Glossary of EMT-Basic(Patient Assessment)
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- Three situations that may require the EMT-Basic to use an urgent move.
- Patient Displays:
1. Inadequate Breathing
3. Altered Mental Status
- Three situations that may require the EMT-Basic to use an emergency move.
- 1. If there is an immediate danger(i.e. fire or other hazard) to the patient.
2. If life-saving care cannot be administered because of patient location or position(i.e. patient in need of CPR found in a chair)
3. The patient must be quickly moved to allow access to other patients with life-threatening conditions.
- Point during patient assessment at which spinal immobilization should be provided.
- Manual stabilization of the spine should be performed when first making contact with a patient who is suspected of having a spinal injury. Suspicion may be based on signs and symptoms, mechanism of injury, or history.
- Nine general categories of priority patients.
- 1. Unresponsive Patients
2. Responsive Patients Who Cannot Follow Commands
3. Patients With Difficulty Breathing
4. Patients With Shock(Hypoperfusion)
5. Patients With Uncontrolled Bleeding
6. Patients Experiencing Severe Pain Anywhere
7. Chest Pain Patients With A Blood Pressure less than 100 Systolic
8. Patients With A Childbirth Complication
9. Patients Who Present With A Poor General Impression
- Two actions which should be taken when a priority patient is identified.
- 1. Expedite transport
2. Consider ALS back-up
- To the scene if it does not delay transport
- At a meeting point enroute to the hospital
- Define the components of the A-V-P-U system for determining level of mental status.
- A - Alert
V - Responds to verbal stimuli
P - Responds to painful stimuli
U - Unresponsive
- Define the components of the O-P-Q-R-S-T system of assessing patient complaints.
- O - Onset
P - Provocation(What makes the problem better or worse)
Q - Quality
R - Radiation
S - Severity
T - Time
- Define the components of the S-A-M-P-L-E history.
- S - Signs and Symptoms
A - Allergies(Meds. foods environmental)
M - Medications currently being taken(prescription and non-prescription)
P - Pertinent past history
L - Last oral intake(liquid or solid)
E - Events leading to the illness or injury
- Methods an EMT-Basic may use to obtain S-A-M-P-L-E history if the patient is unresponsive.
- - Obtain information from family, friends or bystanders.
- Check for medical identification tag.
- Define the components of D-C-A-P B-T-L-S as it relates to the detailed physical exam.
- D - Deformities
C - Contusions
A - Abrasions
P - Punctures/Penetrations
B - Burns
T - Tenderness
L - Lacerations
S - Swelling
- Differentiate sign from symptom.
- SIGN - Something the rescuer sees, hears or feels.
SYMPTOM - Something the patient tells about himself/herself.
- Five components of Baseline Vital Signs.
- 1. Breathing
5. Blood Pressure
- Two factors which should be observed when assessing breathing.
- 1. Rate
- Quality of breath can be placed in what four categories.
- 1. Normal
- Points at which adult breathing rates should be considered inadequate.
- Less than 8 breaths per minute.
Greater than 24 breaths per minute.
- Four abnormal skin colors and what they commonly indicate.
- PALE - Poor perfusion/Impaired blood flow.
CYANOTIC(blue-gray) - Inadequate oxygenation or poor perfusion.
FLUSHED(red) - Exposure to heat or carbon monoxide poisoning(late sign).
JAUNDICE(yellow) - Liver abnormalities.
- Age criteria for checking capillary refill, and normal capillary refill time.
- AGE CRITERIA - Check capillary refill on patients less than six years of age.
NORMAL CAPILLARY REFILL TIME - Less than 2 seconds.
- Age criteria for assessing blood pressure.
- Assess the blood pressure of all patients older than three years of age.
- Two primary methods the EMT-Basic uses to assess blood pressure.
- 1. Auscultation - Involves listening with a stethoscope for systolic and diastolic sounds.
2. Palpation - Involves Measuring systolic blood pressure by feeling for the return of a pulse while deflating the B/P cuff.
- Time intervals for reassessing and recording vital signs on stable and unstable patients.
- STABLE - Every 15 minutes
UNSTABLE - Every 5 minutes
- General situation that would not require a detailed physical examination.
- A patient with an isolated specific injury(Example -- A patient who has injured his wrist).
An alert medical patient with a specific complaint(Example -- A patient with a history of asthma complaining of respiratory distress).
- Four Components of the on-going assessment.
- 1. Repeat the initial assessment.
2. Reassess and record vital signs.
3. Repeat the focused assessment related to the patient's injuries or complaint.
4. Evaluate the adequacy of all interventions.
- Time intervals for performing the on-going assessment on stable and unstable patients.
- STABLE - Repeat and record every 15 minutes.
UNSTABLE - Repeat and record every 5 minutes.
- Proper methods for correcting an error on a written report.
- WHILE REPORT IS BEING WRITTEN -
Draw a single line through error, initial it, and write the correct information beside it. Do not obliterate the error.
AFTER REPORT IS SUBMITTED -
- Draw single line through the error, initial and date it, and add note with correct information. Preferably use different color ink.
- For omitted information, add a note with the new information, initial and date it.
- Eleven essential elements(in suggested order the should be given) of a medical radio report.
- 1. Unit identity and level of provider.
2. Estimated time of arrival to receiving facility.
3. Patient's age and sex.
4. Patient's chief complaint.
5. Brief, pertinent history of the present illness.
6. Major past illnesses.
7. Mental status.
8. Baseline vital signs.
9. Pertinent findings of the physical exam.
10. Emergency medical care rendered.
11. Patient response to medical care.
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