Patient Assessment

Learning objectives (36)

1. Demonstrate how to assess a carotid pulse in an unresponsive patient — Knowledge/skills objective (printed page 340); confirm wording in your course copy.
2. Demonstrate how to assess a radial pulse in a responsive patient and an unresponsive patient — Knowledge/skills objective (printed page 340); confirm wording in your course copy.
3. Demonstrate how to assess capillary refill in an adult or child older than 6 years — Knowledge/skills objective (printed page 340); confirm wording in your course copy.
4. Demonstrate how to assess capillary refill in an infant or child younger than 6 years; include variations that would be required when assessing a newborn — Knowledge/skills objective (printed page 340); confirm wording in your course copy.
5. Demonstrate how to evaluate a patient’s orientation and document his or her status correctly — Knowledge/skills objective (printed page 340); confirm wording in your course copy.
6. Demonstrate how to obtain a pulse rate in a patient — Knowledge/skills objective (printed page 340); confirm wording in your course copy.
7. Demonstrate how to palpate a brachial pulse in a child who is younger than 1 year — Knowledge/skills objective (printed page 340); confirm wording in your course copy.
8. Demonstrate how to use the AVPU scale to test for patient responsiveness — Knowledge/skills objective (printed page 340); confirm wording in your course copy.
9. Demonstrate the assessment of neurovascular status. (pp 396–397, Skill Drill 10-5) 16. Demonstrate the use of a pulse oximetry device to evaluate the effectiveness of oxygenation i — Knowledge/skills objective (printed page 340); confirm wording in your course copy.
10. Demonstrate the techniques for assessing a patient’s airway, and correctly obtain information related to respiratory rate, rhythm, quality, and character of breathing, and depth of — Knowledge/skills objective (printed page 340); confirm wording in your course copy.
11. Demonstrate the use of electronic devices to assist in determining the patient’s blood pressure in the field — Knowledge/skills objective (printed page 340); confirm wording in your course copy.
12. Describe examples of different techniques EMTs may use to obtain information from patients during the history-taking process — Knowledge/skills objective (printed page 339); confirm wording in your course copy.
13. Describe how to determine the mechanism of injury (MOI) or nature of illness (NOI) at an emergency and the importance of differentiating trauma patients from medical patients — Knowledge/skills objective (printed page 339); confirm wording in your course copy.
14. Describe the assessment of a patient’s breathing status, including the key information EMTs must obtain during this process and the care required for patients who have adequate and — Knowledge/skills objective (printed page 339); confirm wording in your course copy.
15. Describe the assessment of a patient’s circulatory status, including the different methods for obtaining a pulse and appropriate management depending on the patient’s status — Knowledge/skills objective (printed page 339); confirm wording in your course copy.
16. Describe the assessment of a patient’s skin color, temperature, and condition, including examples of both normal and abnormal findings and the information this provides related to — Knowledge/skills objective (printed page 339); confirm wording in your course copy.
17. Describe the assessment of airway status in patients who are both responsive and unresponsive, including examples of possible signs and causes of airway obstruction in each case as — Knowledge/skills objective (printed page 339); confirm wording in your course copy.
18. Describe the principal goals of the primary assessment process, including how to identify and treat life threats and determine if immediate transport is required — Knowledge/skills objective (printed page 339); confirm wording in your course copy.
19. Describe the purpose of a secondary assessment and a physical exam; include how to determine which aspects of the physical exam to use, and the steps — Knowledge/skills objective (printed page 340); confirm wording in your course copy.
20. Discuss some of the possible environmental, chemical, and biologic hazards that may be present at an emergency scene, ways to recognize them, and precautions to protect personal sa — Knowledge/skills objective (printed page 339); confirm wording in your course copy.
21. Discuss the importance of protecting a trauma patient’s spine and identifying fractured extremities during patient packaging for transport — Knowledge/skills objective (printed page 339); confirm wording in your course copy.
22. Discuss the process of assessing and methods for controlling external bleeding — Knowledge/skills objective (printed page 339); confirm wording in your course copy.
23. Discuss the process of taking a focused history, its key components, and its relationship to the primary assessment process — Knowledge/skills objective (printed page 339); confirm wording in your course copy.
24. Discuss the steps EMTs should take to survey a scene for signs of violence and protect themselves and bystanders from real or potential danger — Knowledge/skills objective (printed page 339); confirm wording in your course copy.
25. Discuss the steps used to identify and subsequently treat life-threatening conditions that endanger a patient during an emergency — Knowledge/skills objective (printed page 339); confirm wording in your course copy.
26. Explain how the different causes and presentations of emergencies will affect how EMTs perform each step of the patient assessment process — Knowledge/skills objective (printed page 339); confirm wording in your course copy.
27. Explain situations in which patients may receive a focused assessment, including examples by body system of what each focused assessment should include based on a patient’s chief c — Knowledge/skills objective (printed page 340); confirm wording in your course copy.
28. Explain the importance of performing a reassessment of the patient and the steps in this process — Knowledge/skills objective (printed page 340); confirm wording in your course copy.
29. Explain the process for determining the priority of patient care and transport at an emergency scene and include examples of conditions that necessitate immediate transport — Knowledge/skills objective (printed page 339); confirm wording in your course copy.
30. Explain the process of forming a general impression of a patient as part of primary assessment and the reasons why this step is critical to patient management — Knowledge/skills objective (printed page 339); confirm wording in your course copy.
31. Explain the variations required to obtain a pulse in infant and child patients compared with adult patients — Knowledge/skills objective (printed page 339); confirm wording in your course copy.
32. Identify the components of the patient assessment process — Knowledge/skills objective (printed page 339); confirm wording in your course copy.
33. List normal blood pressure ranges for adults, children, and infants — Knowledge/skills objective (printed page 340); confirm wording in your course copy.
34. List the minimum standard precautions that should be followed and personal protective equipment (PPE) that should be worn at an emergency scene, including examples of when addition — Knowledge/skills objective (printed page 339); confirm wording in your course copy.
35. List the signs of respiratory distress and respiratory failure — Knowledge/skills objective (printed page 339); confirm wording in your course copy.
36. List the steps EMTs should follow during the primary assessment of a trauma patient, including examples of abnormal signs and appropriate related actions — Knowledge/skills objective (printed page 339); confirm wording in your course copy.

