Unit 5 Study Guide

what is a sign?

something you can see and observe about

what are some examples of a sign?

\-pale skin

\-rapid pulse

\-open wound to the chest

what is a symptom?

somethings a patient feels or may complain about

* can be obvious or very subtle

what is some examples of a symptom?

\-pain

\-nausea

what is a chief complaint?

begins with the reason why EMS was called

what does the S mean in SAMPLE?

Signs and symptoms

what questions can you ask for the S in SAMPLE?

\-”what is going on today”

\-’how are you feeling”

what does the A mean in SAMPLE?

Allergies

what questions can you ask for the A in SAMPLE?

\-”any allergies”

\-”alleriges to medications”

\-”allergies to anything ingested or exposed to'“

What does the M mean in SAMPLE?

Medications

what questions can you ask for the M in SAMPLE?

\-”are you taking any medications”

\-”supplements”

\-”if so what are they”

\-”can I see them”

\-”what are they”

* Colect and bring with patient to the hospital

What does the P mean in SAMPLE?

past medical history

what questions do you ask for the P in SAMPLE?

\-”has this happened before”

\-”diabetic”

\-”Past heart troubles”

What does the L mean in SAMPLE?

last oral intake

what questions can you ask for the L in SAMPLE?

“when did you last eat”

What does the E mean in SAMPLE?

Events leading up to the problem

what questions can you ask for the E in SAMPLE?

\-“what were you doing when this started”

What does the O mean in OPQRST?

Onset

what questions can you ask for the O in OPQRST?

\-”what brought this on”

\-”what were you doing”

What does the P mean in OPQRST?

Provaction

what questions can you ask for the P in OPQRST?

\-”does anything **make it better or worse**”

What does the Q mean in OPQRST?

Quality

what questions can you ask for the Q in OPQRST?

\-”desrcibe your pain”

\-”is it sharp or dull”

\-”does it come and go or is it consistent”

what does R mean in OPQRST?

Region and Radiation

what questions can you ask for the R in OPQRST?

\-”point to where it hurts”

\-”does the paint travel anywhere”

What does the S mean in OPQRST?

Severity/Scale

what questions can you ask for the S in OPQRST?

\-”on a scale 1-10, 10 being the worst pain you have ever felt. How would you rate your pain”

What does the T mean in OPQRST?

Time

what questions can you ask for the T in OPQRST?

\-”what time did this start”

What are 5 good questions you can ask bystanders to get additional information about a patient that is unresponsive and cannot speak for themselves?

* “What is the patients name”
* “Did you see what happened”
* “Did the patient complain of anything before this happened”
* “Does the patient have any known illnesses”
* “Does the patient take any medications that you know of”

What are the 7 vital sign you will be taking as an EMR?

* Mental status
* Respiration
* Pulse
* Skin
* Pupils
* Blood pressure
* Pulse oximetry

What is the baseline set of vitals?

is the firs test of vitals taken

what does trending mean?

Using more than one set of vital signs to detect changes or “trends” in patient conditions

What is the definition of mental status?

is the general condition of a patients Level Of Conciousness?

What does the A mean in AVPU?

Alert

what does the A do in AVPU?

Who they are (person, place, time, event)

* Questioning

what does the V mean in AVPU?

Verbal

what does the V do in AVPU?

Response to verbal stimuli

what does the P mean in AVPU?

Pain

What does the P mean in AVPU?

response to only painful stimuli

what does the U mean in AVPU?

Unresponsive

What does the U do in AVPU?

Unresponsive patients are a high priority

Alert means many things. We evaluate how alert a patient is by assessing 3 things and giving them a “score”. What are the things we evaluate?

\-Who they are (person)

\-Where are they (place)

\-Time of day (time)

\-their current situation (event)

If your patient is alert but only know their name and where they are, we report that they are

A&OX 2 (Alert and Oriented times X)

What is the normal breathing rate for an adult?

12-20

What is the normal breathing rate for a child?

15-30

What is the normal breathing rate for an Infant?

30-60

How to assess the Respiratory Rate?

Count breaths for 30 seconds and multiply by 2

What does Auscultate mean?

To listen to internal body sounds typically with a stethoscope

Where should the placement of the stethoscope go on a patients back?

right under the shoulder blades

Where should the placement of the stethoscope go on a patients front side?

A few inches lower from the clavicle or collar bone

Where should the placement of the stethoscope go on a patients side?

in the midaxillary following the nipple line on the side

what is pulse?

pressures waves generated by the contraction of the left ventricle

How to take a patients pulse?

