1. Focused History and Physical Examination for Medical Patients CHAPTER 11

2. In the seriously ill patient, treatment may begin before the entire assessment is completed.

3. Responsive Medical Patients The Patient’s History

4. Listen carefully to what patients tell you... …ask open-ended questions if you are unsure of their responses.

5. S igns and symptoms A llergies M edications P ertinent past medical history L ast oral intake (solid or liquid) E vents leading to injury or illness

6. O nset P rovocation Q uality R adiation S everity T ime

7. Rapid Assessment

8. A rapid assessment is a HEAD-TO- TOE examination guided by the chief complaint.

9. Inspect and palpate the head.

10. Assess the neck.

11. P4-10A(2) Expose the chest, look for symmetry and auscultate lung sounds.

12. Palpate the abdomen by quadrants.

13. If the patient complains of extremity or back pain, these areas need to be evaluated.

14. Vital Signs

15.  Breathing  Pulse  Skin  Pupil size and reactivity  Blood pressure

16. Emergency Care

17. Provide emergency medical care based on the information gained from the rapid assessment and SAMPLE history.

18. Unresponsive Medical Patients History from Bystanders

19. Unresponsive medical patients should receive a rapid assessment.

20. Unresponsive Medical Patients  Maintain patent airway  Adjuncts  Position  Constantly monitor airway  If assisted ventilations not needed, provide high-flow oxygen  If history unknown, immobilize for transport  Keep warm

21. SUMMARY Responsive Medical Patients Responsive Medical Patients Unresponsive Medical Patients Unresponsive Medical Patients