EMS Chapter 10 Patient Assessment

Symptom

subjective condition

Sign

objective condition

Field impression

Conclusion about the cause of the patient’s condition

Mechanism of injury (MOI)

Type of force, length of application, and location

Blunt trauma

Force is exerted over a broad area

Penetrating trauma

Force is applied at a specific point

What are the 5 things to consider in a scene size-up?

Scene safety

MOI/NOI

PPE

Number of patients

Additional resources

Triage

Process of sorting patients based on the severity of their condition

Primary assessment

To identify and begin treatment of immediate or imminent life threats

Assessment of LOC

ABCs

General impression

Rapid identification of potentially life-threatening problems

AVPU is used to assess what?

Level of consciousness

What places on the body are used to assess response to pain?

Sternum, posterior edge of mandible, trapezius, ridge of orbital bone

How do you check a patient’s orientation?

Person, place, time, event

Who is considered of “altered mental status?

Anyone who cannot answer all 4 orientation questions correctly

Perfusion

The flow of blood throughout the body

Spontaneous respirations

Describes a patient that breathes without assistance

Shallow respirations

little movement of the chest wall (reduced tidal volume)

Retractions

indentations above the clavicle and between the ribs

What accessory muscles are used in inadequate respiration?

Neck, pectoralis major, and abdominalsS

What are some signs that a pediatric patient is having difficults breathing?

Seesaw breathing and nasal flaring

Two-to-three-word dyspnea

Patient who can only speak two-to-three words without taking a breath

Labored breathing

You can see the effort in the patient’s breathing

What is a common cause of cardiac arrest in children?

Respiratory arrest

What is assessed when evaluating circulation?

Patient’s mental status, pulse, and skin condition

In a responsive >1 yr old patient, what pulse is palpated?

Radial

In an unresponsive >1 yr old patient, what pulse is palpated?

Carotid

In a <1yr old patient, what pulse is palpated?

Brachial

What is assessed when evaluating perfusion?

Skin color, temperature, moisture, and capillary refill

How to asses skin color in beeper pigmented patient’s?

Look at finger nails, mucous membranes in the mouth, lips, underside of the arm and palms, and the conjunctiva

Conjunctiva

Delicate membrane lining the eyelids

Poor peripheral circulation is characterized by what signs?

Skin appears pale, white, ashen or gray

Cyanosis

Low levels of oxygen in the blood causing then to appear blue

High blood pressure can cause the skin to turn what color?

Red / abnormally flush

Jaundice

Yellowing of the skin and sclera due to liver disease or dysfunction

Sclera

Whites of the eyes

Diaphoretic

Wet skin

What does DCAP-BTLS stand for?

Deformity, Contusions, Abrasions, Punctures - Burns, Tenderness, Lacerations, Swelling

Crepitus

A grating or grinding sound caused by fractured or broken bones rubbing together

Stridor

A brassy crowing sound prominent on inspiration

Wheezing

High-pitched whistling most prominent on exhalation

Crackles

Wet, rice crispy-like on exhalation and inhalation

Tachycardia

Greater than 100 beats/min

Bradycharda

Less than 60 beats/min

Systolic pressure

Increased pressure cause with each contraction

Diastolic pressure

Residual pressure that remains in the arteries

Hypotension

Blood pressure is lower than normal

Hypertension

Blood pressure is higher than normal

What does PEARRL stand for?

Pupils, Equal, And Round, Regular in size, React to light

Subcutaneous Emphysema

Crackling sounds produced by air bubbles under the skin

Paradoxical Motion

When only one section of the chest rises on inspiration while another area falls

What does Capnigraphy measure?

Ventilation, circulation and metabolism via carbon dioxide exhaled