditions in which you will be operating
    scene size-up
  6. scene size-up:

    _____ is paying attention to the conditions and people around you at all times and the potential risk those conditions or people pose
    situational awareness
  7. scene size-up:

    what is the first thing to consider, but does not end as providers move thru the assessment process
    scene size-up
  8. scene size-up:Snnac

    issues that appear to be safe can become unsafe
    true/false
    true
  9. scene size-up:Snnac

    if scene is not safe you should do what you can to make it safe or call for _____
    additional resources
  10. scene size-up:Snnac

    when responding to a traffic scene you should wear a ______
    • high visibility class 2 or 3 safety vest
    • -approved by the american national standards institute
  11. scene size-up:Snnac

    any action you take to protect yourself should also be considered for the patient

    true/false
    true
  12. scene size-up:Snnac

    if possible you should help protect ____
    from becoming patients aswell
    bystanders
  13. scene size-up:sNnac

    _____ is the result of physical forces applied to the outside of the body, usually from an object striking the body or the body striking an object
    mechanism of injury(MOI)

    -classified according to the type or amount of force, how long it was applied , and where it was applied
  14. scene size-up:sNnac

    with ____ trauma, the force of the injury occurs over a broad area and the skin is sometimes not broken
    blunt

    -the tissues and organs underneath the area of impact may be damaged
  15. scene size-up:sNnac

    with ____ trauma the force of the injury at a specific point of contact between the skin and the object
    -it is often a open wound with high potential for infection
    penetrating
  16. scene size-up:sNnac

    for medical patients determine the _____ ____ ____
    nature of illness
  17. scene size-up:sNnac

    to determine the nature of illness(NOI) ____ with a the patient, family and bystanders
    • talk
    • - use you sense to check the scene for clues as to the possible problem
  18. scene size-up:sNnac

    scenes with multiple patients who exhibit similar signs and symptoms could indicate a ____ scene for you and your partner
    unsafe
  19. standard precautions:

    clothing or specialized equipment that provide protection to the wearer
    • PPE/BSI
    • -type of PPE depends on the type of patient your working with
  20. standard precautions:

    standard precautions should be taken before ____ contact
    • patient 
    • -at minimum gloves must be worn
    • -also consider glasses and mask
  21. standard precautions:

    if patients condition warrants higher level of PPE providers should _____
    upgrade protection
  22. scene size-up:snNac

    determining ____ of patients is critical knowing if you need additional resources
    number
  23. scene size-up:snNac

    when there are multiple patients you should use the ____ ______ system, identify the number of patients and then begin triage
    incident command system
  24. scene size-up:snNac

    ____ is a flexible system implemented to manage a variety of emergency scenes
    incident command system
  25. scene size-up:snNac

    _____ is the process of sorting patients based on the severity of each patients condition
    triage
  26. scene size-up:snnAc

    consider _____ resources
    additional/specialized
  27. scene size-up:snnAc

    ask you self these question to determine if you need____

    -Does the scene pose a threat to you, your patient, or others?
    -How many patients are there?
    -Do we have the resources to respond to their conditions?
    additional resources
  28. primary assessment: 

    goal of the primary assessment to to identify and begin treatment of ______
    immediate life threats
  29. primary assessment: Gac abc

    first part of you primary assessment is to form a _____ ______
    • general impression
    • -make note of the patients
    •  -age
    •  -sex
    •  -race
    •  -level of distress
    •  -overall appearance
  30. primary assessment: Gac abc

    make sure the patient _____ you coming
    sees
  31. primary assessment: Gac abc

    determine if the patients condition is 
    -____
    -____
    -____
    • stable
    • stable but potentially unstable
    • unstable
  32. primary assessment: gAc abc

    determine if your patient is 
    -_____
    -conscious with an ____ LOC
    -conscious with an _______LOC
    • unconscious 
    • altered
    • unaltered
  33. primary assessment: gAc abc

    if patient is unconscious you should first assess their____
    • ABC
    • -airway
    • -breathing
    • -circulation
  34. primary assessment: gAc abc

    to assess for responsiveness use the mnemonic_____
    • AVPU
    • Awake and alert
    • Verbally responsive
    • Pain responsiveness
    • Unresponsive
  35. primary assessment: gAc abc

