1. Limmer et al., Emergency Care, 11th Edition © 2009 by Pearson Education, Inc., Upper Saddle River, NJ DOT Directory Chapter 12 Ongoing Assessment

2. Limmer et al., Emergency Care, 11th Edition © 2009 by Pearson Education, Inc., Upper Saddle River, NJ DOT Directory U.S. DOT Objectives Directory U.S. DOT Objectives are covered and/or supported by the PowerPoint™ Slide Program and Notes for Emergency Care, 11th Ed. Please see the Chapter 12 correlation below. *KNOWLEDGE AND ATTITUDE 3-6.1 Discuss the reasons for repeating the initial assessment as part of the ongoing assessment. Slides 5-65-6 3-6.2 Describe the components of the ongoing assessment. Slides 4-114-11 3-6.3 Describe trending of assessment components. Slide 1212 3-6.4 Explain the value of performing an ongoing assessment. Slide 1313 3-6.5 Recognize and respect the feelings that patients might experience during assessment. 3-6.6 Explain the value of trending assessment components to other health professionals who assume care of the patient. Slides 5, 12512 (cont.)

3. Limmer et al., Emergency Care, 11th Edition © 2009 by Pearson Education, Inc., Upper Saddle River, NJ DOT Directory U.S. DOT Objectives Directory *SKILLS 3-6.7 Demonstrate the skills involved in performing the ongoing assessment.

4. Limmer et al., Emergency Care, 11th Edition © 2009 by Pearson Education, Inc., Upper Saddle River, NJ DOT Directory Steps of the Ongoing Assessment

5. Limmer et al., Emergency Care, 11th Edition © 2009 by Pearson Education, Inc., Upper Saddle River, NJ DOT Directory Repeat initial assessment. Reassess and record vital signs. Repeat focused assessment. Check on treatment in progress. Steps of the Ongoing Assessment

6. Limmer et al., Emergency Care, 11th Edition © 2009 by Pearson Education, Inc., Upper Saddle River, NJ DOT Directory Repeat Initial Assessment

7. Limmer et al., Emergency Care, 11th Edition © 2009 by Pearson Education, Inc., Upper Saddle River, NJ DOT Directory Reassess and Record Vital Signs

8. Limmer et al., Emergency Care, 11th Edition © 2009 by Pearson Education, Inc., Upper Saddle River, NJ DOT Directory Repeat Focused Assessment

9. Limmer et al., Emergency Care, 11th Edition © 2009 by Pearson Education, Inc., Upper Saddle River, NJ DOT Directory Check Interventions (cont.)

10. Limmer et al., Emergency Care, 11th Edition © 2009 by Pearson Education, Inc., Upper Saddle River, NJ DOT Directory Is oxygen delivery adequate? –Look at skin color. Are artificial ventilations adequate? –Make sure chest rises and falls. Changes in pulse oximetry reading? –Increase oxygen as necessary Check Interventions (cont.)

11. Limmer et al., Emergency Care, 11th Edition © 2009 by Pearson Education, Inc., Upper Saddle River, NJ DOT Directory Are there any signs of bleeding? –Look for new blood. Any other conditions or changes? –Check splinted extremities for distal pulse, sensation, and movement. Check Interventions

12. Limmer et al., Emergency Care, 11th Edition © 2009 by Pearson Education, Inc., Upper Saddle River, NJ DOT Directory Trends are changes over time. Changes noted over time are significant (e.g., changes in BP or pulse). EMT may need to adjust or establish new treatments. Observing Trends

13. Limmer et al., Emergency Care, 11th Edition © 2009 by Pearson Education, Inc., Upper Saddle River, NJ DOT Directory Reassess every 15 minutes Reassess every 5 minutes Reassessment Stable Unstable

14. Limmer et al., Emergency Care, 11th Edition © 2009 by Pearson Education, Inc., Upper Saddle River, NJ DOT Directory 1. Name the four steps of the ongoing assessment and list what assessment you will make during each step. 2. Explain the value of recording, or documenting, your assessment findings, and explain the meaning of the term trending. Review Questions

15. Limmer et al., Emergency Care, 11th Edition © 2009 by Pearson Education, Inc., Upper Saddle River, NJ DOT Directory How does the patient’s mental status affect the way you maintain the patient’s airway? What questions should you ask the patient and her husband? Street Scenes (cont.)

16. Limmer et al., Emergency Care, 11th Edition © 2009 by Pearson Education, Inc., Upper Saddle River, NJ DOT Directory How should you perform an ongoing assessment on this patient? Street Scenes