Ch 05-1: Assessment / Scenario Flashcards Preview

Emergency Medical Responder > Ch 05-1: Assessment / Scenario > Flashcards

Flashcards in Ch 05-1: Assessment / Scenario Deck (91):
1

Order of Assessment

Scene Survey
Primary Survey
Oxygen Administration
Rapid Body Survey
Transport Decision
Secondary Survey
Ongoing Survey

2

Scene Survey

PPE
SPERM
Bystander Info
General Impression
C-Spine

3

PPE

Protect yourself first.

I arrive on scene and put on my personal protective equipment:

Gloves
Goggles
Face Shield
Gown
Reflective Clothing

4

SPERM

Understand what is going on to make your work more efficient and safe.

Safety:
Are there any obvious hazards in the scene?
Do I have clear access to the patient?

Patient:
How many patients are there?
What is the general behaviour of people on scene?

Environment:
What is the weather?
Where is the scene located?
Is it lit?
Is it Cold/Hot

Resources:
ALS / BLS
Fire
Police
Hazmat
Poison Control

Mechanism of Injury:
Are there any obvious clues to the mechanism of injury?

5

Bystander Information

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.

6

General Impression

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
Difficulty breathing
Deadly bleeds
Obvious fractures or dislocations
C-spine precaution necessary
Age / Gender

7

C – Spine

C-spine is proper alignment of the head and neck to minimize the risk of damage to the spinal cord, causing paralyzation.

Rule:
I will take c-spine precaution

Rule – Out:
I will rule out possible trauma to the head and spine

8

Primary Survey

Check for conditions that are immediately life threatening

Introduction/ Gain Consent
C-Spine
LOC
ABCD
Initial Transport Decision

9

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?

10

C - Spine

Delegate Spinal Precautions or state that you don't have to.

11

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
Verbal
Pain
Unresponsive

12

Alert / Oriented x 4

Ask:

What is your name?
Do you know where we are?
Do you know what time it is?
Do you know what happened?

13

Verbal

If they did not respond to questions, yell loudly:

"Hey! Are you ok?"

14

Pain

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

15

Unresponsive

If the patient does not respond to verbal or painful stimulus they are deemed unresponsive.

16

Glasgow Coma Scale

Eye Opening - 4
Best Verbal Response - 5
Best Motor Response - 6

17

Glasgow Coma Scale - Eye Opening

4 - Spontaneous
3 - Verbal
2 - Pain
1 - No Response, eyes do not open

18

Glasgow Coma Scale - Verbal Response

5 - Oriented and converses
4 - Disoriented and converses
3 - Inappropriate words
2 - Incomprehensible sounds
1 - Makes no sound

19

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

20

Decorticate

When stimulus is applied, the body tenses and flexes inward. Signal of brain trauma.

21

Decerebrate

When stimulus is applies, the body tenses and flexes outward. Signal of brain trauma.

22

A B C D

Airway
Breathing
Circulation
Deadly Bleeds

23

Airway

Open the patients airway:
Head-tilt chin lift
Jaw Thrust

Be sure that the airway is clear and insert an OPA or NPA when appropriate.

24

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.

25

Jaw Thrust

A way of opening a patients airway when they are suspected of head or spinal trauma.

26

Oropharyngeal Airway (OPA)

A plastic device inserted into the mouth to keep the tongue off of the airway in order to maintain the airway.

27

Nasopharyngeal Airway (NPA)

A silicon tube that is lubed and inserted into the nostril to maintain an airway.

28

Breathing

Rate
Rhythm
Depth
Effort
Apply Oxygen
Rescue Breathing

29

Respiratory Rate

The number of breaths taken within a set amount of time, typically 60 seconds.

30

Average Respiratory Rates

Adult: 12 - 20
Child: 16 - 24
Baby: 30 - 40
Infant: 40 - 60

31

Respiratory Rhythm

Is their breathing following a rhythm that is even, or does it switch frequently.

32

Respiratory Depth

The breaths that they take, are they full and deep or shallow?

33

Respiratory Effort

Are they using other muscles in the body to help them breathe? Are they having any difficulties taking their breaths?

34

Dispnea

Difficulty Breathing; Shortness of Breath

35

Agonal Respiration

Isolated or infrequent gasping in the absence of other breathing in an unconscious person.

36

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

37

Oxygen Administration Methods

Nasal Cannula: 4-6 lpm
Non Rebreather Mask: 15 lpm
Bag Valve Mask: 15 lpm

38

Assisted Ventilations

Assist when respiratory rate is less than 8 per minute or greater than 30 per minute.

39

Hypoventilation

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

40

Hyperventilation

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

41

Respiratory Arrest

When the patient has stopped breathing

42

Circulation

The continuous movement of blood through the heart and blood vessels

43

Circulation Components

Pulse
Rate
Rhythm
Quality
Skin Color and Condition
CPR

44

Where do we check for a pulse?

Adults:
Radial Pulse
Carotid Pulse

Babies: Bracheal

45

How long do we check for a pulse?