    _____ tests the mental status by checking a patients memory and thinking ability
    • orientation
    • -ask them 
    •  -person-remembers his or her name
    •  -place-identifies the current location
    •  -time-the current year,month, date
    •  -event-describes what happened
  36. primary assessment: gAc abc

    if a patient can answer the orientation questions they are said to be
    fully oriented
  37. primary assessment: gAc abc

    if the patient cant answer all the orientation question they are considered to have an ____ mental status
    altered
  38. primary assessment: gac ABC

    identifying and correcting life threatening issues begins with the ____ followed by ____ and _____
    airway, breathing, circulation
  39. primary assessment: gac ABC

    when patient is in cardiac arrest, what should be done simultaneously to minimize the time to first compression
    ABCs
  40. primary assessment: gac ABC

    when should you start with circulation instead of airway
    when a patient has life threatening bleeding
  41. primary assessment: gac Abc

    when assessing the patients airway stay alert for ____
    obstructions
  42. primary assessment: gac Abc

    to prevent permanent disability to your patient, ensure that the ____ remains open(patent)
    airway
  43. primary assessment: gac Abc

    a patient who is unresponsive or has decreased LOC, immediately asses the patency of the_____
    airway
  44. primary assessment: gac Abc

    use the jaw-thrust maneuver to open the airway when______
    there is potential for trauma
  45. primary assessment: gac Abc

    if the jaw thrust doesnt work you should use the ____
    head tilt chin lift
  46. primary assessment: gac Abc

    these are examples of an _____ in an airway
    -Obvious trauma, blood, or other obstruction
    -Noisy breathing, such as snoring, bubbling, gurgling, crowing, stridor, or other abnormal sounds
    -Extremely shallow or absent breathing
    obstruction
  47. primary assessment: gac aBc

    you should ask yourself these question when assessing _____
    -is the patient breathing?
    -is the patient breathing adequately?
    -is the patient hypoxic?
    breathing
  48. primary assessment: gac aBc

    if breathing adequately but remains hypoxic administer _____
    oxygen
  49. primary assessment: gac aBc

    the goal of oxygenation is to have an oxygen saturation of ____% to ___ %
    94% to 99%
  50. primary assessment: gac aBc

    use positive pressure ventilation with respirations exceeding __ breaths/min or fewer than __ breaths/min
    • exceeding 28 breaths/min or fewer than 8 breaths/min
    • -or when respirations are too shallow to provide adequate air exchange
  51. primary assessment: gac aBc

    _____ occurs when the blood is inadequately oxygenated or ventilation is inadequate to meet the oxygen demands of the body
    respiratory failure
  52. primary assessment: gac abC

    ______ is assessed by evaluating the patients mental status,pulse, and skin condition
    circulation
  53. primary assessment: gac abC

    in responsive patients older than 1 year old you should palpate the ____ pulse
    radial
  54. primary assessment: gac abC

    in unresponsive patients older than 1 year old you should palpate the ___ pulse
    carotid
  55. primary assessment: gac abC

    in patients under 1 year old you should palpate the ____ pulse
    brachial
  56. primary assessment: gac abC

    if you cannot palpate a pulse you should begin____ and prepare an ____
    • CPR 
    • AED
  57. primary assessment: gac abC

    if a patient has a pulse but is not breathing provide _____ at a rate of ___-____breaths/min for adults and ___-___breaths/min for children
    • ventilation
    • 10-12 for adults
    • 12-20 for children
  58. primary assessment: gac abC

    skin condition is assessed by evaluating the _____
    • skin color
    • temp
    • moisture
    • capillary refill
  59. primary assessment: gac abC

    poor ____ will cause the skin to appear pale,white, ashen, gray
    circulation
  60. primary assessment: gac abC

    when blood is not properly saturated with oxygen it appears _____
    blue
  61. primary assessment: gac abC

