Flashcards in Ch 05-1: Assessment / Scenario Deck (91):
Order of Assessment
Rapid Body Survey
Protect yourself first.
I arrive on scene and put on my personal protective equipment:
Understand what is going on to make your work more efficient and safe.
Are there any obvious hazards in the scene?
Do I have clear access to the patient?
How many patients are there?
What is the general behaviour of people on scene?
What is the weather?
Where is the scene located?
Is it lit?
Is it Cold/Hot
ALS / BLS
Mechanism of Injury:
Are there any obvious clues to the mechanism of injury?
Gain more information about what happened from others who may know.
Send your partner to ask bystanders if they know anything related to the incident.
May alert you to a serious problem that requires additional resources or a minor problem that can easily be cared for.
Are their eyes tracking
Obvious fractures or dislocations
C-spine precaution necessary
Age / Gender
C – Spine
C-spine is proper alignment of the head and neck to minimize the risk of damage to the spinal cord, causing paralyzation.
I will take c-spine precaution
Rule – Out:
I will rule out possible trauma to the head and spine
Check for conditions that are immediately life threatening
Introduction/ Gain Consent
Initial Transport Decision
Introduction / Consent
Gain valuable rapport with patient by introducing yourself as an emergency responder.
Hi, my name is ______, I am a trained EMR, may I help you?
C - Spine
Delegate Spinal Precautions or state that you don't have to.
Level of Consciousness - AVPU
Can range from being fully alert to unconscious and is an indicator of a potentially serious problem.
Alert / Oriented x 4
Alert / Oriented x 4
What is your name?
Do you know where we are?
Do you know what time it is?
Do you know what happened?
If they did not respond to questions, yell loudly:
"Hey! Are you ok?"
If they do not respond to verbal stimulus, apply a painful stimulus to rouse a response.
Adults can be pinched at the collar bones
Infants can have the bottoms of their feet tapped
If the patient does not respond to verbal or painful stimulus they are deemed unresponsive.
Glasgow Coma Scale
Eye Opening - 4
Best Verbal Response - 5
Best Motor Response - 6
Glasgow Coma Scale - Eye Opening
4 - Spontaneous
3 - Verbal
2 - Pain
1 - No Response, eyes do not open
Glasgow Coma Scale - Verbal Response
5 - Oriented and converses
4 - Disoriented and converses
3 - Inappropriate words
2 - Incomprehensible sounds
1 - Makes no sound
Glasgow Coma Scale - Motor Response
6 - Obeys Command
5 - Localizes Pain
4 - Withdraws from pain
3 - Decorticate Posture (flexes inward)
2 - Decerebrate Posture (flexes outward)
1 - Makes no movement
When stimulus is applied, the body tenses and flexes inward. Signal of brain trauma.
When stimulus is applies, the body tenses and flexes outward. Signal of brain trauma.
A B C D
Open the patients airway:
Head-tilt chin lift
Be sure that the airway is clear and insert an OPA or NPA when appropriate.
Head-tilt Chin Lift
A way of opening a patients airway that simultaneously moves the tongue and epiglottis off of the airway. Performed on patients without risk of head or spinal trauma.
A way of opening a patients airway when they are suspected of head or spinal trauma.
Oropharyngeal Airway (OPA)
A plastic device inserted into the mouth to keep the tongue off of the airway in order to maintain the airway.
Nasopharyngeal Airway (NPA)
A silicon tube that is lubed and inserted into the nostril to maintain an airway.
The number of breaths taken within a set amount of time, typically 60 seconds.
Average Respiratory Rates
Adult: 12 - 20
Child: 16 - 24
Baby: 30 - 40
Infant: 40 - 60
Is their breathing following a rhythm that is even, or does it switch frequently.
The breaths that they take, are they full and deep or shallow?
Are they using other muscles in the body to help them breathe? Are they having any difficulties taking their breaths?
Difficulty Breathing; Shortness of Breath
Isolated or infrequent gasping in the absence of other breathing in an unconscious person.
How long do we check breathing?
Maximum 5 to 10 seconds.
(Number of breaths in 5 seconds) x (12) = Breaths per minute
(Number of breaths in 10 seconds) x 6 = Breaths per Minute
Oxygen Administration Methods
Nasal Cannula: 4-6 lpm
Non Rebreather Mask: 15 lpm
Bag Valve Mask: 15 lpm
Assist when respiratory rate is less than 8 per minute or greater than 30 per minute.
