secondary assessment

Question 1

what does bruising behind the ear can indicate

Answer 1

basal skull fracture

Question 2

what is battle sign

Answer 2

raccoon eye: basal skull fracture

Question 3

what do you look for when assessing the head

Answer 3

Observe for discharge
Assess pupil size
❑ Observe for bruising behind the ears
❑ Reassess airway
❑ Look for blood or clear fluid coming from ears, nose or mouth

Question 4

what do you asses in the neck

Answer 4

airway, tracheal deviation,
jugular vein distension/flatness, cervical trauma…

Question 5

what do you asses in the chest and back

Answer 5

Assess for abnormalities
❑ Look and listen for more subtle signs of breathing difficulties

Question 6

what do you assess in the abdomen

Answer 6

Gently feel the top of the abdomen
Palpate for:
-Rigidity -Tenderness

Question 7

what do you asses in the pelvis

Answer 7

Observe for incontinence and/or blood
❑ Place hands on both sides of the pelvis: in-
flare, alternate rotation.
Do not “open  book” a potential pelvic fracture.

Question 8

the arm are done when during secondary assessment

Answer 8

at the end

Question 9

vital are done every _ min and if stable

Answer 9

5
15

Question 10

average pulse in adult, child, toddler, athlete

Answer 10

adult 60-80 bpm
child 80-100 bpm toddler 100-120 bpm athlete 50-60 bpm

Question 11

interpretation of pulse if rapid/weak

Answer 11

shock, bleeding, diabetic coma

Question 12

interpretation of pulse if rapid/strong

Answer 12

fright, apprehension, heat, CVA

Question 13

interpretation of pulse if slow/strong

Answer 13

stroke, skull fracture, etc.

Question 14

name some caractéristique of the ventilatory rate

Answer 14

normal, shallow, deep, depressed, arrest, labored, gasping, noisy, agonal, etc.

Question 15

interpretation of rapid/shallow ventillatory

Answer 15

shock, bleeding, heat exhaustion

Question 16

interpretation of rapid/deep ventillatory

Answer 16

cheyne-stokes, neurologic, metabolic…

Question 17

interpretation of prolonged expiration in ventillatory rate

Answer 17

lower airway obstruction, asthma…

Question 18

interpretation of prolonged inspiration during ventillatory rate

Answer 18

upper airway obstruction…

Question 19

interpretation of deep gasping laboured during ventillatory rate

Answer 19

obstructive, chest injury

Question 20

interpretation of absent ventillatory rate

Answer 20

obstructive, respiratory arrest, many cases…

Question 21

interprétation of bright frothy coughed up blood

Answer 21

lung injury

Question 22

systolic BP female and male

Answer 22

female range 90mm Hg + age (20-50 age) male range 100mm Hg + age (20-50 age)

Question 23

diastolic BP

Answer 23

around 80mm hg

Question 24

if no cuff available listen for radial, femoral, carotid pulse and it need to be at least at

Answer 24

If radial pulse at least 80mm Hg sys
If femoral pulse, at least 70 mm Hg sys
If carotid pulse, at least 60 mm Hg sy

Question 25

when does SP02 start to become problematic

Answer 25

<90%

Question 26

can we start O2 therapy at or above 93% SPo2 and when do we stop

Answer 26

no and at 96%

Question 27

what does cool/clammy skin indicate

Answer 27

shock, bleeding, heat exhaustion…

Question 28

what does hot/moist skin indicate

Answer 28

reaction to increased temperature, exercise

Question 29

what does hot/dry skin indicate

Answer 29

heat stroke, high fever

Question 30

contraindication of rectal temperature

Answer 30

cardiac issue (vagus nerve stimulation)
-hemorrhoids
-recent rectal surgery -diarrhea

Question 31

what is a sims position

Answer 31

position for rectal temperature, side line with top knee flex

Question 32

how to apply thermal temp

Answer 32

Thermometer, cover, gauze, lubricant, watch
* Shake thermometer down, apply cover, lubricate
* Lift upper buttock, expose, have athlete breath in then out (insert) * Insert 1-2”,release buttock,
* Hold thermometer 3 min, ensure safe position
* Lift buttock, tell athlete thermometer removed on exhalation
* Wipe thermometer with gauze, read, clean

Question 33

interpretation of blood under skin colour
red
blue
yellow
mottled

Answer 33

ed- burn, fever, allergic rx, heat stroke, hypertensive… blue- cyanosis, hypoxemia, vasoconstriction, cold, shock… yellow- jaundice
mottled- cardio-vascular embarassment

Question 34

how many mm of pupil difference is significant

Answer 34

> 1mm

Question 35

GCS + abnormal pupil become abnormal when

Answer 35

GCS < 14 in combination with abnormal pupil
exam can indicate presence of life-threatening TBI