Medical Patient Assessment Aaron J. Katz, AEMT-P, CIC www.es26medic.net.

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Presentation transcript:

Medical Patient Assessment Aaron J. Katz, AEMT-P, CIC

Scene size-up BSI Scene safety Mechanism of illness Number of patients Need for additional resources  ALS Consider c-spine precautions

Initial assessment General impression Level of consciousness (AVPU) Chief complaint / Apparent life threats ABCs Identify priority patients Transport decision Rapid vs. delayed

Focused history & PE Perform an “illness dependent” History of Present Illness Essentially “OPQRST” with adjustments Illnesses follow…

Respiratory Onset Provokes / palliates Quality Radiation Severity Time Interventions

Cardiac Onset Provokes / palliates Quality Radiation Severity Time Interventions

Altered Mental Status Description of episode Onset Duration Symptoms Trauma? Interventions Seizures Fever? – especially in elderly

Allergic reaction Allergic history? Exposed to? How? Ingested, injection… Effects Progression Interventions

Poisoning / overdose Substance When? How much? Over how long? Weight interventions

Environmental Source Environment Duration Loss of consciousness? Local or systemic

Obstetric Pregnant? How long? Pain/contractions Bleeding/discharge Water broken? Need to push? LMP

Behavioral How do you feel? Suicidal? Threat to self or others? Medical problem? Interventions

Assessment continued… SAMPLE In “E” consider traumatic causes Focused physical exam Consistent with illness Vital signs Treatment Transport Consider detailed physical exam especially for patients with “minimal” Level of consciousness Ongoing assessment (initial, vitals, focused)

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