Vocabulary (13)

Scene size-up

The initial steps on arrival — scene safety, BSI, number of patients, mechanism or nature of illness, and need for additional resources.

Primary assessment

Rapid identification and treatment of immediate life threats using the ABCDE approach.

AVPU

A mental-status mnemonic — Alert, responds to Verbal stimuli, responds to Painful stimuli, Unresponsive.

General impression

The across-the-room first impression of how sick or injured a patient appears.

Chief complaint

The patient's primary reason for seeking help, ideally stated in their own words.

SAMPLE history

A focused history mnemonic — Signs/symptoms, Allergies, Medications, Past history, Last oral intake, Events leading up.

OPQRST

A pain-assessment mnemonic — Onset, Provocation/palliation, Quality, Region/radiation, Severity, Time.

Secondary assessment

The detailed head-to-toe or focused exam performed after life threats have been addressed.

Reassessment

Repeating the primary survey, vitals, and chief-complaint check at intervals — every 5 minutes for unstable patients, every 15 for stable.

Mechanism of injury (MOI)

The force or event that produced the patient's injuries, used to anticipate hidden trauma.

Nature of illness (NOI)

The general medical cause or context of a patient's complaint — analogous to MOI but for medical patients.

ABCDE

Primary survey priorities — Airway, Breathing, Circulation, Disability (neuro), Exposure.

Body substance isolation (BSI)

Standard precautions — gloves, eye protection, gown, mask as appropriate — to prevent provider exposure to patient body fluids.

Sequence practice (2 puzzles on Quiz Me)

Quick fire sample (13 of 13 on Quiz Me)