Primary Survey for Emergency Medical Technicians

Vocabulary practice flashcards covering the primary survey, airway management, spinal injury triage, respiratory and circulatory assessments, skin evaluations, and clinical status determinations for Emergency Medical Technicians.

Primary Survey

An initial assessment focused on establishing the patient's clinical status and only applying interventions essential to maintain life, to be completed within one minute ($60$ to $90\text{ seconds}$) of arrival on scene.

Assisted Decision-Making (Capacity) Act 2015

Legislation establishing that a person is presumed to have capacity regarding clinical decisions affecting themselves unless the contrary is proven.

Scene Size-up

A preliminary evaluation composed of three key elements: scene safety, mechanism of injury/nature of illness (trauma vs. medical), and scene situation (additional resources, PPE, and number of patients).

General Impression

The initial assessment formed in the first $60\text{ seconds}$ by looking at, talking with, and touching the patient to evaluate whether they are stable or unstable, and sick or not sick.

Catastrophic Hemorrhage

A massive external blood loss, such as an arterial bleed or traumatic limb amputation, that severely impairs oxygen delivery and must be controlled before addressing any other assessment priority.

Tourniquet

A constricting band applied $2\text{ inches}$ above an extremity injury and tightened until bleeding stops; may require a second device placed proximal to the first, with the time of application recorded.

Haemostatic Gauze

A specialized dressing coated with coagulant granules packed directly into bleeding wounds, requiring direct manual pressure for $2\text{ minutes}$ before being secured with a pressure dressing.

Airway Patency vs. Airway Protection

A clinical distinction where a patient's ability to talk implies airway protection, but does not confirm patency, which can still be threatened by conditions like laryngeal fractures or inhalational injuries.

Oropharyngeal Airway (OPA)

A curved semicircular plastic adjunct inserted through the mouth to keep the tongue from blocking the airway in unresponsive patients.

Snoring Respirations

An abnormal airway sound indicating a 'position problem' caused by partial obstruction of the airway by the tongue, managed with basic airway repositioning manoeuvres.

Gurgling Respirations

A bubbling airway sound indicating the presence of fluids such as blood, mucus, or vomit in the mouth or posterior pharynx, requiring immediate suctioning.

Trauma Jaw Thrust

The recommended manual airway manoeuvre used to open and maintain the airway when cervical spine injury is suspected, avoiding movement of the neck.

Phrenic Nerve Innervation

Motor innervation to the diaphragm arising from spinal nerves C3, C4, and C5, summarized by the rule 'C3, 4 and 5 keeps the diaphragm alive.'

Manual In-Line Stabilisation

The only form of cervical spine restriction performed during the primary survey; rigid cervical collars should not be sized and fitted during this rapid life-threat identification phase.

Work of Breathing

The total physical effort required to move air in and out of the lungs; signs of an increase include accessory muscle use, intercostal retractions, restlessness, and tripoding.

Abnormal Adult Respiratory Rates

Breathing rates outside normal limits, defined as greater than $30\text{ breaths/min}$ (too fast) or less than $10\text{ breaths/min}$ (too slow), with $< 10\text{ breaths/min}$ requiring especially urgent intervention.

Radial Pulse

The peripheral pulse site located on the lateral wrist, assessed to evaluate circulation rate, regularity, and quality in a conscious patient.

Carotid Pulse

The central pulse palpated in the neck along the trachea, assessed to verify circulation in an unconscious patient.

Capillary Refill Time (CRT)

The time taken for color to return to an external capillary bed after pressure causes blanching, with a normal value being less than $2\text{ seconds}$.

Pallor

An abnormal paleness of the skin associated with severe conditions such as excessive blood loss, anaphylaxis, hypoglycaemia, or extreme anxiety.

Cyanosis

A bluish or purplish discoloration of the skin and mucous membranes indicating hypoxemia and inadequate oxygen saturation in the blood.

Mottled Skin

A blotchy, patchy skin appearance resulting from poor peripheral perfusion due to cardiovascular collapse or disseminated intravascular coagulopathy (DIC).

Jaundice

A yellow discoloration of the skin, sclera, and mucous membranes caused by bilirubin accumulation secondary to liver dysfunction.

Cool, Wet Skin

A skin temperature and moisture presentation indicative of shock or prolonged exposure to environmental cold.

Hot, Dry Skin

A skin temperature and moisture presentation characteristic of excessive internal body heat or heatstroke.

AVPU Scale

A rapid assessment system for neurological responsiveness that grades a patient as Alert (A), responsive to Voice (V), responsive to Pain (P), or Unresponsive (U).

Life Threatening Clinical Status

A triage category on the Patient Care Report (PCR) for conditions such as cardiac arrest, respiratory arrest, or critical airway compromise, requiring Advanced Life Support (ALS) request and on-scene time $\le 10\text{ minutes}$.

Serious Not Life Threatening Clinical Status

A triage category on the Patient Care Report (PCR) for urgent medical conditions such as stroke, cardiac chest pain, or breathing difficulties, where Advanced Paramedic (AP) or Paramedic dispatch should be considered.

Non Serious or Life Threatening Clinical Status

A triage category on the Patient Care Report (PCR) for low-acuity problems, minor injuries, or simple fractures managed by the on-scene practitioner.

Clinical Impression

A working diagnosis synthesized from subjective and objective assessments, medical history, and clinical knowledge to establish and execute an evidence-based care plan.