Tanvi Patel Ms.

Alogna MRT / 45B 1/14/12 Chapter 8 Key Terms Initial Assessment - another term for Primary Assessment ABCs airway, breathing, and circulation Chief Complaint the main and most severe problem the patient is experiencing LOC level of consciousness AMS altered mental status AVPU stands for Alert, Verbal, Pain, Unconscious; to distinguish patients level of consciousness 7. Inspection quickly looking at the scene and looking for potential problems, cause of call, any other information that can be observed 8. Auscultation listening to sounds with a stethoscope 9. Palpation to examine by touch 10. DOTS stands for Deformities, Open injuries, Tenderness, and Swelling, are signs of injury 11. Dorsalis Pedis Pulse located on top of the foot 12. Stethoscope instrument used for listening to heart of breathing 13. Sphygmomanometer instrument used for measuring BP; also known as BP cuff 14. COPD Chronic Obstructive Pulmonary Disorder 15. Apical pulse pulse at the base of the heart, usually used when using a stethoscope 16. Skin Temperature use hands to just get a relative idea; hot, warm, or cold 17. Skin Color color can change so must be monitored; some colors are pale, flushed, blue, yellow, or normal 18. Capillary refill ability of the circulatory system to return blood to the capillaries after the blood has been squeezed out 19. Pupils circular openings in the middle of the eye 20. Constrict reaction of pupils when light is shone into them (get smaller) 21. Dilate when pupils do not shrink but get larger; sign of relaxed or unconscious 22. Blood Pressure used to measure condition of circulatory system 23. Systolic pressure exerted against walls of arteries when heart contracts 24. Diastolic pressure exerted against the walls of arteries while left ventricle is at rest 25. Patient History using past medical conditions, illnesses, and injuries to determine information about current situation 26. SAMPLE stands for Signs and Symptoms, Allergies, Medications, Pertinent history, Last oral intake, Event/s; information that should be collected about patients history 27. Sign condition that you observe in a patient 28. Symptom condition that patient tells you 29. Ongoing Assessment regularly repeating certain parts of the patient assessment 30. Primary Assessment first actions taken to form impression of patients condition 31. Detailed Physical Assessment a thorough assessment of the entire body of the patient 32. Focused History used on conscious patients, asking questions more directed to problem 33. Secondary History step in patient assessment where you carefully examine patient form head to toe and measure vital signs 1. 2. 3. 4. 5. 6.

Assessment in Action 1. 2. 3. 4. 5. 6. 7. 8. 9. C B A B B C A D Form a general impression of the patient, assess responsiveness, and perform a rapid scan. Then update responding EMS units 10. Pale and moist skin indicates decreased circulation. This could be caused by dehydration or low body temperature or shock. Cognitive Objectives 1. Scene size-up is a general overview of the incident. You must make decisions about the scene-safety, type of incident, mechanism of injury of illness, number of patients, and necessary additional resources. 2. Hazards may be visible or invisible. Some visible hazards are unstable buildings, traffic, weather, crime scene, ect. Invisible hazards may be unstable surfaces, electricity, poisonous fumes, ect. 3. It is important to determine the total number of patients because it will allow you call for back-up if necessary. It also means that patients will get help faster. 4. Getting a general impression of the patient will allow you to work faster at helping the patient. Also it will give you insight into the level of consciousness of the patient. 5. To establish the mental status of the patient, first introduce yourself. The patients reaction to this will tell you if they are alert, verbally responsive. Then shake them or pinch them to determine if they are responsive to pain, or unresponsive. 6. It is important to prioritize the patient care and transport. This is because those in the most life-threatening situations need help fast whereas people with simple injuries can be treated even in 24 hours. Also serious patients need expert help faster so must be transported quickly. 7. For the body assessment, observe and palpate the head, assess the eyes, check the nose for drainage, assess the mouth, check for unusual breath odors and assess the neck. Then inspect the chest and observe breathing motion, gently palpate the chest, assess the abdomen, gently press on the pelvic bones, log roll the patient and assess the back. And inspect the extremities. 8. SAMPLE history is made up of signs and symptoms, allergies, medications, pertinent medical history, last oral intake, and event/s. 9. The ongoing assessment consists of, repeating the primary assessment, then reassessing vital signs and the chief complaint. Then, check the effectiveness of the treatment, treat changes in patients conditions, and reassess the patient. 10. The handoff report should include, age and sex of patient, history of the incident, chief complaint, level of responsiveness, status of vital signs, results of the secondary patient assessment, report pertinent medical conditions using SAMPLE, and report interventions provided.

Story Hey Jia, are you ready to start studying? asked Lana. Yup, ok so what is another name for primary assessment? Jia replied. It is initial assessment. ABCs stands for airway, breathing, and circulation, right? Lana questioned. Yes, that would be correct, said Jia alright, why is it important to check skin temperature and skin color? To get an idea of what is wrong with the patient. Oh and what are some vital signs to check? replied Lana Blood pressure, capillary refill, and pupil size and reactivity. You have to ask me harder questions than that. Really? Ok then please tell me where the apical pulse is. Ummmm apical pulse? On the top of the foot? Wow, nice job. I know, now tell me what the difference between systolic pressure and diastolic pressure is. Ok, well systolic is the pressure when the heart is contracting and diastolic is when the left ventricle of the heart is at rest. You are going to do great on this test. Just make sure that you look up what LOC and COPD stand for. Good luck. Jia said as she left.