Chapter 14 The Secondary Assessment Flashcards
Short Answer
Explain how and why the secondary assessment for a trauma patient differs from the secondary for a medical patient.
In medical patients, unlike trauma patients, there are not many external sources of information about what is wrong with the patient. For medical emergencies, the most important source of information about the problem is usually what the patient can tell you. So when the patient is awake and responsive, obtaining the patient’s history comes first.
Short Answer
Explain how and why the secondary assessment for a trauma patient with a minor injury differs from the secondary assessment for a trauma patient with a serious injury or multisystem trauma.
For the responsive medical patient, the first step of your secondary assessment is talking with the patient to obtain the history of his present illness and the past medical history, followed by performing the physical exam and gathering the vital signs. In the unresponsive medical patient, the process is turned around. Because you cannot obtain a history from the patient, you will begin with a rapid physical assessment and collection of baseline vital signs. After these procedures, you will gather as much of the patient’s history as you can from any bystanders or family members who may be present.
Short Answer
How would you describe critical thinking?
Critical thinking is an analytic process that can help someone think through a problem in an organized and efficient manner. It is thinking that is reflective, reasonable, and focused on deciding what to do in a particular situation. It involves the use of facts, principles, theories, and other pieces of information.
Short Answer
What are the differences in the way an emergency physician reaches a diagnoses compared to the way an EMT reaches a diagnoses?
Different clinicians have different levels of training and experience, time, technology, and other resources. All clinicians begin with the same basic approach: gather information, consider possibilities, and reach a conclusion. How they implement these steps, however, varies significantly. The emergency physician and the EMT are similar in some ways in that they both work under certain time constraints, must quickly rule out of treat immediate threats to life, and focus much of their questioning and assessment on ruling out the worst-case scenario. When settling on a differential diagnosis, they primarily differ in the number of tools and tests available to them. An emergency physician has many more tools available, allowing him or her to focus on a significantly larger number of possible diagnoses compared to the EMT, not to mention the thousands of additional hours of training and clinical exposure physicians have compared to folks working in the prehospital environment.
Short Answer
What are “search satisfying” and “confirmation bias”?
“Search satisfying” means that once you find what you are looking for, you stop looking for other causes or possibilities. If you suspect something is causing the problem and have the slightest inkling it may be true, you may fail to look for a secondary diagnosis. “Confirmation bias” is somewhat similar and means that a clinician looks for evidence to support a particular diagnosis. In doing so, he may overlook evidence that refutes or reduces the probability of the diagnosis.
Short Answer
How can overthinking (considering too many possibilities) make it more difficult for an EMT to determine what to do for a patient?
Considering too many possibilities often interferes with developing a coherent and timely treatment plan because it becomes too difficult to organize information, rule out pertinent negatives, and form a conclusion based on the assessment findings. Caregivers who overthink often second-guess themselves and worry more about what they’ve missed than what they’ve found. In fact, your best approach may be to accept the ambiguity of medicine and not let your endless search for a cause delay treatment of the patient.
Key Terms
a question requiring only a “yes” or “no” answer
Closed-Ended Question
Key Terms
the grating sound or feeling of broken bones rubbing together
Crepitation
Key Terms
an assessment of the head, neck, chest, abdomen, pelvis, extremities, and posterior of the body to detect signs and symptoms of injury. It differs from the rapid trauma assessment only in that it also includes examination of the face, ears, eyes, nose, and mouth during the examination of the head
Detailed Physical Exam
Key Terms
a description or label for a patient’s condition that assists a clinician in further evaluation and treatment
Diagnosis
Key Terms
a list of potential diagnoses compiled early in the assessment of the patient
Differential Diagnosis
Key Terms
a condition of being stretched, inflated, or larger than normal
Distention
Key Terms
information gathered regarding the symptoms and nature of the patient’s current concern
History of the Present Illness (HPI)
Key Terms
bulging of the neck veins
Jugular Vein Distention (JVD)
Key Terms
a patient with one or more medical diseases or conditions
Medical Patient
