Download presentation
Presentation is loading. Please wait.
1
Chapter 5 Patient Assessment
EMR 5-1 1-
2
Introduction An Emergency Medical Responder (EMR) is often the first trained responder on the scene and is vital in the initiation of patient assessment Assessment protocols may differ depending on the condition of the patient and his level of consciousness An EMR must assess the overall patient presentation to see the complete medical picture Being familiar with systematic assessment guidelines and having critical thinking skills help EMRs obtain pertinent information to make appropriate treatment decisions EMR 5-2 1-
3
Medical Patient and Trauma Patient
Learning Objective 1 Medical Patient and Trauma Patient ASSESSING MEDICAL AND TRAUMA PATIENTS Medical patient is one who verbalizes Trauma patient is one who has an injury that may or may not be visible EMR must assess the overall patient presentation Systematic assessment guidelines and critical thinking skills EMR 5-3
4
Medical Patient and Trauma Patient
Learning Objective 1 Medical Patient and Trauma Patient PENMAN ASSESSMENT Personal and personnel safety Environmental hazards Number of victims Mechanism of injury or nature of illness Additional resources needed from your agency Need for resources outside your agency EMR 5-4
5
A – What do I have (to help)? N – What do I need (to help)?
Questions related to PENMAN P – Is the scene safe? E – Will it stay safe? N – How many injured? M – What happened? A – What do I have (to help)? N – What do I need (to help)?
6
Medical Patient and Trauma Patient
Learning Objective 1 Medical Patient and Trauma Patient SPINAL STABILIZATION Upon approaching the patient, state your name, agency, and credentials Position yourself at the head of the patient Avoid “yes” and “no” questions EMR 5-6
7
Medical Patient and Trauma Patient
Learning Objective 1 Medical Patient and Trauma Patient PRIMARY SURVEY Begins with assessing LOC Responsiveness initially assessed with AVPU Alert Verbally responsive Painful stimuli response Unresponsive EMR 5-7
8
Unresponsive and Responsive Patients
Learning Objective 2 Unresponsive and Responsive Patients UNRESPONSIVE MEDICAL OR TRAUMA PATIENT No signs of life-sustaining perfusion Critical interventions Rapid survey Immediate transportation Cont. EMR 5-8
9
Unresponsive and Responsive Patients
Learning Objective 2 Unresponsive and Responsive Patients UNRESPONSIVE MEDICAL OR TRAUMA PATIENT CAB for unresponsive patient Circulation Airway Breathing Cont. EMR 5-9
10
Unresponsive and Responsive Patients
Learning Objective 2 Unresponsive and Responsive Patients UNRESPONSIVE MEDICAL OR TRAUMA PATIENT Hands-only CPR or compression-only CPR Defibrillation Rapid survey Transport EMR 5-10
11
Unresponsive and Responsive Patients
Learning Objective 2 Unresponsive and Responsive Patients RESPONSIVE MEDICAL OR TRAUMA PATIENT Varying degrees of responsiveness Breathing and pulse are evident May be inadequate perfusion Continually monitor the patient’s status Cont. EMR 5-11
12
Unresponsive and Responsive Patients
Learning Objective 2 Unresponsive and Responsive Patients RESPONSIVE MEDICAL OR TRAUMA PATIENT Primary survey Orientation Airway Breathing Circulation Cont. EMR 5-12
13
Unresponsive and Responsive Patients
A B C D E F A – airway assessment B – rate/depth/quality of breathing C – quality of circulation D – check for disabilities E – expose any area of concern F – assess body temperature (Fahrenheit)
14
Unresponsive and Responsive Patients
Learning Objective 2 Unresponsive and Responsive Patients BASELINE VITAL SIGNS Blood pressure by auscultation Systolic reading and the diastolic reading Blood pressure cuff in addition to stethoscope Blood pressure by palpation Only the systolic pressure can be obtained EMR 5-14
15
Unresponsive and Responsive Patients
Learning Objective 2 Unresponsive and Responsive Patients SECONDARY OR RAPID SURVEY Used on both trauma victims and medical patients If unstable or complications suspected Detailed secondary survey performed on stable patient Start assessment at the feet of a responsive child EMR 5-15
