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2
Patient Assessment
Components of the Initial Assessment
• Develop a general impression• Assess mental status• Assess airway “A”• Assess the adequacy of
breathing “B”• Assess circulation “C”• Identify patient priority
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Patient Assessment
Develop a General Impression
• Looks for life-threatening conditions• Occurs as you approach the scene and
the patient
• Assessment of the environment
• Patient’s chief complaint
• Presenting signs and symptoms of patient
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Patient Assessment
Distinguishing Between Medical and Trauma
• Determination should come after assessment is finished.
• Patients may have traumatic injuries caused by a medical reason.
• Initially assume all patients have both medical and traumatic aspects to their condition.
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Patient Assessment
Level of Consciousness
• A Alert
• V Responsive to Verbal stimulus
• P Responsive to Pain
• U Unresponsive
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Patient Assessment
Assessing the Airway (Unconscious)
• Open the airway
• Head tilt, chin lift technique.
• Look, Listen, Feel for breathing for 5 seconds.
• If not breathing, give two initial breaths.
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Patient Assessment
Assessing the Airway (Conscious)
• Look for signs of airway compromise:
• Two- to three-word dyspnea
• Use of accessory muscles
• Nasal flaring and use of accessory muscles in children
• Labored breathing
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Patient Assessment
Assessing Breathing
• Are the patient’s respirations shallow or deep?
• Does the patient appear to be choking?
• Is the patient cyanotic (blue)?
• Is the patient moving air into and out of the lungs as the chest rises and falls?
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Patient Assessment
Managing Breathing
• If patient is having difficulty breathing re-evaluate airway.
• Consider assisting ventilations with a BVM or applying a nonrebreathing mask if patient’s respirations are greater than 24/min or less than 8/min.
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Patient Assessment
Unresponsive Patients
• Look, listen and feel for breathing about 5 seconds
• Consider spinal cord injury.
• Provide high-flow oxygen.
• Assist ventilations if needed.
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Patient Assessment
Assessing Circulation (1 of 2)
• Assess the pulse.
• Rate, rhythm and strength
• Assess and control external bleeding.
• Direct pressure
• Evaluate skin color.
• Cyanotic, flushed, pale or jaundiced
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Patient Assessment
Assessing Circulation (2 of 2)
• Evaluate skin temperature.
• Skin is an organ.
• Evaluate skin condition.
• Dry or moist
• Evaluate capillary refill.
• Should be less than 2 seconds
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Patient Assessment
Identifying Priority Patients• Poor general
impression
• Unresponsive
• Difficulty breathing
• Signs of poor perfusion (capillary refill)
• Uncontrolled bleeding
• Severe pain
• Severe chest pain
• Inability to move any part of the body
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Patient Assessment
Goals of Exam
• Identify life threatening conditions.
• Identify the patient’s chief complaint.
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Patient Assessment
Trauma Assessment
• D Deformities
• C Contusions
• A Abrasions
• P Punctures/ Penetrations
• B Burns
• T Tenderness
• L Lacerations
• S Swelling
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Patient Assessment
Assessing the Responsive Patient
• Ask general questions to find out the chief complaint.
• If they answer, they are conscious, breathing, and have a pulse.
• Listen to the patient.