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SPM 100 Clinical Skills Lab 7

SPM 100 Clinical Skills Lab 7. Emergency Assessment Daryl P. Lofaso, M.Ed, RRT. Initial Assessment Guide. Primary Assessment Observational Assessment Appearance, WOB, and Circulation Intervention to any life-threatening condition Secondary Assessment (Serial) Vital Signs GCS.

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SPM 100 Clinical Skills Lab 7

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  1. SPM 100 Clinical Skills Lab 7 Emergency Assessment Daryl P. Lofaso, M.Ed, RRT

  2. Initial Assessment Guide • Primary Assessment • Observational Assessment • Appearance, WOB, and Circulation • Intervention to any life-threatening condition • Secondary Assessment (Serial) • Vital Signs • GCS

  3. Primary Assessment • A = Airway / C-spine immobilization • B = Breathing • C = Circulation • D = Disability or Neurologic Status

  4. Secondary Assessment • E = Exposure and environmental control to prevent heat loss • F = Full set of vital signs, wt. • G = Give comfort measures • H = Head-to-toe assessment and History (Hx) • I = Inspect posterior surfaces

  5. Triage Assessment • Emergent • Urgent • Non-urgent

  6. Emergent • Airway and Breathing Difficulties • Cardiac Arrest • C-spine compromise • Seizure states • Life or limb-threatening condition

  7. Emergent (continued) • Severe medical problems(Overdose, poisoning, DM complications) • Obvious multiple injuries • Excessive high temperature (> 105oF or 40.5oC) • Cardiac CP • Neurological Deficit – Stroke (CVA)

  8. Urgent • Chest Pain (Non-Cardiac) • Burns • ↓ LOC • Persistent nausea, vomiting, or diarrhea • Severe pain • Temperature(102-105oF or 39o-40.5oC) • Delay of up to 2 hrs will not compromise life or limb

  9. Non-Urgent • Chronic backache • Moderate headache • Minor Fx or other injuries • Obviously dead on arrival (DOA) • Stable illness or injury, wait > than 2 hrs without an increased risk of morbidity or mortality

  10. Patient’s Condition • Stable – VS within normal limits. Pt conscious & comfortable. • Guarded – VS within normal limits. Pt has some discomfort. • Unstable – VS outside of normal limits. Major complications. Prognosis guarded.

  11. Universal Precautions • All Patients are potentially infectious. • Good Handwashing is the key to reducing nosocomial infections • Wash before and after patient contact • Wear a mask, eye protection, gloves and gown when needed

  12. 3 Types of Precautions • Airborne • Droplet • Contact

  13. Pathogens Requiring Airborne Precautions • Tuberculosis • Measles (Rubeola) • Varicella (Chickenpox)

  14. Airborne Precautions Management • Place patient in an isolation room with negative pressure • Keep door closed • Wear N-95 mask

  15. Pathogens Requiring Contact Precautions • Multi-drug resistance bacteria (e.g., VRE – Vancomycin Resistant Enterococci, MRSA - Methicillin Resistant Staphylococcus Aureus) • RSV - Respiratory Syncytial Virus • Clostridium difficile • Scabies

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