Patient Assessment 11-15

Which of the following scenes would require you to be extra vigilant?

A. A noisy scene room in a factory

B. Police on scene motioning you in

C. An unusually quiet scene

D. A large crowd at a daycare

An unusually quiet scene

Which of the following provides the best protection against bloodborne pathogens?

A. Standard Precautions

B. The use of HEPA respirators

C Appropriate personal decontamination

D. Decontamination of common surfaces

Standard Precautions

The EMTs initial evaluation of the scene is called the ?

scene size up

You have been dispatched to 29 park Avenue for a man having chest pain. As you approach the house you hear loud voices and verbal threats coming from inside. You should?

not enter the scene

A​ 77-year-old female complains of chest pain. When you​ arrive, her husband greets you at the front door. You note that he is out of​ breath, sweaty, and holding his chest. You​ should:

radio for an additional unit and have your partner assess him while you check on his wife.

You suspect that your patient may have tuberculosis. Which of the following should be added to your personal protective​ equipment?

N-95 mask

You are performing a scene​ size-up at a large motor vehicle crash scene. Which of the following elements should be assessed​ first?

A. The need for additional resources..

B. general impression of the patient.t

.C.The number of patients.

D.Possible hazards to your safety.

possible hazards to your safety

You are dispatched to the scene of a child who was bitten by a dog. What step of the scene​ size-up can you begin to perform before​ arrival?

Determine whether the dog has been secured

You are dispatched to a motor vehicle crash on a street in a residential neighborhood. As you pull​ up, you note that none of the houses along the street have lights on. You should​ suspect:

downed power lines

Which of the following would be considered one of the three basic goals of the scene​ size-up?

A.Determining whether the patient is breathing

B.Determining the​ patient's chief complaint

C.Determining the​ patient's medical history

D.Determining what led to your being called to the scene

determining what led to your being called to the scene

Your unit arrives first at the scene of a​ tractor-trailer motor vehicle crash. Your partner notes that he sees hazardous materials placards on the truck. You should​ first:

A.stage in​ place, uphill and upwind from the scene.

B.approach the truck to identify the placard.

C.use your intercom to ask the driver to come to the ambulance.

D.immediately leave the scene

stage in place, uphill and upwind from the scene

Your patient is an elderly male who has paralysis of his right arm and leg. What is likely the nature of his​ illness?

stroke

Which of the following would be the appropriate place to park an ambulance if you were responding to a hazardous materials scene that involved gases or​ fumes?

A.Uphill from the scene

B.Downhill from the scene

C.Level with the scene

D.Downwind from the scene

level with the scene

Which of the following elements would be considered parts of the mechanism of​ injury?

A. specific injury such as fractured femur

B. scene safety hazard such as a unstable vehicle

C. the speed of the vehicle that struck the patient

D. the patients chief complaint

The speed of the vehicle that struck the patient

You respond to a motor vehicle accident. Determining where the patient was​ seated, if he was wearing a seat​ belt, and if the airbags deployed are part of​ the:

A. scene size up

B. reassessment

C. rapid physical exam

D. patient history

scene size up

You are dispatched for a​ 35-year-old male complaining of chest pain. You arrive on scene at a residential address in a very​ run-down section of town. You approach the scene​ carefully, and upon​ entering, you find that the patient has been shot in the chest. You​ should:

A. call for law enforcement and then begin care.

B.provide treatment of immediate life threats only.

C.exit the scene and call for law enforcement.

D.provide treatment of immediate life threats and then leave the scene.

exit the scene and call for law enforcement

An explosion has occurred at a local church. You are the first responding medical​ unit, and you note many patients lying in the street. After establishing incident​ command, you should​ next:

call for additional resources and begin the scene size up

What is the purpose for establishing a danger zone while working at a motor vehicle crash​ scene?

to designate the area where special safety precautions should be taken

a 66 year old female has been found apneic and pulseless. you should immediately?

begin chest compressions

As you interview with a medical complaint , the reason why the ambulance was called for is often called the ?

chief complaint

Which of the following acronyms may be used in assessing the​ patient's level of​ consciousness?

