a _____ is a subjective condition the patient feels and tells you about
symptom
patient assessment:
a _____ is an objective condition you can observe or measure about the patient
sign
patient assessment:
treatment EMTs provide is based on ____, not exact diagnosis
symptoms
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
scene size-up:
____ refers to your evaluation of the conditions in which you will be operating
scene size-up
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
scene size-up:
what is the first thing to consider, but does not end as providers move thru the assessment process
scene size-up
scene size-up:Snnac
issues that appear to be safe can become unsafe
true/false
true
scene size-up:Snnac
if scene is not safe you should do what you can to make it safe or call for _____
additional resources
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
scene size-up:Snnac
any action you take to protect yourself should also be considered for the patient
true/false
true
scene size-up:Snnac
if possible you should help protect ____
from becoming patients aswell
bystanders
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
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
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
scene size-up:sNnac
for medical patients determine the _____ ____ ____
nature of illness
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
scene size-up:sNnac
scenes with multiple patients who exhibit similar signs and symptoms could indicate a ____ scene for you and your partner
unsafe
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
standard precautions:
standard precautions should be taken before ____ contact
patient
-at minimum gloves must be worn
-also consider glasses and mask
standard precautions:
if patients condition warrants higher level of PPE providers should _____
upgrade protection
scene size-up:snNac
determining ____ of patients is critical knowing if you need additional resources
number
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
scene size-up:snNac
____ is a flexible system implemented to manage a variety of emergency scenes
incident command system
scene size-up:snNac
_____ is the process of sorting patients based on the severity of each patients condition
triage
scene size-up:snnAc
consider _____ resources
additional/specialized
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
primary assessment:
goal of the primary assessment to to identify and begin treatment of ______
immediate life threats
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
primary assessment: Gac abc
make sure the patient _____ you coming
sees
primary assessment: Gac abc
determine if the patients condition is
-____
-____
-____
stable
stable but potentially unstable
unstable
primary assessment: gAc abc
determine if your patient is
-_____
-conscious with an ____ LOC
-conscious with an _______LOC
unconscious
altered
unaltered
primary assessment: gAc abc
if patient is unconscious you should first assess their____
ABC
-airway
-breathing
-circulation
primary assessment: gAc abc
to assess for responsiveness use the mnemonic_____
AVPU
Awake and alert
Verbally responsive
Pain responsiveness
Unresponsive
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
primary assessment: gAc abc
if a patient can answer the orientation questions they are said to be
fully oriented
primary assessment: gAc abc
if the patient cant answer all the orientation question they are considered to have an ____ mental status
altered
primary assessment: gac ABC
identifying and correcting life threatening issues begins with the ____ followed by ____ and _____
airway, breathing, circulation
primary assessment: gac ABC
when patient is in cardiac arrest, what should be done simultaneously to minimize the time to first compression
ABCs
primary assessment: gac ABC
when should you start with circulation instead of airway
when a patient has life threatening bleeding
primary assessment: gac Abc
when assessing the patients airway stay alert for ____
obstructions
primary assessment: gac Abc
to prevent permanent disability to your patient, ensure that the ____ remains open(patent)
airway
primary assessment: gac Abc
a patient who is unresponsive or has decreased LOC, immediately asses the patency of the_____
airway
primary assessment: gac Abc
use the jaw-thrust maneuver to open the airway when______
there is potential for trauma
primary assessment: gac Abc
if the jaw thrust doesnt work you should use the ____
head tilt chin lift
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
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
primary assessment: gac aBc
if breathing adequately but remains hypoxic administer _____
oxygen
primary assessment: gac aBc
the goal of oxygenation is to have an oxygen saturation of ____% to ___ %
94% to 99%
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
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
primary assessment: gac abC
______ is assessed by evaluating the patients mental status,pulse, and skin condition
circulation
primary assessment: gac abC
in responsive patients older than 1 year old you should palpate the ____ pulse
radial
primary assessment: gac abC
in unresponsive patients older than 1 year old you should palpate the ___ pulse
carotid
primary assessment: gac abC
in patients under 1 year old you should palpate the ____ pulse
brachial
primary assessment: gac abC
if you cannot palpate a pulse you should begin____ and prepare an ____
CPR
AED
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
primary assessment: gac abC
skin condition is assessed by evaluating the _____
skin color
temp
moisture
capillary refill
primary assessment: gac abC
poor ____ will cause the skin to appear pale,white, ashen, gray
circulation
primary assessment: gac abC
