Chapter 10 Introduction to Patient Assessment and Vital Signs

1. Chapter 10 Introduction to Patient Assessment and Vital Signs

2. Medical Alerts or ID’s 2.1

3. Introduction to Patient Assessment and Vital Signs • I. Patient Assessment (pp. 186-189) • A. Definition of patient assessment (p. 186) • Components of the patient assessment plan (pp. 186-187) • (Fig. 10-1, p. 187) •  C. Medical vs. trauma patients (pp. 187-189) (Fig. 10-2, p. 188) • Lets look at each of these areas

4. Definition of patient assessment (p. 186) • Important skill • What emergency medical care does your patient need? • Observation • Listening • Touching • Smelling 2.2

5. Components of the patient assessment plan • (pp. 186-187) (Fig. 10-1, p. 187) • Scene size-up • Initial assessment • Physical examination • Patient history • Ongoing assessment • Hand-off report. 2.2

6. Medical vs. trauma patients (pp. 187-189) • (Fig. 10-2, p. 188) • Medical: Medical patient is ill, not injured • The patient history will most likely give you the most important information about a medical patient. • Trauma: Injury, not illness • The physical examination will most likely give you the most important information about a trauma patient. 2.2

7. II. Vital Signs (pp. 189-195) • Components of vital signs (pp. 189-190) (Fig. 10-3, p. 189) • Respiration • Pulse • Skin • Pupils • Blood Pressure 2.2

8. II. Vital Signs (pp. 189-195) B. Equipment needed (p. 189) Wristwatch to count seconds Pen light to examine pupils Stethoscope: to take a pulse and to listen to respiration, and to take blood pressure; Blood-pressure cuff to take blood pressure Pen and notebook to record vital signs and to take notes. (p. 189) 2.2

9. C. Respiration (pp. 190-191) (Fig. 10-4, p. 190) 1. Normal respiratory rates (Table 10-1, p. 190) Infant 25 – 50 breaths per minute Child 15-30 breaths per minute Adult 12-20 breaths per minute  2.2

10. 2. Counting respirations (p. 190) Count for 30 seconds Try not to let patient know your watching maybe do while still holding wrist from pulse 2.2

11. Respiratory distress, signs and symptoms (p. 190) • Gasping, wheezing, gurgling • Fast, slow, deep, shallow • Moist flushed skin, or cyanotic • Difficulty speaking • Dizziness • Chest pain 2.2

12. D. Pulse (p. 191) (Fig. 10-5, p. 191) 1. Normal pulse rates (Table 10-2, p. 191) Infant 120-150 Child 80-150 Adult 60-80 2. Noting rate, relative strength, and rhythm 2.2

13. E. Skin (pp. 191-192) 1. Skin temperature Relative skin temperature, or touching the patient's skin with the back of the hand is most common measure This method does not give an exact body temperature, but it does tell the First Responder if the patient's temperature is very high or low. (pp. 191-192) 2. Skin color (pale, yellow, red, blue) 3. Skin condition (normal, moist, warm, dry) 2.2

14. Pupils (pp. 192-193) (Fig. 10-7, p. 193) • Pupil size, reactivity, and equality • 1. Normal findings • 2. Abnormal findings 2.2

15. G. Blood pressure (pp. 193-195) (Table 10-3, p. 193) 1. Measuring by auscultation (pp. 193-194) (Fig. 10-8, p. 194) 2. Measuring by palpation (p. 194) (Fig. 10-9, p. 194) 2.2

16. 3. Standards for adults (p. 195) Adults-patient's age + 100 (up to 150) for the systolic blood pressure 65 to 90 for diastolic blood pressure. (p. 193) 2.2

17. 4. Standards for children (p. 195) Children-twice the patient's age + 80 for the systolic blood pressure 50 to 80 for diastolic blood pressure. 2.2

18. Variables (p. 195) • Cold • Environment • high altitude • physical and emotional stress • pain • full bladder • cigarette smoke • caffeine • Decongestants 2.2

19. Study Questions

20. Section 1: Patient Assessment Q1. What are the six parts of a First Responder's patient assessment plan?

21. Section 1: Patient Assessment Q1. What are the six parts of a First Responder's patient assessment plan? A1. Scene size-up, initial assessment, physical examination, patienthistory, ongoing assessment, and hand-off report. (p. 187)

22. Q2. What is the difference between a medical patient and a trauma patient?

23. Q2. What is the difference between a medical patient and a trauma patient? A2. A medical patient is ill. A trauma patient has been injured. (p. 188)

24. Q3. In what part of the patient assessment plan will you obtain the most important information about a medical patient? About a trauma patient?

25. Q3. In what part of the patient assessment plan will you obtain he most important information about a medical patient? About a trauma patient? A3. The patient history will most likely give you the most important information about a medical patient. The physical examination will most likely give you the most important information about a trauma patient. (pp. 187-188)

26. Section 2: Vital Signs Q1. What equipment should you have in order to take a patient's vital signs?

27. Section 2: Vital Signs Q1. What equipment should you have in order to take a patient's vital signs? A1. Wristwatch to count seconds; a pen light to examine pupils; a stethoscope to take a pulse, to listen to respiration, and to take blood pressure; a blood-pressure cuff to take blood pressure; and a pen and notebook to record vital signs and to take notes. (p. 189)

28. Q2. What are normal respiratory rates for the infant, child, and adult?

29. Q2. What are normal respiratory rates for the infant, child, and adult? A2. Infant-25-50 breaths per minute. Child-15-30 breaths per minute. Adult-12-20 breaths per minute. (p. 190)

30. Q3. What are normal pulse rates for the infant, child, and adult?

31. Q3. What are normal pulse rates for the infant, child, and adult? A3. Infant-120-150 beats per minute. Child-80-150 beats per minute. Adult-60-80 beats per minute. (p. 191)

32. Q4. What is the most common way for a First Responder to take a patient's temperature?

33. Q4. What is the most common way for a First Responder to take a patient's temperature? A4. Relative skin temperature, or touching the patient's skin with the back of the hand. This method does not give an exact body temperature, but it does tell the First Responder if the patient's temperature is very high or low. (pp. 191-192)

34. Q5. What should a First Responder look for during assessment of a patient's pupils?

35. Q5. What should a First Responder look for during assessment of a patient's pupils? A5. Pupil size, reactivity, and equality. (pp. 192-193)

36. Q6. What are the normal blood pressure ranges for children and adults?

37. Q6. What are the normal blood pressure ranges for children and adults? A6. Children-twice the patient's age + 80 for the systolic blood pressure and 50 to 80 for diastolic blood pressure. Adults-patient's age + 100 (up to 150 mmHG) for the systolic blood pressure and 65 to 90 for diastolic blood pressure. (p. 193)

38. ANY QUESTIONS ?