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 ( oF 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