A. AVPU

B. SAMPLE

C. DCAP-BTLS

D. OPQRST

AVPU

A​ 13-year-old male has crashed an ATV. He was not wearing a helmet and was found unconscious. His airway is​ patent, but he has crepitus and diminished lung sounds in his right chest. Which of the following destinations would be most appropriate for this​ patient?

A. community hospital 5 miles away

B. A level III trauma center 12 miles away

C. A level I trauma center 14 miles away

D. an urgent care center 3 miles away

a level I trauma center 14 miles away

A​ 45-year-old female is found unconscious. She is not breathing but has a pulse. You should​ NEXT

initiate positive pressure ventilation's

Which of the following findings would address the breathing section of the primary​ assessment

A. Capillary refill time

B. Pale skin

C. Cyanotic skin

D. Absent radial pulse

cyanotic skin

A​ 56-year-old male has fallen off a​ 12-foot ladder. After ensuring scene safety and completing the scene​ size-up, you should​ NEXT:

A. assess baseline vital signs

B. asses the patients airway

C. question the bystanders

D. take manual cervical spine precautions

take manual spine precautions

During your primary​ assessment, you note blood in the​ patient's mouth and hear gurgling. You should​ NEXT:

suction the airway and clear any secretions

The following statements is TRUE about the primary assessment ?

A.

The primary assessment includes​ airway, breathing, and circulation​ (ABCs) and baseline vitals.

B.

Critical conditions that are identified during the primary assessment must be treated immediately as found.

C.

You cannot gain enough information about the patient during the primary assessment to make a transport decision.

D.

The main purpose of the primary assessment is to perform a​ head-to-toe physical examination to discover injuries.

B.

Critical conditions that are identified during the primary assessment must be treated immediately as found.

What would be the best method to open an airway of an unresponsive trauma patient?

jaw thrust

How would you assess the mental status of an infant who appears unresponsive?

Shout as a verbal stimulus and flick the feet as a painful stimulus

Which of the following phases of patient assessment would be conducted immediately after the scene​ size-up?

A.

Transport decision

B.

Primary assessment

.C.

Baseline vitals

D.

Rapid trauma assessment

primary assessment

Which of the following is not apart of the scene size up ?

A. Determining the MOI

B. Determining the number of patients

C. Establishing an airway

D. Taking body substance isolation precautions

establishing an airway

Body substance isolation precautions (standard precautions) may include:

gloves eyewear mask

A scene size-up should take place :

at the beginning and throughout the entire call

When there are no apparent hazards, the danger zone at the scene of a vehicle collision should extend at least :

50 feet in all directions

When fuel has been spilled at a motor-vehicle collision, the danger zone should be extended at least :

100 feet in all directions

If you observe potential signs of violence at a scene , your first action generally should be to:

retreat to a position of safety

In every motor vehicle accident there are actually how many collisions?

three

a fall should be considered severe whenever patients have fallen :

A.twice their height

B. 5 feet

C. 10 feet

D. three times their height

three times their height

During scene size up at a multiple-vehicle crash, it is important to determine the number of patients because:

A. additional EMS resources may have to be called if there are more patients than the first crew on the scene can handle.

B. run reports are required for each patient.

C. ALS must be called if there are more than two patients.

D. the media must be given accurate information.

additional EMS resources may have to be called if there are more patients than the first crew on the scene can handle

The temporary hole in the body that is caused by the pressure wave of the bullet is called :

A. the entry wound

B. A powder burn

C. the exit would

D. cavitation

cavitation

Determining scene safety means looking for possible threats to the safety of the _____________,_____________,and _______________.

crew, the patient; bystanders

A(n)__________________ ________________ exist around the wreckage of every vehicle collision, within which special safety precautions must be taken

danger zone

the forces that may have caused injury to a patient are the _______________ ________________ _______________.

mechanism of injury

The key element of _____________ ________________ is always to have personal protective gear readily avaliable.

standard precautions (BSI)

During scene size up the EMT must maintain a high ___________ _________ _______________ based on the mechanism of injury.

index of suspicion

When hazardous material is involved at a scene, check the dept of transportation's ___________ ____________ ___________ ___________ _________ .

