Chapter 12 - Primary Assessment

Primary assessment

Steps taken for the purpose of discovering and dealing with any life-threatening problems (specifically dealing with airway, breathing, and circulation)

How quickly must you suction the airway if vomit is present?

Immediately. It is a life threat.

Is exsanguination a life threat?

Yes !!!

Six parts of the primary assessment

1. General impression

2. Assess mental status (and stabilize head and neck when needed)

3. Assess airway

4. Assess breathing

5. Assess circulation

6. Determine patient’s priority

General impression

Based on environment, chief complaint, and appearance

SMR

Spinal motion restriction

Unusual anxiety and pale and sweaty skin can indicate…

shock

Chief complaint

The reason EMS was called

Clinical judgment

Judgment based on experience in observing and treating patients

Mental status

Level of responsiveness

How to assess mental status

AVPU (alert, verbal response, painful response, unresponsive)

How do you describe a responsive patient’s mental status?

Oriented to person, place, and time

If level of responsiveness is lower than alert, …

provide oxygen based on spO2 and level of distress; consider pt high transport priority

What are the possible results for a pulse check in the primary assessment?

1. Within normal limits

2. Unusually slow

3. Unusually fast

What is priority?

Need for immediate transport vs. further on-scene assessment and care

High priority conditions

-Poor general impression

-Unresponsive

-Responsive but not following commands

-Difficulty breathing

-Shock

-Complicated childbirth

-Chest pain consistent with cardiac problems

-Uncontrolled bleeding

-Severe pain anywhere

pg. 330