Reduced or deficient ventilation of the lungs
Repirations taken less than 8 per minute.
Assist ventilation at each breath and in the space between breaths.
5 second check = <1.5
a condition characterized by abnormally prolonged and rapid breathing.
A respiratory rate greater than 30 per minute.
Assist ventilations at every second breath taken.
5 second check = >2.5
10 second check = >5
When the patient has stopped breathing
The continuous movement of blood through the heart and blood vessels
Skin Color and Condition
Where do we check for a pulse?
How long do we check for a pulse?
Maximum 5 - 10 seconds
If a pulse is not found at the carotid, begin CPR
CPR; Technique that combines rescue breathing and chest compressions for a patient whose breathing and heart have stopped.
Bleeding that spurts from a wound or cannot be controlled. Also known as a 'deadly bleed'
The moment after brief assessment of patient where you choose to get them advanced help or can treat the patient at the scene.
Load and Go
Stay and Play
Load and Go Emergencies
Instability/absence of ABC's
Burns with inhalation injury
Abdominal distention and tenderness
Unstable pelvic injury
Pregnancy related conditions
Conditions related to environment (Hypothermia, animal bites, lighting strike)
Rapid Body Survey
A hands on physical check of the patient to locate life threatening injuries and conditions to be stabilized on scene.
Non life threatening conditions are treating in the ambulance.
DCAP BLS TIC
Acronym for rapid body survey.
Bruising around the back of the ears, sign of a skull fracture.
Blood from skull fracture seeps into the soft tissue around the eyes.
Term to describe the grating, crackling or popping sounds and sensations experienced under the skin and joints or a crackling sensation due to the presence of air in the subcutaneous tissue.
Fractured bone ends grating
Jugular Vein Distention
When pressure in the veins causes the jugular to be pronounced from under the skin surface.
When pressure within the thoracic cavity alters the position of the trachea.
When a part or parts of the chest do not rise and fall with the breathing rhythm. Commonly move the opposite of breathing.
Sucking Chest Wound
Penetration of the thoracic cavity causing air movement through the wound to produce a sucking sound.
Abnormal accumulation of fluid beneath the skin or in cavities of the body.
S A M P L E
Signs and Symptoms
Past Medical History
Last Oral Intake
O P Q R S T
Onset - Sudden/Gradual
Provoke - What makes it worse
Quality - What does pain feel like
Radiate/Region - Where is it
Severity - How bad is it
Time - When did it start
Name the Vitals
Blood Glucose Level
Pupils equal and reactive to light
Level of Consciousness
Skin Color and Condition
The force exerted by the blood against the blood vessel walls as it travels through the body.
The upper part of the lungs. Auscultate with a stethescope at the mid clavicular level.
The bottom part of the lungs. Auscultate with a stethescope at the mid auxilliary level.
Systolic Blood Pressure
The pressure of blood in the arteries and blood vessels during a heart contraction.
Diastolic Blood Pressure
Pressure of the arteries and blood vessels at rest.
The sugar the body uses as fuel
Healthy Blood Glucose Level (BGL)
4 - 8 mmol/L
"Four to Eight, Feeling Great!"
A medical emergency that involves an abnormally diminished content of glucose in the blood.
BGL < 4 mmol/L
A condition in which an excessive amount of glucose circulates in the blood plasma.
BGL > 8 mmol/L
Device used to measure levels of glucose in the body. Requires a droplet of blood on special test strips.
Pulse / Blood Oximetry
The percentage of oxygen saturation in the blood; SPO2.
The reading appears as a percentage of hemoglobin saturated with oxygen. (O2)
What O2 percentage cannot sustain life?
80 and under
SPO2 readings for adults who are smokers and non smokers
Non Smokers: 95 - 100
Smokers: 94 - 96
Low oxygen levels in the blood
Mild Hypoxia Level
91 - 94 %
Moderate Hypoxia Level
86 - 90 %
Blueness of the skin and mucous membranes, as from improperly oxygenated blood.
6 Rights - Medication
4 C's and E
C H A T
Estimated Time of Arrival
Average Vitals - Newborn: < 28 days
Blood Pressure: 80/40
Average Vitals - Baby: 1 - 12 months
Blood Pressure: 80/40
Average Vitals - Child: 1 - 8 Years
Blood Pressure: 90/50
Average Vitals - Adult: > 8 years
Blood Pressure: 120-80