16
Medical Acronyms Used to Assess Patients
Learning Objective 3 Medical Acronyms Used to Assess Patients ASSESSMENT TOOLS SAMPLE—basic information DOTS—medical and trauma TIC—muscular or joint trauma CMS —extremities Cont. EMR 5-16
17
SAMPLE History Evaluation
Learning Objective 3 SAMPLE History Evaluation S – Signs & Symptoms A – Allergies M – Medications P – Previous pertinent medical History L – Last oral intake E – Events that lead to this current illness or injury EMR 5-17
18
DOTS and TIC – Bone and Joint Screening
Learning Objective 3 DOTS and TIC – Bone and Joint Screening D – Deformities O – Open wounds T – Tenderness S – Swelling T – Tenderness I – Instability C – Crepitus Cont. EMR 5-18
19
CMS — secondary assessment for extremities
Learning Objective 3 CMS — secondary assessment for extremities C – Circulation M – Motor (movement) S – Sensory (feel) Cont. EMR 5-19
20
ASSESSMENT TOOLS Learning Objective 3 PERRL—eyes DRGERM—abdomen
OPQRSTI—pain assessment EMR 5-20
21
ASSESSING THE EYES PERRL Learning Objective 3
a. P—Pupils, the dark part in the center of the eye b. E—Equal—Observe if both pupils are equal in size c. R—Round—Observe if both pupils are round d. RL—Reactive to light—Observe reaction to light of both pupils EMR 5-21
22
DRGERM – abdominal assessment
EMR 5-22
24
PAIN ASSESSMENT - OPQRST
Learning Objective 3 PAIN ASSESSMENT - OPQRST EMR 5-24
25
PAIN ASSESSMENT - OPQRST
Learning Objective 3 PAIN ASSESSMENT - OPQRST S—Severity: Ask the patient to rate his pain using a pain scale of zero to ten, with zero being no pain at all and ten being his worst pain ever When reassessing, ask how the pain compares with the last time it was reported If the patient cannot understand the numbers on the chart, a face scale can be used to obtain a rating When either the number or face scale is not possible due to age or special needs, document behaviors such as: tensing muscles, drawing up legs, arching, or difficulty to console T—Time: Ask the patient when the pain started and if she has had this type pain before, when, and how long it lasted EMR 5-25
26
Medical Acronyms Used to Assess Patients
Learning Objective 3 Medical Acronyms Used to Assess Patients APPLYING ASSESSMENT TOOLS Areas to be assessed with tools Head Eyes Face Ears and nose Mouth Neck Cont. EMR 5-26
27
Medical Acronyms Used to Assess Patients
Learning Objective 3 Medical Acronyms Used to Assess Patients APPLYING ASSESSMENT TOOLS Areas to be assessed with tools Chest Abdomen Pelvis Legs Arms Back EMR 5-27
28
Medical Acronyms Used to Assess Patients
Learning Objective 3 Medical Acronyms Used to Assess Patients REASSESSMENT EMR has the responsibility to reassess patients Unstable patients every five minutes or less Stable patient every 15 minutes unless a change in the patient’s status Dialogue is essential in reassessment EMR 5-28
29
Medical Acronyms Used to Assess Patients
Learning Objective 3 Medical Acronyms Used to Assess Patients TRANSPORTATION DECISIONS An EMR must make the decision to rapidly package Method of packaging depends on the MOI Condition of patient Resources available Environmental issues Medications and legal documents also transported EMR 5-29
30
Critical Thinking and EMRs
Learning Objective 4 Critical Thinking and EMRs CRITICAL THINKING Assess, treat, communicate, and make transportation decisions Identification and evaluation of evidence to guide decision making Knowledge base, experience, skills, and protocols EMR 5-30
31
Summary Care provided by an EMR is based on a complete and accurate assessment of the patient’s condition An EMR uses assessments such as PENMAN, spinal stabilization, patient assessment, proper interventions, reassessment, and transportation decisions to provide care Systematic assessment tools and using critical thinking skills help the EMR Obtaining pertinent patient data is vital to give appropriate, life-saving medical treatment EMR 5-31 1-
Similar presentations