30 seconds and mulitply by 2

Which pulse (body location) do you take for a **Responsive** adult?

Check radial location (wrist)

Which pulse (body location) do you take for a **Unresponsive** adult?

Check carotid pulse (neck)

For an infant less than 1 year, where do you obtain their pulse?

check brachial pulse (inner arm)

What is the average pulse rate for an adult?

60-100 bpm (resting)

What is the average pulse rate for children 3 months to 2 years?

85-205 bpm

For an adult, Tachycardia is a heart rate that is over…

100 ppm

For an adult, Bradycardia is a heart rate that is under..

what is palpation mean?

Using ones hands to touch or feel a body

What is the full medical name for a Blood Pressure Cuff?

Sphygmomanometer

What is the Systolic pressure mean?

Blood pressure is the higher pressure prevent during **contraction** of the left ventricle

what number is the Systolic pressure?

118/78

**118**/78

What is Diastolic pressure?

Blood pressure is the pressure present during the relaxation of the left ventricle

What number is the Diastolic pressure?

118/78

118/**78**

What is an average blood pressure for an adult?

120/80

A systolic pressure above _____ is considered high

140 bpm

Blood pressures for children under ____ years old unreliable

3

When taking a blood pressure by palpation, if you got a systolic pressure of 116, how do you write this for documentation?

116/p

What is the difference between palpating a blood pressure and ausculating a blood pressure?

only get the styli pressure when palpate

What are the 3 things we are assessing when we are checking the skin?

* Color
* Temperature
* Moisture/Condition

What is the possible cause for Red (flushed) Warm toned skin?

Hypertensive or heat issue

What is the possible cause for Pale skin?

Blood loss of shock

What is the possible cause for Cyanotic (blue) Cool toned skin?

Respiratory compromise

What is the possible cause for jaundiced (yellow) skin?

Underlying liver problems

What are the 4 places on the body that we look for so we can determine the skin color or pressing status of a patient with darker skin?

\-Oral Mucosa

* Inside the lower lip, should be pink and moist

\-Conjunctiva

* Skin that surrounds each eye. should be pink and moist

\-Nail beds

* tissue below each finer or toenail

\-palms

* Capillary refill test can indicate perfusion status

What does it mean when out patient is Diaphoretic?

Excessively sweaty

Capillary refil is another took to evaluate perfusion status. How do we check capitulary refill?

pushing on the sides of the skin and releasing. the skin should pink back up

An average adult should have a capillary refill of ___ seconds or less

2

what are the 3 things we are assessing when we look at the pupils?

* size
* Equality: ensure both pupils
* Reactivity to light

\-Constriction: sudden introduction of light

\-Dilation: When light to pupil is blocked

When assessing the pupils. we use this PERRL mnemonic. what does the letter P stand for?

Pupils

When assessing the pupils. we use this PERRL mnemonic. what does the letter E stand for?

Equal

When assessing the pupils. we use this PERRL mnemonic. what does the first letter R stand for?

Round

When assessing the pupils. we use this PERRL mnemonic. what does the second letter R stand for?

Reactive to

When assessing the pupils. we use this PERRL mnemonic. what does the letter L stand for?

Light

Dilated, non-reactive pupils =

shock, cardiac arrest, bleeding, certain meds, head injury

constricted, non-reactive pupils =

Central nervous system damage, certain meds

Unequal pupils=

Stroke or the head injury

When measuring the pulse oximetry

____% SpO2 is considered normal

97-100%

When measuring the pulse oximetry

____% SpO2 is considered Hypoxic

94% or less

When measuring the pulse oximetry

____% SpO2 is considered severely hypoxic

89%

What is the purpose of a Scene Size-Up?

To ensure scene safety

What are the 6 components of a Scene Size Up?

* Take standard precautions (PPE)
* To ensure Scene Safety
* Determine mechanism of injury or nature of illness
* Establish the number of patients
* Determine the need the additional resources
* Considers stabilization of Spine or C-Spine

What is mechanism of injury (MOI)?

Force or forces that caused the injury. Used for traumas

What is nature of illness (NOI)?

What is medically wrong with the patient. Directly related to a chief complaint used for medicals

Whare is a Medical patient?

Describe illness

Ex: Heart attack

What is a Trauma patient?

something caused it

Ex: car vs person

what is general impression?

On approach, the first informal impression of the patients overall condition. sick/not sick