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    Patient Assessment: Nabua Fire Station

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    kheyan2013
    This document outlines the process of patient assessment for first responders. It describes the 6 phases of patient assessment: 1) scene size-up, 2) initial assessment, 3) physical examination, 4) patient history, 5) ongoing assessment, and 6) hand-off report. The initial assessment involves checking for responsiveness, ensuring an open airway, and assessing breathing and circulation. The physical examination proceeds from head to toe, looking for signs of injury. Vital signs are also measured. Patient history involves gathering information on signs/symptoms, allergies, medications, and events. Assessment must be ongoing and the receiving medical provider given a thorough hand-off report.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd

    Patient Assessment: Nabua Fire Station

    Uploaded by

    kheyan2013
    162 views34 pages
    This document outlines the process of patient assessment for first responders. It describes the 6 phases of patient assessment: 1) scene size-up, 2) initial assessment, 3) physical examination, 4) patient history, 5) ongoing assessment, and 6) hand-off report. The initial assessment involves checking for responsiveness, ensuring an open airway, and assessing breathing and circulation. The physical examination proceeds from head to toe, looking for signs of injury. Vital signs are also measured. Patient history involves gathering information on signs/symptoms, allergies, medications, and events. Assessment must be ongoing and the receiving medical provider given a thorough hand-off report.

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    This document outlines the process of patient assessment for first responders. It describes the 6 phases of patient assessment: 1) scene size-up, 2) initial assessment, 3) physical examination, 4) patient history, 5) ongoing assessment, and 6) hand-off report. The initial assessment involves checking for responsiveness, ensuring an open airway, and assessing breathing and circulation. The physical examination proceeds from head to toe, looking for signs of injury. Vital signs are also measured. Patient history involves gathering information on signs/symptoms, allergies, medications, and events. Assessment must be ongoing and the receiving medical provider given a thorough hand-off report.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    162 views34 pages

    Patient Assessment: Nabua Fire Station

    Uploaded by

    kheyan2013
    This document outlines the process of patient assessment for first responders. It describes the 6 phases of patient assessment: 1) scene size-up, 2) initial assessment, 3) physical examination, 4) patient history, 5) ongoing assessment, and 6) hand-off report. The initial assessment involves checking for responsiveness, ensuring an open airway, and assessing breathing and circulation. The physical examination proceeds from head to toe, looking for signs of injury. Vital signs are also measured. Patient history involves gathering information on signs/symptoms, allergies, medications, and events. Assessment must be ongoing and the receiving medical provider given a thorough hand-off report.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 34

    PATIENT ASSESSMENT

    NABUA FIRE STATION


    Pre-Fire Planning, Training and
    Community Relations Section
    OBJECTIVES:
    Upon completion of this lesson, you will be able to:
    1) List the five (5) general procedures a medical first
    responder should complete when arriving at the
    scene.
    2) List the six (6) phases of the patient assessment
    plan
    3) List six (6) steps of the initial assessment
    4) Demonstrate a complete physical examination as
    defined in this lesson
    PATIENT ASSESSMENT
    Gathering of information in determining the victims illness
    or injury.
    Includes interviews and physical examination

    Classification of Patients:
    • Medical Patients
    - One who has no determining symptoms of an illness, has no injury
    • Trauma Patients
    - Has a physical injury caused by an external force
    Types of Patients:
    Medical Responsive Patients
    Medical Unresponsive Patients
    Trauma Responsive Patients
    Trauma Unresponsive Patients
    1. SCENE SIZE-UP
    A. Arrival on the Scene
    Ensure your own safety (Wear proper PPE)
    Ensure patient’s safety
    Establish general impression of the scene and begin your initial assessment of
    the patient
    Identify life-threatening injuries

    B. Identify Yourself
    State your name and organization
    Ask the patient if you may help him/her (Obtain Consent)
    C. Immediate Sources of Information
    The Scene itself (Observe the Scene)
    Patient (if responsive)
    Relatives or Bystanders
    The mechanism of injury (kinematics – forces that caused the
    injury)
    Any remarkable deformity of obvious injury
    Any signs of characteristics of certain types of injury or illness
    2. INITIAL ASSESSMENT
    A process used to identify and treat condition that pose an
    immediate threat to the patient’s life.

    Steps on the Initial Assessment:


    A. Form a General Impression
    Determine if the situation is trauma or medical
    Examine front and back of the neck
    Apply Cervical collar if needed
    B. Check for Responsiveness
    Four Levels of Responsiveness;
    a) A = ALERT – Patient who is alert, responsive and oriented
    b) V = VERBAL – Patient who responds only when spoken to
    c) P = PAINFUL – Patient who responds only to painful stimulus
    d) U = UNRESPONSIVE – Patient does not respond to any stimulus

    C. Ensure Adequate Airway


    If Patient is unresponsive perform;
    HEAD TILT CHIN MANUEVER – Medical Patient
    JAW THRUST MANUEVER – Trauma Patient
    Head-Tilt-Chin Maneuver Jaw-Thrust Maneuver
    D. Verify Breathing
    Full rise and fall of chest (LOOK)
    Easy breathing (LISTEN)
    Normal respiratory rate (FEEL)

    E. Assess Circulation
    Use the 2nd and 3rd finger for palpation
    • Radial pulse – Responsive Patients
    • Carotid pulse – Unresponsive Patients
    • Brachial pulse – infants
    Control serious external bleeding
    Look-Listen-Feel
    F. Patient Status Update
    Inform responding EMS units of your findings;
    If more resources will be needed
    If patient has life threatening injuries or illness
    If patient is stable with minor injuries

    NOTE: The initial assessment should be completed and all life-


    threatening conditions treated before proceeding to the physical
    examination.
    3. PHYSICAL EXAMINATION
    “Head-to-Toe” or the “Cephalocaudal Approach Method”
    A through survey of the patient’s entire body
    Its main purpose it to reveal any injury or medical problem that could
    be a threat to the patient’s survival if left untreated.