North American Emergency Response Guidebook

With a medical patient, finding out what is or may be wrong with the patient is called identifying the __________ ___________ ___________.

nature of the illness

Important sources of information for determining what is wring with a medical patient include : the patient __________ _____________ or _________, and the ___________.

family member ; bystanders; scene

One sign of potential violence at a scene is unusual ____________.

silence

If your scene size-up indicates you do not have sufficient resources to handle the call, you should request _____________ _____________.

additional resources

List the four basic elements of the scene size up .

scene safety

standard precautions (BSI)

mechanism of injury / nature of illness

Determining number of patients

List three categories of people that the EMT must be concerned with in ensuring scene safety.

1.Personnel

2.Patient

3. Bystanders

List at least four scene size up considerations you should have in mind when you are in sight of a motor vehicle crash or hazardous materials emergency .

1. Look for clues to escaped hazardous materials

2. Look for collision victim on road

3. Look for smoke

4. Look for broken utility poles downed wires

5. Be alert for people walking on road

6. Watch for signals of police and other EMS crews

list 4 signals that would lead you to suspect danger of violence at the scene of a call.

1. fighting or loud noises

2. weapons visible

3. signs of alcohol or drug use

4. unusual silence

5. knowledge of prior violence

list 5 types of motor vehicle collisions .

1. head on (up-and-down and over-and-under)

2. rear end

3. side-impact

4. rollover

5. rotational impact

list three potential sources of information about the nature of a patients illness.

1. The patient

2. family members or bystanders

3. the scene

What are the types of injuries that happen in a head on collision?

up-and-over ; head neck chest abdominal injuries

down-and-under ; knee hip and leg injuries

What are the types of injuries that happen in a rear-end collision?

Most common are head chest neck

What are the types of injuries that happen in side impact collisions?

head and neck, chest, abdomen, pelvis. thighs

The portion of the assessment that is designed to identify and treat immediately life-threatening conditions is called the :

A. priority assessment

B. ongoing assessment

C. detailed assessment

D. primary assessment

primary assessment

Actions taken to correct a patients problems are known as:

A. ABCs

B. AVPU

C. interventions

D. primary assessment

interventions

When an EMT feels that a patient just "doesn't look right" this is called :

A.prehospital perspective

B. diagnostic insight

C. clinical judgement

D. critical facilitation

clinical judgement

All of the following are examples of interventions EXCEPT:

A.clearing the airway

B. ventilating a non breathing patient

C. checking a carotid pulse

D. taking manual spinal immobilization

checking a carotid pulse

In any patient with suspected spinal imjury, an EMT should apply manual stabilization:

A. after the primary assessment

B. on first contact with the patient

C. after the SAMPLE history

D. en route to the hospital

on the first contact with the patient

Using the AVPU scale , a patient who will respond only to a brisk rubbing of the sternum would receive a rating of :

A. alert

B. verbal

C. painful

D unresponsive

painful

if a patient is not alert and is breathing less than 8 breaths a minute, the EMT should :

A. begin mouth to mouth ventilations

B. give high-concentration oxygen via NRB mask

C.ventilate with positive pressure device & 100% oxygen

D. give high concentration oxygen via nasal cannula

ventilate with positive pressure device & 100% oxygen

In light-skinned people, poor circulation is indicated if the skin at the wrist is pale and :

A. warm

B. clammy

C. pink

D. dry

clammy

the assessment sign that is generally more reliable in children than adults is :

A. capillary refill

B. blood pressure

C. pulse rate

D. respiratory rate

capillary refill

The mental status of unresponsive infants is typically checked by flicking the feet and:

A. talking to the infant

B. rubbing the sternum briskly

C. shaking the infant

D. picking up the infant

talking to the infant

The purpose of the primary assessment is to identify and treat immediately ______-_______ conditions and to set _____for further assessment.

life-threatening; priorities

Actions to stop threats to life, such as gross bleeding, are called______________.

interventions

The _____________ ________________ is the reason EMS was called and should usually be recorded in the patients own words .

chief complaint

The "sixth sense" that an EMT develops about a patient's condition is known as _______ ____________.

clinical judgement

The _________, or physical setting, can provide many clues in forming a general impression of the patient.

environment

An EMT should apply__________ ________ on first contact with any patient who he or she suspects may have an injury to the spine.

manual stabilization

Before beginning any primary assessment , an EMT should take ___________ precautions .