when blood is not properly saturated with oxygen it appears _____
blue
primary assessment: gac abC
____ may cause the skin to be abnormally flushed or red
high blood pressure
primary assessment: gac abC
normal skin temp. is ____
98.6F
primary assessment: gac abC
capillary refil should not take longer than __ secs
2 secs
primary assessment: gac abC
bleeding from a vein is characterized by a ____ of blood
steady flow
primary assessment: gac abC
bleeding from an artery is characterized by a ____ if blood
spurting flow
primary assessment: gac abC
check for bleeding by _____ from head to toe, pausing periodically checking your ___ for blood
running your gloves
gloves
primary assessment: gac abC
when controlling bleeding apply pressure, if that is unsuccessful apply a ____
tourniquet
a rapid scan should take ___ to ___ secs to perfom
60-90secs
a rapid scan is systematic and focused
true/false
false
a rapid scan is performed to identify _____
life threats
primary assessment: snnaC
if spinal injury is suspected
consider spinal immobiliztion
primary assessment: gaC abc
____ is the main reason why the patient called you
chief complaint
a ____ decision should be made after the completion of your primary assessment
transport decision
these factors determine if you should _____
-patients condition
-availability of advanced care
-distance of transport
-local protocols
transport
secondary assessment:
_____ provides details about the the chief complaint and the patients signs and symptoms
history taking
secondary assessment:
if patient is unresponsive you can obtain info from his/her _____
family
secondary assessment:Opqrst
what is "onset" in the secondary assessment
what the patient was doing when the symptoms began
secondary assessment:oPqrst
what is "provocation/ palliation" in the secondary assessment
does anything make the symptoms better or worse
secondary assessment:opQrst
what is "Quality" in the secondary assessment
what does the symptoms feel like(sharp,dull, burning)
secondary assessment:opqRst
what is "radiation" in the secondary assessment
where do you feel the symptoms and does it radiate anywhere
secondary assessment:opqrSt
what is "severity" in the secondary assessment
how much does the symptom hurt
(scale of 1-10)
secondary assessment:opqrsT
what is "time" in the secondary assessment
has the symptom been constant or does it come and go?
secondary assessment:opqrst
______ are negatives that warrant no care or intervention
pertinent negatives
secondary assessment: SAMPLE
complaints that cannot be felt or observed by others
symptoms
secondary assessment: SAMPLE
conditions that can be seen,heard,felt,smelled, or measured by you or others
signs
secondary assessment: Sample
the "S" in SAMPLE means
signs and symptoms
-what signs and symptoms occured at the onset of the incident
secondary assessment: Sample
the "A" in SAMPLE means
allergies
-is the patient allergic to anything?
secondary assessment: Sample
the "M" in SAMPLE means
medication
-what medications are prescribed to the patient,
secondary assessment: Sample
the "P" in SAMPLE means
pertinent past medical history
-does the patient have any medical history relating to the issue
secondary assessment: Sample
the "L" in SAMPLE means
last oral intake
-when did the patient last eat or drink
secondary assessment: Sample
the "E" in SAMPLE means
events leading up to the issue
-what events lead up to the incident
critical thinking:
seeking facts to help your clinical decision making and scene management
gathering
critical thinking:
considering what the info gathered means
evaluating
critical thinking:
putting together the information that you have gathered and making a plan to manage the scene
synthesizing
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
alcohol dulls a patients sense, which makes it difficult for the to inform you if something feel painful
true/false
true
the most effective treatment in handling a patient with depression is to be a ______
good listener
you can use a ____ as a hearing aid for the patient
stethoscope
secondary assessment:
purpose of the secondary assessment is to is to perform a
systematic physical(focused assessment)
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
secondary assessment: physical examination
inspection refers to _____
looking at the patients abnormalities
secondary assessment: physical examination
palpation refers to
touch or feel the patient for abnormalities
secondary assessment: physical examination
auscultation refers to
listening to the sounds the body makes by using a stethoscope
secondary assessment: dcap-btls
goal is to identify _______ that may not have been found during the primary assessment
hidden injuries
secondary assessment: dcap-btls
focused assessments are performed on patients who have sustained _____ MOI or on responsive medical patients
nonsignificant
respiratory system:
normal respirator rate is ___ to ___ breaths/min
12-20 breaths/min
respiratory system:
breath rate in children is faster than adults
true/false
true
respiratory system: assessment
determine respirator rate by counting number of breaths in a ___ period and multiplying by ___
30sec period
multiply by 2
respiratory system: assessment
chest the patients chest for signs of
damage
respiratory system: assessment
look for signs of airway
obstructions
respiratory system: assessment
check chest for overall
symmetry
respiratory system: assessment
____ carefully to the breathing, checking for abnormalities
listen
respiratory system: assessment
check for equal chest ____ and ___
rise and fall
respiratory system: assessment
normal breathing is not silent
true/false
false
respiratory system: assessment
_____ and _____ sounds suggest an obstruction or narrowing in the lower airways
snoring and wheezing
respiratory system: assessment
wet,crackling may indicate fluid in the lungs.
