EMT 100

1. EMT 100 Patient Assessment

2. Vital Signs *SIGNS OF LIFE*

3. Pulse Is the heart rate expressed in beats per minute

4. Radial Artery Palpation

5. Carotid Artery Palpation

6. Normal Pulse Values • Adult – 60-100 • Children – 80-100 • Infants – 100-140

7. Rapid Weak Pulse May Be A Sign Of Shock!

8. Respiration • Expressed in breaths per minute • Each breath consists of an inspiration and an expiration • Look, Listen, and Feel!

9. Normal Respiration Rates • Adults = 12-20 • Children = 20-40 • Infants = 30-50

10. Rapid And Shallow Respirations May Be A Sign Of Shock!

11. Temperature • Normal = 98.6F or 37C • Warm, dry skin

12. Cool, Clammy Skin May Be A Sign Of Shock!

13. Skin Color • Pale, white ashen appearance, ie Pallor, may be a sign of shock! • Bluish, gray skin, ie Cyanosis, shows poor oxygenation of the blood • Yellowish-orange skin, ie Jaundice, may be a sign of liver disease or blood disease

14. Pupils • Normally are the same size and react equally to light

18. Level of Consciousness (LOC)assessed by asking: • Who are you? (Orientation to self) • What were you doing? (Orientation to situation) • Where are you ? (Orientation to place) • What day of the week is it? (Orientation to time)

19. LOC continued • Questions must be asked in this order • May need to assess every few minutes • As patients become disoriented, they lose the ability to answer the questions in the reverse order that they are asked

20. Psychological Concerns • Extremely aberrant behavior by the patient may be a manifestation of illness or injury

21. Psychological Concerns (continued) • Be in control • Be supportive • Be honest

22. Golden Rule Treat each patient the way you would want to be treated if you were the patient!

23. Patient Assessment Sequence • Perform scene size-up. • Perform primary assessment. • Obtain SAMPLE History. • Secondary assessment—head to toe exam. • Perform on-going re-assessment.

24. Step I: Scene Size-up • Maintain body substance isolation. • Maintain scene safety. • Determine mechanism of injury or nature of illness. • Determine need for additional resources.

25. Step II: Perform Primary AssessmentLook for Life-Threatening Conditions • Form general impression of patient. • Assess responsiveness. • Check airway. • Check breathing. • Check circulation.

26. Primary Assessment:Assess Responsiveness AVPU Scale • Alert • Verbal • Pain • Unresponsive

27. Primary Assessment: Check Patient’s Airway • Head tilt–chin lift technique • The tongue is the most common cause of obstruction in an unconscious person • Jaw-thrust technique • Inspect mouth • Insert airway if needed

28. Primary Assessment: Check Patient’s Breathing • If conscious: • Check rate and quality. • Check for any difficulty. • If unconscious: • Look, listen, and feel for breathing. • Start rescue breathing, if needed.

29. Primary Assessment:Check Patient’s Circulation • Check carotid or radial pulse. • Check for severe bleeding. • Check skin color and temperature: • Pale - decreased circulation • Flushed - excess circulation • Yellow - liver problems

30. Step III: Patient’s Medical History • Signs/Symptoms (Chief Complaint) • Allergies • Medications • Pertinent, past medical history • Last oral intake • Events associated with or leading to the injury or onset of illness

31. Step IV: Seconday Assessment - Physical Examination • Check patient from head to toe for non-life-threatening conditions. • Purpose of exam is to locate and begin initial management of injury or illness.

32. Physical Exam: Examine the Patient from Head to Toe • Look and feel for signs of injury: • Deformity • Open injuries • Tenderness • Swelling • Search all areas of body in a clear, concise, consistent format.

33. Examine Patient’s Head and Eyes • Examine head: • Use both hands. • Do not move patient’s head. • Remove eyeglasses. • Remove wigs if necessary. • Examine eyes: • Cover one eye for 5 seconds. • Watch for pupil contraction.

34. Examine Patient’s Neck and Chest • Examine neck: • Examine each side; check for pain. • Check neck veins. • Check for a medical identification tag.

35. Examine Patient’s Chest • Examine chest: • Check for pain on inhalation/exhalation. • Look for signs of difficult breathing. • Note injuries, bleeding, or abnormal, unequal, or painful movement. • Check for collarbone or rib fractures.

36. Examine Patient’s Abdomen • Look for signs of external bleeding, penetrating injuries, or protruding parts. • Check for stomach rigidity or swelling. • Check for soiled clothing. • Check genital area for external injuries.

37. Examine Patient’s Pelvis • Examine pelvis: • Check for obvious bruising, bleeding, or swelling. • Check for pain if no pain has been reported. • Examine back: • Stabilize head and neck and log-roll • Check one side of the back at a time.

38. Examine the Extremities • Observe the extremity. • Examine for tenderness. • Check for movement. • Check for sensation. • Assess the circulatory status.

39. Step V: On-going Reassessment • Monitor patient’s vital signs: • Every 5 minutes if unstable. • Every 15 minutes if stable. • Maintain an open airway. • Monitor breathing and pulse. • Monitor skin color and temperature.

40. It is time for lab! Check and record the radial/carotid pulse and the respirations of 5 fellow students

41. Primary Survey Looks for life-threatening conditions!

42. Determine whether victim is conscious or unconscious, then check: • Airway • Breathing • Circulation • Hemorrhage • Shock

43. Secondary Survey Is a head to toe survey that looks for otherinjuries/problems

44. Secondary Survey (cont.) • Neck • Skull • Face, Nose, and Mouth • Chest and Lungs • Abdomen • Pelvis, Genitals, Incontinence • Extremities • Back and Buttocks • Reassure!

45. Don’t Overlook: • Situation • Bystanders, Family or Friends • Medications and Medical History • Wallet Cards • Vial of Life • Med-Alert Tags