Patient Assessment

What is the first priority on every EMS scene?

Scene safety.

What is a scene size-up?

A rapid assessment of scene safety, hazards, patient count, nature of illness/mechanism of injury, and need for resources.

Is scene size-up a one-time action?

No. Reassess it throughout the call.

What common hazards should EMTs look for?

Traffic, fire, hazardous materials, violence, structural instability, electrical hazards, environmental dangers, and infectious risks.

What is the general rule for requesting extra resources?

Call early when current resources may be insufficient or overwhelmed.

When should law enforcement be requested?

For violent, hostile, or unsafe scenes.

When should Hazmat be requested?

When hazardous materials or dangerous substances are involved.

What information should be included when requesting resources?

Why they are needed, type/quantity, location/access, and updates.

What is mutual aid?

Formal assistance between agencies across jurisdictional boundaries.

What is the purpose of the primary assessment?

To rapidly identify and treat immediate life threats and determine patient priority.

Should you wait until the end of the primary assessment to treat a life threat?

No. Treat it as soon as you find it.

What does ABCDE stand for?

Airway, Breathing, Circulation, Disability, Exposure.

What is assessed under Airway?

Whether the airway is open, protected, and free of obstruction.

What immediate airway interventions may be needed?

Positioning, suctioning, or airway adjuncts.

What is assessed under Breathing?

Respiratory rate, depth, effort, and adequacy of ventilation.

What should you do if breathing is inadequate?

Support oxygenation and assist ventilations as needed.

What is assessed under Circulation?

Pulse, skin signs, perfusion, and life-threatening bleeding.

What should be done for severe hemorrhage during the primary assessment?

Control it immediately.

What is assessed under Disability?

Rapid neurologic status using AVPU and checking for obvious neurologic deficits.

What does AVPU stand for?

Alert, Verbal, Pain, Unresponsive.

What is assessed under Exposure?

Hidden injuries or life threats while preventing heat loss afterward.

What does the primary assessment help determine besides life threats?

Whether the patient is stable or unstable and how urgent transport should be.

What is the purpose of the secondary assessment?

To gather more detailed information after immediate life threats are addressed.

When may a complete secondary assessment not be possible?

When ongoing life-saving care such as CPR takes priority.

What does DCAP-BTLS stand for?

Deformities, Contusions, Abrasions, Punctures/Penetrations, Burns, Tenderness, Lacerations, Swelling.

What technique is used during a head-to-toe exam?

Look, Listen, and Feel.

Why are repeat vital signs important?

They show trends and help identify improvement or deterioration.

How often should unstable patients be reassessed according to the lesson?

About every 5 minutes.

How often should stable patients be reassessed according to the lesson?

About every 15 minutes.

What does SAMPLE stand for?

Signs/Symptoms, Allergies, Medications, Past medical history, Last oral intake, Events leading up.

What does OPQRST stand for?

Onset, Provocation/Palliation, Quality, Region/Radiation, Severity, Time.

What does Onset assess?

When and how the problem started.

What does Provocation/Palliation assess?

What makes the problem worse or better.

What does Quality assess?

How the patient describes the symptom.

What does Region/Radiation assess?

Where the symptom is and whether it spreads.

What does Severity assess?

How intense the symptom is.

What does Time assess?

How long it has been present and how it has changed.

What is a focused physical exam?

An exam concentrated on the body system or area related to the chief complaint.

Why compare bilateral findings?

To identify asymmetry or abnormal differences.

Why is patient history important?

It helps identify causes, guide the exam, support treatment decisions, and reveal red flags.

Who should be the primary source of history when possible?

The patient.

When are family members or bystanders especially useful?

When the patient cannot communicate well or important events were witnessed.

What should be used for significant language barriers when available?

A professional interpreter.

What are pertinent negatives?

Important findings you specifically assessed for but did not find.

What factors influence transport priority?

Life threats, mechanism of injury, vital signs, LOC, time-sensitive conditions, available resources, and distance to appropriate care.

What is START triage?

Simple Triage and Rapid Treatment using respirations, perfusion, and mental status.

What does a Red START tag mean?

Immediate.

What does a Yellow START tag mean?

Delayed.

What does a Green START tag mean?

Minor.

What does a Black START tag mean?

Deceased or expectant.

What is the overall goal of triage?

Do the greatest good for the greatest number.

Is triage a one-time decision?

No. Reassess and re-triage as conditions change.

What are examples of time-critical conditions needing rapid transport?

Severe trauma, stroke, ACS, severe respiratory distress, obstetric emergencies, severe burns, and serious pediatric emergencies.

What does 'Load and Go' mean?

Prioritize rapid transport with minimal on-scene delay.

When is 'Load and Go' preferred?

For unstable patients or when needed definitive care is not available in the field.

What does 'Stay and Play' mean?

Perform more treatment on scene before transport.

When may 'Stay and Play' be reasonable?

When the patient is stable and on-scene interventions can significantly help.

What information should be given to a receiving facility?

Age, sex, chief complaint, vital signs, pertinent history, treatments, and response.

Why should critical patients be called in early?

So the hospital can prepare before arrival.

If a patient's condition changes during transport, what should you do?

Reassess, treat as needed, and update the receiving facility.

You arrive at a crash scene with downed power lines. What comes first?

Do not enter the unsafe area; secure the scene and request appropriate resources.

A patient has severe airway obstruction during the primary assessment. What should you do?

Treat the airway problem immediately before continuing.

A trauma patient is pale, confused, and bleeding heavily. What should happen first?

Control the life-threatening bleeding and support circulation.

A stable patient has abdominal pain. Which history tool helps characterize the pain?

OPQRST.

A patient cannot answer questions because of altered mental status. Who can help provide history?

Family, bystanders, medical alert information, or other reliable sources.

A patient is unstable with rapidly changing vitals. How often should reassessment occur?

About every 5 minutes.

A stroke patient is identified in the field. What transport approach is appropriate?

Rapid transport to an appropriate stroke-capable facility.

A patient has no immediate life threat but needs more detailed evaluation. What comes after the primary assessment?

Secondary assessment.

A multi-patient incident has limited resources. What process should be used?

Triage.