    ____ may cause the skin to be abnormally flushed or red
    high blood pressure
  62. primary assessment: gac abC

    normal skin temp. is ____
    98.6F
  63. primary assessment: gac abC

    capillary refil should not take longer than __ secs
    2 secs
  64. primary assessment: gac abC

    bleeding from a vein is characterized by a ____ of blood
    steady flow
  65. primary assessment: gac abC

    bleeding from an artery is characterized by a ____ if blood
    spurting flow
  66. primary assessment: gac abC

    check for bleeding by _____ from head to toe, pausing periodically checking your ___ for blood
    • running your gloves 
    • gloves
  67. primary assessment: gac abC

    when controlling bleeding apply pressure, if that is unsuccessful apply a ____
    tourniquet
  68. a rapid scan should take ___ to ___ secs to perfom
    60-90secs
  69. a rapid scan is systematic and focused
    true/false
    false
  70. a rapid scan is performed to identify _____
    life threats
  71. primary assessment: snnaC

    if spinal injury is suspected
    consider spinal immobiliztion
  72. primary assessment: gaC abc

    ____ is the main reason why the patient called you
    chief complaint
  73. a ____ decision should be made after the completion of your primary assessment
    transport decision
  74. these factors determine if you should _____
    -patients condition
    -availability of advanced care
    -distance of transport
    -local protocols
    transport
  75. secondary assessment:

    _____ provides details about the the chief complaint and the patients signs and symptoms
    history taking
  76. secondary assessment:

    if patient is unresponsive you can obtain info from his/her _____
    family
  77. secondary assessment:Opqrst

    what is "onset" in the secondary assessment
    what the patient was doing when the symptoms began
  78. secondary assessment:oPqrst

    what is "provocation/ palliation" in the secondary assessment
    does anything make the symptoms better or worse
  79. secondary assessment:opQrst

    what is "Quality" in the secondary assessment
    what does the symptoms feel like(sharp,dull, burning)
  80. secondary assessment:opqRst

    what is "radiation" in the secondary assessment
    where do you feel the symptoms and does it radiate anywhere
  81. secondary assessment:opqrSt

    what is "severity" in the secondary assessment
    • how much does the symptom hurt
    • (scale of 1-10)
  82. secondary assessment:opqrsT

    what is "time" in the secondary assessment
    has the symptom been constant or does it come and go?
  83. secondary assessment:opqrst

    ______ are negatives that warrant no care or intervention
    pertinent negatives
  84. secondary assessment: SAMPLE

    complaints that cannot be felt or observed by others
    symptoms
  85. secondary assessment: SAMPLE

    conditions that can be seen,heard,felt,smelled, or measured by you or others
    signs
  86. secondary assessment: Sample

    the "S" in SAMPLE  means
    • signs and symptoms
    • -what signs and symptoms occured at the onset of the incident
  87. secondary assessment: Sample

    the "A" in SAMPLE  means
    • allergies 
    • -is the patient allergic to anything?
  88. secondary assessment: Sample

    the "M" in SAMPLE  means
    • medication
    • -what medications are prescribed to the patient,
  89. secondary assessment: Sample

    the "P" in SAMPLE  means
    • pertinent past medical history
    • -does the patient have any medical history relating to the issue
  90. secondary assessment: Sample

    the "L" in SAMPLE  means
    • last oral intake
    • -when did the patient last eat or drink
  91. secondary assessment: Sample

    the "E" in SAMPLE  means
    • events leading up to the issue
    • -what events lead up to the incident
  92. critical thinking:

    seeking facts to help your clinical decision making and scene management
    gathering
  93. critical thinking:

    considering what the info gathered means
    evaluating
  94. critical thinking:

