Medical Assessment Review

Medical Assessment Overview

• Medical assessment simulates a 911 medical call.

  • Focuses on proper procedures to ensure patient safety and care.

Initial Assessment Steps

• BSI (Body Substance Isolation):

  • Make sure gloves are on before approaching the scene.

  • Prepare any additional protective gear as needed.

• Scene Safety:

  • Ensure it is safe to enter (look out for dangers like traffic, fire, etc.).

Scene Size-Up

• Scene Size-Up:

  • Evaluate the scene as you arrive in the ambulance.

  • Determine the number of patients and their condition.

  • Consider Mechanism of Injury (MOI) and Nature of Illness (NOI).

    • Example of MOI: Falling down stairs.

    • Example of NOI: Patient experiencing shortness of breath and vomiting.

• C-Spine Stabilization:

  • Evaluate if there’s a need to stabilize the cervical spine.

• Additional EMS Assistance:

  • Consider if other services (fire department, police) are needed based on scene dynamics.

Primary Survey

• Primary Survey:

  • Look for any life threats and general impression of the patient.

  • Assess airway, breathing, and circulation (ABC).

• Responsiveness – AVPU:

  • A: Alert.

  • V: Verbal response.

  • P: Pain response.

  • U: Unresponsive.

• Chief Complaint:

  • Determine the main issue based on the patient's statements.

• Life Threats:

  • Check for signs of chest pain, difficulty breathing, and other critical signs.

History Taking

• History Taking:

  • Use OPQRST and SAMPLE methods to gather information about the patient.

  • OPQRST Details:

    • O: Onset of symptoms.

    • P: Provocation (what makes it better or worse?).

    • Q: Quality of pain.

    • R: Radiates (does the pain spread?).

    • S: Severity (scale of 1-10).

    • T: Time (how long has it been happening?).

  • SAMPLE Questions:

    • S: Signs/Symptoms.

    • A: Allergies.

    • M: Medications.

    • P: Past medical history.

    • L: Last oral intake.

    • E: Events leading up to the incident.

Secondary Assessment

• Secondary Assessment:

  • Focused assessment of body systems to identify any additional injuries or conditions.

  • Conduct a systematic head-to-toe examination, assessing:

    • Head and neck (look for any step offs or JVD).

    • Cardiovascular (heart sounds and pulse).

    • Pulmonary (lung sounds and chest rise).

    • Musculoskeletal and neurological checks.

Vital Signs

• Vital Signs Collection:

  • Assess Blood Pressure, Pulse, and Respiratory Rate.

  • Consider additional metrics when necessary (e.g., SpO2 levels, blood glucose).

• Adult Normal Ranges:

  • Blood Pressure: 120/80 mmHg.

  • Heart Rate: 60-100 bpm.

  • Respiratory Rate: 12-20 breaths per minute.

• Children's Normal Ranges:

  • 5-Year-Old: 100/60 mmHg, Heart Rate 80-120 bpm, Respiratory Rate 20-30 bpm.

  • Infant (11 months): 90/54 mmHg, Heart Rate 80-160 bpm, Respiratory Rate 30-60 bpm.

Reassessment

• Reassessment:

  • Continuously monitor the patient's vitals, complaints, and consciousness level.

  • Be prepared to recognize changes, especially during transport.

Summary and Communication

• Ensure to document and communicate vital findings and a summary of the intervention once at the hospital.

  • Prepare for potential scenario changes or additional patient requirements throughout the assessment.