Patient Assessment System Flashcards
The patient assessment system is one of the most important WFR skills. (41 cards)
What should be assessed under Circulatory in the Primary Assessment?
- Pulse – is it present?
- Bleeding – are there any life-threatening bleeds?
Nervous System
A complex network of nerves and cells that carry messages to and from the brain and spinal cord to various parts of the body.
Respiratory Distress
Difficulty breathing, but the respiratory system is still able to adequately oxygenate the blood to maintain brain function. The patient remains awake and responsive. Any mental status changes are mild or primarily due to ASR.
List each of the 3 components of the Primary Assessment.
- Circulatory System
- Respiratory System
- Nervous System
What types of questions should be asked when asking about symptoms in a SAMPLE history?
- *Symptoms**
- What were you doing when symptoms started?
- What makes it worse? What makes it better?
- What does it feel like?
- Where does it hurt? Can you point with one finger? Does it radiate anywhere? If so, where?
- How badly does it hurt? On a scale of 1-10; 10 = worst pain you have been in. What is the worst pain you have experienced?
- When did the symptoms start? Have you experienced this before?
When should 9-1-1 be called in a delayed care setting where communication devices are limited to SAT phones, In-Reach devices, and/or radios? How is this different from a front country setting? Hint: Think about the limitations of SAT phones and other communication devices.
9-1-1 should be called after an entire patient assessment, problems list, and treatment plan has been completed. Reason = incoming rescuer teams need a full understanding of the problem and location specifics (i.e., terrain, weather) to provide the best available resources/extrication plan. In the frontcountry we have the luxury of fully equipped ambulances, hospitals nearby, and most often we are in areas that are easily accessible. Calling 9-1-1 at the primary assessment level is best practice in a front country setting.
What is meant by mechanism of injury (MOI)? Give 3 examples.
Trauma = something that hit a patient or something the patient hit (i.e., mountain bike accident)
Medical = internal system glitch (i.e., low blood sugar)
Environmental = weather, flora, fauna (i.e., lightning, poison oak, tick bite)
Scene Size-Up
A step within the Patient Assessment System that involves a quick assessment of the scene and the surroundings to provide information about scene safety and the mechanism of injury or nature of illness before you enter and begin patient care. This regularly needs to be reassessed in a dynamic wilderness environment.
What should be assessed under Nervous in the Primary Assessment?
- AVPU – what is their level of consciousness?
- Spine – is there a MOI for spine injury?
When evaluating resources, what are you taking into account?
Ratio of # patients to rescuers.
Amount of resources available to treat patient problems/multiple patients; materials to improvise.
Ability to spend the night out/# of nights; access to food, water, shelter, stove, ability to stay warm, etc.
List the three parts of the Patient Assessment System.
Scene Size Up
Primary Assessment
Secondary Assessment
What types of questions should be asked when asking about events in a SAMPLE history?
Events
- Please describe what you were going leading up to the event or these symptoms. Having patient give a play by play helps identify TBI.
Respiratory Arrest
Absence of breathing; a.k.a. apnea.
Mental Status
Describes the level of brain function.
Cardiac Arrest
Loss of effective heart function, which results in cessation of functional circulation.
What does “Risk” mean? Give examples of things that would pose a risk to those at the scene.
Answer varies. Risk = things that would make the scene unsafe to anyone involved.
Examples: Rock fall, swift water, crevasses, active lightning, other people, etc.
What is the minimum number of sets of vital signs needed to establish a pattern?
Three
Patient Assessment System
A system of surveys including Scene Size Up, Primary Assessment, and Secondary Assessment designed to gather information about an injured or ill patient and the environment in which the patient is found.
Secondary Assessment
The Secondary Assessment takes place after immediate life threats have been treated or ruled out. The secondary Assessment is a thorough assessment to identify more subtle, yet still important, injuries or illnesses.
What four vital signs will you most often take? Describe how to measure each one.
Pulse – using your index and middle finger gently palpate for pulse on the inside of the wrist thumb side for at least 30 seconds. If counting for 30 seconds multiple # by two to get rate/minute.
Respirations – this is best done with one hand on patient to feel movement in the chest/abdominal area. Count for at least 30 seconds (multiply by 2 to get rate/minute). You should count for a full minute for any patient having trouble breathing.
Skin – note color of skin, temperature (mom touch – cold, warm, hot), and moisture.
AVPU – note where they are on the scale. If awake also add a descriptive word for their mental status (i.e., A + lethargic).
Where should you start in the Secondary Assessment?
Start where it makes sense.
What are the 3 components of Scene Size-Up?
Risk
Mechanism of Injury
Numbers
Respiratory Failure
Difficulty breathing where the respiratory system is not able to adequately oxygenate the blood to maintain brain function. The patient will have altered mental status or reduced level of consciousness.
Before touching an awake patient, what should rescuers ask?
Get consent. Identify yourself, ask if they would like help, explain what you are observing, explain what you would like to do (assessment/treatment), and ask permission to do it.