Standard (BSI)

For infants and children, circulation can be evaluated by testing __________ ____________.

capillary refill

The level of responsiveness in a patient is called __________ ______________.

mental status

___________ on the AVPU scale applies to a patient who is not awake but responds to shouting .

verbal (V)

The rating on the AVPU scale that indicates the most serious mental status is __________.

unresponsive (U)

An awake patient's mental status can be assessed by determining his orientation to __________,__________, and ___________.

person, place, time

If a patient is not alert and her breathing rate is slower than 8 breaths per minute, provide ________,______________,___________.

positive pressure ventilations

If a patient is alert and his breathing rate is more than 24 breaths per minute, provide 100 perccent oxygen by _________________- _______________.

nonrebreather mask (NRB)

In child and infant trauma patients, the head should be immobilized in a _________ position

neutral

List the 6 steps of primary assessment

1. Form a general impression

2. Assess mental status

3. Assess airway

4. Assess breathing

5. Assess circulation

6. Determine Priority

List 4 levels of responsiveness on the AVPU scale

1. Alert

2. Awake and oriented

3. Verbal: responds to verbal stimulis

4. Painful: responds to painful stimuli

5. Unresponsive : does not respond to any stimulus

List the 9 high priority concerns

1.Poor general impression

2. Unresponsive

3. Responsive, but not following commands

4. Difficulty breathing

5. Shock

6. Complicated childbirth

7. Chest pain consistent with cardiac problems

8. Uncontrolled bleeding

9. Severe pain anywhere

list 5 things that will help the EMT determine if the patient is stable, unstable, or potentially unstable.

1. Mechanism of injury

2. Nature of illness

3. Mental status

4. vital signs

5. significant blood loss

Which of the following is NOT a vital sign?

A. pulse

B. Mental Status

C. Temperature

D. Blood pressure

mental status

You should obtain the first vital signs:

A. during the scene size up

B. during the focused history and physical exam

C. during the beginning of the initial assessment

D. immediately after determining responsiveness

during the focused history and physical exam

The vital sign that is least useful in adults is:

A. skin color

B. capillary refill

C. pupillary reaction

D. Blood pressure

capillary refill

The patient that you would expect to have the slowest at rest pulse rate is a(n):

A. child

B. adult man

C. athlete

D. elderly woman

athlete

An EMT should be most concerned with a pulse rate maintained above :

a. 60 bpm

B. 80 bpm

C. 100 bpm

D. 120 bpm

120 bpm

In case of shock or later stages of blood loss, an EMT would expect the pulse to be :

A. rapid strong bounding

B. rapid and thready

C. slow

D. absent

rapid and thready

The first pulse taken by an EMT on patients one year and older is the

A. carotid pulse

B. radial pulse

C. femoral pulse

D. pedis dorsalis pulse

radial pulse

If an EMT has trouble finding the radial pulse on a conscious patient, he should first :

A. try the other side of the same wrist

B. press more gently

C. use the thumb to palpate the pulse

D. try the wrist on the other arm

try on the wrist on the other arm

a rapid pulse, or any pulse over 100 bpm, is called:

A. tacycardia

B. bradycardia

C. diastolic

D. systolic

tacycardia

A person is considered febrile if he has a temperature greater thab :

A. 98.6

B. 100

C 101

D 99

100

In cases of children and infants, an EMT can expect to find the highest normal respiration rates in a(n):

A. adolescent

B. preschooler

C. infant

D. newborn

newborn

All the following are labored breathing EXCEPT:

A. nasal flaring

B. retractions

C. grunting

D. palpitations

palpitations