    A. Principles of Patient Assessment;


    Is a skill, and must be practiced
    Involves the use of your senses.
    Three Methods are used during your Patient Assessment:
    a. Inspection (Looking)
    b. Auscultation (Listening)
    c. Palpation (Feeling)

    B. Conducting an Examination
    Examination of Trauma Patient is different from Medical Patients
    Physical signs of an injury can be observed and palpated. While medical
    problems are felt by the patient.
    When conducting an exam, look for the following signs of
    injury;
    1. BLOOD
    - Presence of bleeding

    2. DCAP 3. BTLS
    D – DEFORMITY B – BURNS
    C – CONTUSION T – TENDERNESS
    A – ABRATION
    L – LACERATION
    P – PUNCTURE/
    PENETRATION S - SWELLING
    Deformity Contusion
    Abrasion Puncture/ Penetration
    Burns Laceration
    Swelling
    C. Physical Examination – Head to Toe Assessment
    1. Examination of the Head
    Scalp and Skull
    Ears and Nose
    “Battle Sign”- Black discoloration of the back of the ear
    Pupils
    Usually symmetrical
    “Raccoon Sign” - Black Eye associated with Facial Trauma
    Mouth
    Battle Sign Racoon Sign
    Asymmetrical Pupil Size
    2. Examination of the Neck
    Always go front and back (anterior and posterior)
    Check trachea for mid-line position
    Palpate vertebrae

    3. Examination of the Chest


    - NOTE: Any injury may involve vital organs or major blood vessels.
    Use stethoscope, assess lungs for equal breath sounds
    Feel ribs all the way to the spine
    Palpate sternum
    4. Examination of the Abdomen
    Check for rigidity
    Palpate quadrant with pain as your last step

    5. Examination of the Pelvis


    Crepitus Sign – Grating sounds, sign of fracture
    Priapism – Involuntary erection, signs of spinal injury
    6. Examination of the Lower Extremities
    7. Examination of the Upper Extremities
    - NOTE: Common sites of injury – do not rush your examination
    Check for Cyanosis – “Bluish discoloration of the skin” – Using Capillary Refill
    Check for P – Pulse (Radial – Arms/ Dorsalis Pedis – Foot)
    Check for M – Motion
    Check for S – Sensation

    8. Examination of the Back (Recovery Position)


    Blood accumulation in the flanks and or tenderness may indicate abdominal
    bleeding
    Keep head and neck of the patient in alignment
    D. Measuring of Vital Signs Proper Equipment to Measure Vital
    Signs:
    Patient’s vital signs include :  Wristwatch
    Respiration  Penlight
    Pulse  Thermometer
    Skin Temperature  Stethoscope
    Skin Coloration  Blood Pressure Cuff
    (Sphygmomanometer)
    Pupils  Pen and Notebook
    Blood Pressure
    Age Definition
     Infant – under 1 year old
     Child – 1 to 8 years old
     Adult – 9 and older
    Normal Respiration Rates Normal Pulse Rates
    oInfant – 25-50 RPM oInfant – 120-150 PPM
    oChild – 15-30 RPM oChild – 80-150 PPM
    oAdult – 12-20 RPM oAdult – 60-80 PPM

    NOTE: Count the number of times a NOTE: You can feel the pulse by
    chest or abdomen rises in one (1) pressing on an artery over a bony
    Minute prominence
    Skin Temperature Skin Coloration
    oNormal Body Temperature Paleness – Blood Loss
    98.6 ◦F or 37◦C Redness – Heat exposure,
    oIf without thermometer, you high blood pressure
    can use the back of your Blueness – Decrease oxygen
    hands, this is called “Relative level
    Skin Temperature”. Yellowness – Liver
    abnormalities (Jaundice)
    Black or Blue Mottling -
    Shock
    Normal Pupils Response Normal Blood Pressure
    • Pupils constrict with Rates
    exposure to light and dilates o Adult – Systolic 100-150 mmHg
    with less light o Adult – Diastolic 65-90 mmHg
    • Both should be the same size o Child – Systolic 80+(2 x mmHg)
    o Child – Diastolic 50-80 mmHg
    4. PATIENT HISTORY
    Re-evaluate what you observe when you arrived on scene
    In trauma, perform physical exam first. For a medical
    patient, take history first.
    Patient Interview;
    S = SIGNS AND SYMPTOMS
    A = ALLERGIES
    M = MEDICATION (Medication Taken)
    P = PERTINENT HISTORY (illness)
    L = LAST ORAL INTAKE
    E = EVENTS (Last Activity)
    5. ONGOING ASSESSMENT
    A patient may be in stable or unstable condition
    Assessment process must be ongoing until your patient is turned
    over to the next level of care.
    Reassess/Repeat every 5 to 15 minutes;
    Level of consciousness
    Airway
    Breathing rate and quality
    Pulse rate and quality
    Skin temperature
    Physical examination
    Interventions to check effectiveness
    6. HAND-OFF REPORT
    Also known as “Patient Transfer Information”
    When you are relieved of your patient by a higher-level care provider, be
    prepared to give appropriate written information about your patient
    Hand-off report includes:
    Age and Sex
    Chief complain
    Level of Consciousness
    Airway status
    Breathing status
    Circulation status
    Physical Examination Findings
    Treatment given
    END OF PRESENTATION
    Prepared by:
    Pre-Fire Planning, Training, and Community Relation Section
    NABUA FIRE STATION
    Nabua, Camarines Sur

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