Maximum 5 - 10 seconds

If a pulse is not found at the carotid, begin CPR

46

Cardiopulmonary Resuscitation

CPR; Technique that combines rescue breathing and chest compressions for a patient whose breathing and heart have stopped.

47

Severe Bleeding

Bleeding that spurts from a wound or cannot be controlled. Also known as a 'deadly bleed'

48

Transport Decision

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

49

Load and Go Emergencies

Serious trauma
Instability/absence of ABC's
Decreased LOC
Ongoing Seizures
Chest Pain
Burns with inhalation injury
Extensive burns
Abdominal distention and tenderness
Unstable pelvic injury
Fractured Femur
Amputation
Pregnancy related conditions
Conditions related to environment (Hypothermia, animal bites, lighting strike)

50

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.

51

DCAP BLS TIC

Acronym for rapid body survey.

Look For:
Deformities
Contusions
Abrasions
Penetrations
Burns
Lacerations
Swelling

Feel For:
Tenderness
Instability
Crepitus

52

Contusion

Bruise

53

Battle Signs

Bruising around the back of the ears, sign of a skull fracture.

54

Raccoon Eyes

Blood from skull fracture seeps into the soft tissue around the eyes.

55

Crepitus

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

56

Jugular Vein Distention

When pressure in the veins causes the jugular to be pronounced from under the skin surface.

57

Tracheal Deviation

When pressure within the thoracic cavity alters the position of the trachea.

58

Paradoxical Movement

When a part or parts of the chest do not rise and fall with the breathing rhythm. Commonly move the opposite of breathing.

59

Sucking Chest Wound

Penetration of the thoracic cavity causing air movement through the wound to produce a sucking sound.

60

CMS

Acronym

Circulation
Motor Function
Sensation

61

Edema

Abnormal accumulation of fluid beneath the skin or in cavities of the body.

62

S A M P L E

Acronym;

Signs and Symptoms
Allergies
Medications
Past Medical History
Last Oral Intake
Events Prior

63

O P Q R S T

Acronym;

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

64

Name the Vitals

Blood Pressure
Blood Glucose Level
Blood Oximetry
Body Temperature
Breathing Rate
Pulse
Pupils equal and reactive to light
Level of Consciousness
Skin Color and Condition

65

Blood Pressure

The force exerted by the blood against the blood vessel walls as it travels through the body.

66

Auscultate

To listen

67

Apeces

The upper part of the lungs. Auscultate with a stethescope at the mid clavicular level.

68

Baces

The bottom part of the lungs. Auscultate with a stethescope at the mid auxilliary level.

69

Systolic Blood Pressure

The pressure of blood in the arteries and blood vessels during a heart contraction.

70

Diastolic Blood Pressure

Pressure of the arteries and blood vessels at rest.

71

Glucose

The sugar the body uses as fuel

72

Healthy Blood Glucose Level (BGL)

4 - 8 mmol/L

"Four to Eight, Feeling Great!"

73

Hypoglycemia

A medical emergency that involves an abnormally diminished content of glucose in the blood.

BGL < 4 mmol/L

74

Hyperglycemia

A condition in which an excessive amount of glucose circulates in the blood plasma.

BGL > 8 mmol/L

75

Glucometer

Device used to measure levels of glucose in the body. Requires a droplet of blood on special test strips.

76

Pulse / Blood Oximetry

The percentage of oxygen saturation in the blood; SPO2.

The reading appears as a percentage of hemoglobin saturated with oxygen. (O2)

77

What O2 percentage cannot sustain life?

80 and under

78

SPO2 readings for adults who are smokers and non smokers

Non Smokers: 95 - 100
Smokers: 94 - 96

79

Hypoxia

Low oxygen levels in the blood

80

Mild Hypoxia Level

91 - 94 %

81

Moderate Hypoxia Level

86 - 90 %

82

Severe Hypoxia

85 %

83

Cyanosis

Blueness of the skin and mucous membranes, as from improperly oxygenated blood.

84

6 Rights - Medication

Patient
Medication
Route
Dose
Time
Documentation

85

4 C's and E

Color
Concentration
Clarity
Condition
Expiry Date

86

C H A T

Chief Complaint
History
Assessment
Estimated Time of Arrival

87

Average Vitals - Newborn: < 28 days

Pulse: 120-160
Respirations: 40-60
Blood Pressure: 80/40

88

Average Vitals - Baby: 1 - 12 months

Pulse: 100-120
Respirations: 30-40
Blood Pressure: 80/40

89

Average Vitals - Child: 1 - 8 Years

Pulse: 80-120
Respirations: 16-24
Blood Pressure: 90/50

90

Average Vitals - Adult: > 8 years

Pulse: 60-100
Respirations: 12-20
Blood Pressure: 120-80

91

H A I N E S Recovery Position

High Arm In Endangered Spine
A position unconscious patients are put into to maintain and open airway and allow blood and vomit drainage.