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

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

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

Triage Assessment Emergent Urgent Non-urgent

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

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)

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

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

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.

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

3 Types of Precautions Airborne Droplet Contact

Pathogens Requiring Airborne Precautions Tuberculosis Measles (Rubeola) Varicella (Chickenpox)

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

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