    putting together the information that you have gathered and making a plan to manage the scene
    synthesizing
  95. you should consider all female patients with child bearing capacity and lower abdomen pain to be pregnant unless ruled out by other info
    true/false
    true
  96. alcohol dulls a patients sense, which makes it difficult for the to inform you if something feel painful
    true/false
    true
  97. the most effective treatment in handling a patient with depression is to be a ______
    good listener
  98. you can use a ____ as a hearing aid for the patient
    stethoscope
  99. secondary assessment:

    purpose of the secondary assessment is to is to perform a
    systematic physical(focused assessment)
  100. secondary assessment:

    secondary assessments must be performed enroute to the hospital
    true/false
    • false,
    • secondary assessments maybe performed on scene or enroute depending on the patients condition
  101. secondary assessment: physical examination

    inspection refers to _____
    looking at the patients abnormalities
  102. secondary assessment: physical examination

    palpation refers to
    touch or feel the patient for abnormalities
  103. secondary assessment: physical examination

    auscultation refers to
    listening to the sounds the body makes by using a stethoscope
  104. secondary assessment: dcap-btls

    goal is to identify _______ that may not have been found during the primary assessment
    hidden injuries
  105. secondary assessment: dcap-btls

    focused assessments are performed on patients who have sustained _____ MOI or on responsive medical patients
    nonsignificant
  106. respiratory system:

    normal respirator rate is ___ to ___ breaths/min
    12-20 breaths/min
  107. respiratory system:

    breath rate in children is faster than adults
    true/false
    true
  108. respiratory system: assessment

    determine respirator rate by counting number of breaths in a ___ period and multiplying by ___
    • 30sec period
    • multiply by 2
  109. respiratory system: assessment

    chest the patients chest for signs of
    damage
  110. respiratory system: assessment

    look for signs of airway
    obstructions
  111. respiratory system: assessment

    check chest for overall
    symmetry
  112. respiratory system: assessment

    ____ carefully to the breathing, checking for abnormalities
    listen
  113. respiratory system: assessment

    check for equal chest ____ and ___
    rise and fall
  114. respiratory system: assessment

    normal breathing is not silent
    true/false
    false
  115. respiratory system: assessment

    _____ and _____ sounds suggest an obstruction or narrowing in the lower airways
    snoring and wheezing
  116. respiratory system: assessment

    wet,crackling may indicate fluid in the lungs.
    • crackles
    • -sounds like rice crispies 
    • _fluid will pool at bottom of lungs first
  117. respiratory system: assessment

    congested breath sounds may suggest the presence of mucus in the lungs
    rhonchi
  118. respiratory system: assessment

    often heard before listen with a stethoscope and may indicate that the patient has an airway obstruction in the neck or upper part of the chest
    stridor
  119. cardiovascular system: assessment

    check chest for
    trauma
  120. cardiovascular system: assessment

    check pulse for _____, _____ and ____
    rate rhythm and quality
  121. cardiovascular system: assessment

    check distal pulse for equal _____
    strength
  122. cardiovascular system: assessment

    normal heart rate of an adult is ___ to ___ beats/min
    60-100beats/min
  123. cardiovascular system: assessment
    older patients could be as much as ____beats/min
    100beats/min
  124. cardiovascular system: assessment

    children generally have a ___ than adults do
    faster pulse
  125. cardiovascular system: assessment

    you should count number of pulses felt in a ___ period then multiply by ___
    • 30 secs
    • multiply by 2
  126. cardiovascular system: assessment

    a heart rate of less than ___beats/min is described as bradycardia
    60beats/min
  127. cardiovascular system: assessment 

    normal pulse quality is described as
    strong
  128. cardiovascular system: assessment

    pulse quality stronger than normal is described as
    bounding
  129. cardiovascular system: assessment

    pulse quality that is weak is described as
    weak or thready
  130. cardiovascular system: assessment

    a regular heart rhythm should beat with even and constant intervals 
    true/false
    true
  131. cardiovascular system: assessment

    decreased blood pressure is a late indication of ___
    shock
  132. cardiovascular system: assessment

