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Patient assessment for the Basic EMT

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Presentation on theme: "Patient assessment for the Basic EMT"— Presentation transcript:

1 Patient assessment for the Basic EMT
CONFIDENTIAL

2 Lesson Goal Obtain and interpret vital signs & SAMPLE history
Provide information necessary to evaluate scene during initial stages of response Perform initial patient assessment, form a general impression, and determine transport priority of medical or trauma patient Recognize MOI to predict injury in trauma patient CONFIDENTIAL

3 Presentation Information
Lesson Goal Perform detailed physical examination, understand findings, and use findings to provide appropriate patient care Perform ongoing assessment Reassess & confirm patient’s status Review assessment Check interventions for adequacy & response Assess patients with medical complaint and obtain a focused history CONFIDENTIAL CONFIDENTIAL

4 Why is it important? We are the eyes and ears
We cannot treat what we do not assess We cannot report what we do not assess or treat CONFIDENTIAL

5 Assessment tools CONFIDENTIAL

6 Most Important Assessment Tools
CONFIDENTIAL

7 When does assessment begin?
CONFIDENTIAL

8 PATIENT ASSESSMENT OVERVIEW
Scene Size-up Initial Assessment Rapid Focused and Physical Exam: Trauma Rapid Focused And Physical Exam: Medical Vital Signs/History Detailed Exam Ongoing Assessment CONFIDENTIAL

9 Scene Size-Up CONFIDENTIAL

10 General Impression Includes: NOI for medical patients
MOI for trauma patients Determine need for cervical spine stabilization Both medical problem & injury possible Age Gender Race (ethnicity) CONFIDENTIAL

11 Level of Consciousness (Mental Status)
A Alert V responds to Verbal stimulus P responds only to Painful stimulus U Unresponsive CONFIDENTIAL

12 PATIENT ASSESSMENT OVERVIEW
Scene Size-up Initial Assessment Rapid Focused and Physical Exam: Trauma Rapid Focused And Physical Exam: Medical Vital Signs/History Detailed Exam Ongoing Assessment CONFIDENTIAL

13 Initial Assessment Find and fix Assess disability/environment
Airway Breathing Circulation/Shock Assess disability/environment Expose as necessary Transport decision CONFIDENTIAL

14 Assess Airway Look Listen Feel Patient position Intact structure
No foreign bodies Patient color Listen Snoring Gurgling Crowing/stridor Silence Patient complaint Feel Stable structure Air exchange CONFIDENTIAL

15 Treat Airway Position Suction Adjuncts Consider early transport
CONFIDENTIAL

16 Assess Breathing Look Listen Feel Patient position Patient color
Chest wall movement Use of accessory muscles Rate/Regularity Pulse oxymetry Listen Audible wheezing Breath sounds Patient complaint Feel Chest wall Subcutaneous emphysema CONFIDENTIAL

17 Treat breathing Position for comfort Consider early transport
Apply oxygen High-flow/NRB Assist breathing Once every 5-6 seconds Seal chest wounds Occlusive dressing CONFIDENTIAL

18 Assess Circulation/Shock
Look External bleeding Patient color Listen Mental status Feel Pulse Location Quality Rate regularity CONFIDENTIAL

19 Treat Circulation/Shock
Stop the bleeding High-flow oxygen Maintain body temperature CONFIDENTIAL

20 Consider C-Spine stabilization
CONFIDENTIAL

21 Assess Disability (neuro status)
Mental Status Pupil check Bilateral movement Glasgow Coma scale CONFIDENTIAL

22 Assess Environment/Expose
Too hot/too cold Surface contact Move patient to a controlled environment ASAP Expose injuries CONFIDENTIAL

23 PATIENT ASSESSMENT OVERVIEW
Scene Size-up Initial Assessment Rapid Focused and Physical Exam: Trauma Rapid Focused And Physical Exam: Medical Vital Signs/History Detailed Exam Ongoing Assessment CONFIDENTIAL

24 Focused History and Physical Exam—Trauma
Presentation Information Focused History and Physical Exam—Trauma Rapid Trauma Assessment VS Focused Trauma Assessment CONFIDENTIAL CONFIDENTIAL

25 Check the nooks and crannies
Detailed Exam Check the nooks and crannies CONFIDENTIAL

26 Hands-on Assessment—Head to Toe
Presentation Information Hands-on Assessment—Head to Toe D Deformities C Contusions A Abrasions P Penetrations B Burns T Tenderness L Lacerations S Swelling The video will start when the mouse is clicked. CONFIDENTIAL CONFIDENTIAL

27 PATIENT ASSESSMENT OVERVIEW
Scene Size-up Initial Assessment Rapid Focused and Physical Exam: Trauma Rapid Focused And Physical Exam: Medical Vital Signs/History Detailed Exam Ongoing Assessment CONFIDENTIAL

28 Focused History and Physical Exam--Medical
Getting a history is the key!! S Signs and Symptoms--OPQRST A Allergies M Medications P Pertinent Past history L Last oral intake E Events leading up to Focused physical assessment CONFIDENTIAL

29 Assessing Signs and Symptoms
O Onset P Provoke Q Quality R Radiate S Severity T Time CONFIDENTIAL

30 PATIENT ASSESSMENT OVERVIEW
Scene Size-up Initial Assessment Rapid Focused and Physical Exam: Trauma Rapid Focused And Physical Exam: Medical Vital Signs/History Detailed Exam Ongoing Assessment CONFIDENTIAL

31 Check the nooks and crannies
Detailed Exam Check the nooks and crannies CONFIDENTIAL

32 PATIENT ASSESSMENT OVERVIEW
Scene Size-up Initial Assessment Rapid Focused and Physical Exam: Trauma Rapid Focused And Physical Exam: Medical Vital Signs/History Detailed Exam Ongoing Assessment CONFIDENTIAL

33 Presentation Information
On-Going Assessment Assess, re-assess and then assess again Vital signs every 15 minutes for the stable patient Vital signs every 5 minutes for the unstable patient CONFIDENTIAL CONFIDENTIAL

34 Vital Signs Pulse Respirations Breath Sounds Blood Pressure
Oxygen saturation Pupils GCS Skin color, condition, and temperature Time CONFIDENTIAL

35 Skin color/condition Pupils Normal, pale, jaundiced, flushed, cyanotic
Warm, hot, cool , cold, moist, dry Pupils Equal/reactive CONFIDENTIAL

36 Pulse Respirations Breath sounds Rate: adult normal 60-100
Location: carotid/radial Quality: strong, weak, thready Regularity: regular/irregular Respirations Rate: adult normal 12-20 Quality: easy, labored, noisy Regularity Breath sounds Present and equal CONFIDENTIAL

37 Blood pressure Oxygen saturation Auscultation Palpation Oscillation
Automatic Oxygen saturation > 90% for adults > 95% for pediatrics CONFIDENTIAL

38 Presentation Information
Glasgow Coma Scale Criteria Patient Response Score Eye opening Spontaneously To speech To pain None 4 3 2 1 Verbal response Oriented Confused Inappropriate words Incomprehensible words 5 Motor response Obeys commands Localizes pain Withdraws to pain Flexion to pain Extension to pain 6 CONFIDENTIAL CONFIDENTIAL

39 EVERYONE gets an assessment
The Last Word… EVERYONE gets an assessment CONFIDENTIAL

40 Questions and answers CONFIDENTIAL

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