1. Principles of Patient Assessment in EMS

2. Rapid Physical Exam

3. Introduction
A rapid PE is completed on the unresponsive medical patient, conscious stroke, intoxicated, or postictal patient.
The RPE is a rapid systematic exam of the following body areas:
Head/neck
Chest/abdomen/pelvis
Back/buttocks
Extremities

4. Introduction (continued)
The RPE is similar to the rapid trauma exam (RTE)
The acronym DCAP-BTLS is used to recall assessment points.
Deformities
Contusions
Abrasions
Punctures/penetrations
Burns
Tenderness
Swelling

5. © 2003 Delmar Learning, a Division of Thomson Learning, Inc.
Steps in the RPE
Utilize appropriate BSI precautions
Remove any clothing needed to actually look at the skin
Consider environmental conditions
Be considerate for privacy and modesty
Reconsider the nature of illness (NOI)
Be alert for any possible MOIs
© 2003 Delmar Learning, a Division of Thomson Learning, Inc.

6. Steps in the RPE (continued)
Systematically evaluate each of the following body areas from head-to-toe:
Head & Neck
Assess for DCAP-BTLS, crepitation and JVD
Do not poke fingertips into fractures or soft spots
Chest
Assess for DCAP-BTLS, paradoxical motion, crepitation and breath sounds
Note any obvious scars from past medical history (e.g.: CABG)
© 2003 Delmar Learning, a Division of Thomson Learning, Inc.

7. Steps in the RPE (continued)
Abdomen
Assess for DCAP-BTLS, firmness, softness, and distension
Note any tenderness, masses, or bulges
Note any scars as a clue to past medical history
Pelvis
Assess for DCAP-BTLS, pain, tenderness, unstable motion
The pelvis is made up of 3 bones (ilium, ischium, pubis) and the lower spine
The potential for blood loss is great and may mask 1,500 ml
© 2003 Delmar Learning, a Division of Thomson Learning, Inc.

8. Steps in the RPE (continued)
Extremities
Assess for DCAP-BTLS, distal pulse, motor function & sensation (PMS)
Assess reflexes, strength and range of motion (ROM)
Posterior
Assess for DCAP-BTLS
This area is often overlooked
Do not roll patient onto a fractured hip or arm!
© 2003 Delmar Learning, a Division of Thomson Learning, Inc.

9. © 2003 Delmar Learning, a Division of Thomson Learning, Inc.
Following the RPE
Obtain baseline VS
Obtain the SAMPLE history
Consider info from the: family, bystanders, caretakers and first responders
Look for clues on medical history
Consider calling physician if known
Ask about advanced directives
Explain to the family/caretaker what is happening and what to expect next
© 2003 Delmar Learning, a Division of Thomson Learning, Inc.

10. Conclusion
Upon completion of IA, if you determine the patient has a medical emergency and is not responsive, the RPE should be done.
The RPE is a systematic exam of the head, neck, chest, abdomen, pelvis, posterior, and extremities.
Time is often a factor
Achieving proficiency takes practice!