    normal blood pressure for adults is
    90-130
  133. cardiovascular system: assessment

    normal blood pressure in teens is
    110-130
  134. cardiovascular system: assessment

    normal blood pressure in kids is
    88-115
  135. neurologic system: assessment

    evaluate ____ and orientation
    LOC
  136. neurologic system: assessment

    use ____ if appropriate to determine patients mental status
  137. pupils: assessment

    normally pupils are ____ in size
    equal
  138. pupils: assessment

    the ___ and ____ to light of  the patients pupil can indicate the status of the brain
    diameter and reactivity
  139. pupils: assessment

    anisocoria is when someone has
    unequal pupil
  140. pupils: assessment

    you should assume altered brain function if pupil dont react in a normal manner
    true/false
    • true
    • (this is usually a medical emergency)
  141. pupils: assessment

    the mnemonic PEARRL should be used when assessing pupils, what does PEARRL stand for
    • Pupils
    • Equal
    • And
    • Round
    • Regular in size
    • react to Light
  142. neurovascular status:assessment

    check for ___ muscle strength and weakness
    bilateral
  143. ears: assessment 

    check for ___
    • fluid
    • - maybe a n indication of head trauma
  144. nose: assessment

    check for __
    • fluid 
    • -maybe an indication of trauma
  145. abdomen: assessment

    check for tenderness, rigidity, and
    disstension
  146. pelvis: assessment

    check for ____ and any obvious signs of injury, bleeding,deformity
    symmetry
  147. pelvis: assessment

    check for movement or ____
    • crepitus
    • -maybe an indication of severe injury
  148. pulse oximetry is used to evaluate
    oxygen saturation in the blood
  149. capnography provides info on the patients____
    ventilation, circulation and metabolism
  150. blood glucometry measures the patients
    glucose levels
  151. sphygmomanometer  (blood pressure cuff) is used to measure the patients
    blood pressure
  152. reassessment:

    purpose of reassessment is to monitor ____
    changes in the patients condition
  153. reassessment:

    consist of repeating the
    primary assessment
  154. reassessment:

    after repeating the primary assessment reassess
    vital signs
  155. reassessment:

    compare new vitals with
    baseline vitals
  156. reassessment:

    reassess the ___ complaint
    chief
  157. reassessment:

    recheck all _____
    interventions
  158. DCAP-BTLS:

    the D in the mnemonic means:
    • deformities 
    • -broken bones, dislocated joints
  159. DCAP-BTLS:

    the C in the mnemonic means:
    • contusions
    • -bruising/ bleeding under the skin
  160. DCAP-BTLS:

    the A in the mnemonic means:
    • abrasions
    • -scrapes along the epidermis
  161. DCAP-BTLS:

    the P in the mnemonic means:
    • punctures 
    • - openings made by something sharp
  162. DCAP-BTLS:

    the B in the mnemonic means:
    • burns
    • -injuries caused by heat,chemicals,electric, radiation
  163. DCAP-BTLS:

    the T in the mnemonic means:
    • tenderness
    • -pain upon palpation
  164. DCAP-BTLS:

    the L in the mnemonic means:
    • lacerations
    • -openings in the skin, maybe from blunt force
  165. DCAP-BTLS:

    the S in the mnemonic means:
    • swelling
    • -tissue injury after a strain, sprain or a hematoma(blood collecting under the skin)
  166. VOMIT:

    the V in the mnemonic means:
    vitals
  167. VOMIT:

    the O in the mnemonic means:
    oxygen
  168. VOMIT:

    the M in the mnemonic means:
    • monitor
    • (EKG)
  169. VOMIT:

    the I in the mnemonic means:
    • interventions
    • -did i do all the treatment i could
  170. VOMIT:

    the T in the mnemonic means:
    • transport 
    • -do i need to transport
Author
daniel.ramos702
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342315
Card Set
chapter 9 patient assessment
Description
emergency care and transportation of the sick and injured 11th edition
Updated