crackles
-sounds like rice crispies
_fluid will pool at bottom of lungs first
respiratory system: assessment
congested breath sounds may suggest the presence of mucus in the lungs
rhonchi
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
cardiovascular system: assessment
check chest for
trauma
cardiovascular system: assessment
check pulse for _____, _____ and ____
rate rhythm and quality
cardiovascular system: assessment
check distal pulse for equal _____
strength
cardiovascular system: assessment
normal heart rate of an adult is ___ to ___ beats/min
60-100beats/min
cardiovascular system: assessment
older patients could be as much as ____beats/min
100beats/min
cardiovascular system: assessment
children generally have a ___ than adults do
faster pulse
cardiovascular system: assessment
you should count number of pulses felt in a ___ period then multiply by ___
30 secs
multiply by 2
cardiovascular system: assessment
a heart rate of less than ___beats/min is described as bradycardia
60beats/min
cardiovascular system: assessment
normal pulse quality is described as
strong
cardiovascular system: assessment
pulse quality stronger than normal is described as
bounding
cardiovascular system: assessment
pulse quality that is weak is described as
weak or thready
cardiovascular system: assessment
a regular heart rhythm should beat with even and constant intervals
true/false
true
cardiovascular system: assessment
decreased blood pressure is a late indication of ___
shock
cardiovascular system: assessment
normal blood pressure for adults is
90-130
cardiovascular system: assessment
normal blood pressure in teens is
110-130
cardiovascular system: assessment
normal blood pressure in kids is
88-115
neurologic system: assessment
evaluate ____ and orientation
LOC
neurologic system: assessment
use ____ if appropriate to determine patients mental status
pupils: assessment
normally pupils are ____ in size
equal
pupils: assessment
the ___ and ____ to light of the patients pupil can indicate the status of the brain
diameter and reactivity
pupils: assessment
anisocoria is when someone has
unequal pupil
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)
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
neurovascular status:assessment
check for ___ muscle strength and weakness
bilateral
ears: assessment
check for ___
fluid
- maybe a n indication of head trauma
nose: assessment
check for __
fluid
-maybe an indication of trauma
abdomen: assessment
check for tenderness, rigidity, and
disstension
pelvis: assessment
check for ____ and any obvious signs of injury, bleeding,deformity
symmetry
pelvis: assessment
check for movement or ____
crepitus
-maybe an indication of severe injury
pulse oximetry is used to evaluate
oxygen saturation in the blood
capnography provides info on the patients____
ventilation, circulation and metabolism
blood glucometry measures the patients
glucose levels
sphygmomanometer (blood pressure cuff) is used to measure the patients
blood pressure
reassessment:
purpose of reassessment is to monitor ____
changes in the patients condition
reassessment:
consist of repeating the
primary assessment
reassessment:
after repeating the primary assessment reassess
vital signs
reassessment:
compare new vitals with
baseline vitals
reassessment:
reassess the ___ complaint
chief
reassessment:
recheck all _____
interventions
DCAP-BTLS:
the D in the mnemonic means:
deformities
-broken bones, dislocated joints
DCAP-BTLS:
the C in the mnemonic means:
contusions
-bruising/ bleeding under the skin
DCAP-BTLS:
the A in the mnemonic means:
abrasions
-scrapes along the epidermis
DCAP-BTLS:
the P in the mnemonic means:
punctures
- openings made by something sharp
DCAP-BTLS:
the B in the mnemonic means:
burns
-injuries caused by heat,chemicals,electric, radiation
DCAP-BTLS:
the T in the mnemonic means:
tenderness
-pain upon palpation
DCAP-BTLS:
the L in the mnemonic means:
lacerations
-openings in the skin, maybe from blunt force
DCAP-BTLS:
the S in the mnemonic means:
swelling
-tissue injury after a strain, sprain or a hematoma(blood collecting under the skin)
