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CHAPTER 9 PATIENT ASSESSMENT QUESTIONS WITH COMPLETE ANSWERS.
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CHAPTER 9 PATIENT ASSESSMENT QUESTIONS WITH COMPLETE ANSWERS.
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CHAPTER 9 PATIENT ASSESSMENTQUESTIONS WITH COMPLETE
ANSWERS
Importance ffof ffPatient ffassessment ff- ffAnswer ff1. ffEMTs ffmust ffmaster ffand ffbe
ffcomfortable ffwith ffthe ffpatient ffassessment ffprocess.
2. ffPatient ffassessment ffis ffused, ffto ffsome ffdegree, ffin ffevery ffpatient ffencounter.
Main ffpts ffof ffthe ffAssessment ffprocess ff- ffAnswer ff1. ffScene ffsize-up
2. ffPrimary ffassessment
3. ffHistory fftaking
4. ffSecondary ffassessment
5. ffReassessment
a. ffOrder ffdep ffon ffpt. ffcondition ffand ffenv. ff
b. ffchange ffthe fforder ffafter ffscene ffsize-up ffbased ffon ffyour fffindings ffand ffneed ffto
ffprioritize ffcare ffof ffcertain ffconditions. ff
1. ffA ffsymptom ffis ffa ffsubjective ffcondition ffthe ffpatient fffeels ffand fftells ffyou ffabout.
2. ffA ffsign ffis ffan ffobjective ffcondition ffyou ffcan ffobserve ffor ffmeasure ffabout ffthe
ffpatient.
D. ffThe fftreatment ffEMTs ffprovide ffpatients ffis ffbased ffon ffsymptoms, ffnot ffan ffexact
ffdiagnosis. ff
E. ffThe ffpatient ffassessment ffprocess ffis ffthe fffoundation ffupon ffwhich ffall fflevels ffof
ffEMT ffeducation ffare ffbuilt ffand ffis ffthe ffstarting ffpoint fffor ffall ffpatient ffcare.
What ffdo ffyou ffdo ffduring ffa ffscene ffsize-up? ff- ffAnswer ffScene ffSafety
MOI ffand ffNOI
ffstandard ffprecautions
Determine ff# ffpatients.
Consider ffadditional/specialized ffresources.
the ffScene ffsize-up ff- ffAnswer ff1. ffSituational ffawareness ffis ffnecessary ffthroughout
ffthe ffentire ffcall ffto ffensure ffsafety. ff
ffa. ffSituational ffawareness ffis ffpaying ffattention ffto ffthe ffconditions ffand ffpeople
ffaround ffyou ffat ffall fftimes ffand ffthe ffpotential ffrisks ffthose ffconditions ffor ffpeople ffpose.
ff
ffb. ffScene ffsize-up ffis ffthe fffirst ffthing ffto ffconsider, ffbut ffit ffdoes ffnot ffend ffas ffproviders
ffmove ffthrough ffthe ffassessment ffprocess.
2.Disptach ffprovides ffbasic ffinformation ffabout ffthe ffrequest fffor ffassistance. ff
,ffa. ffScene ffsize-up ffcombines ffinformation ffand ffobservations ffto ffhelp ffensure ffsafe
ffand ffeffective ffoperations. ff
ffi. ffAn ffunderstanding ffof ffthe ffsituation ffand ffconditions ffprior ffto ffresponding
ffii. ffThe ffdispatcher's ffinformation
ffiii. ffAn ffobservation ffof ffthe ffscene
Ensuring ffScene ffSafety ff- ffAnswer ff1. ffIssues ffthat ffyou ffmay ffencounter ffin ffthe
ffprehospital ffsetting ffcan ffrange fffrom ffminor ffdifficulties ffto ffmajor ffdangers.
a. ffEven ffscenes ffthat fffirst ffappear ffrelatively ffsafe ffand ffsecure ffcan ffturn ffunsafe ffwith
fflittle ffnotice. ff
2. ffIf ffa ffscene ffis ffnot ffsafe fffor ffyou ffand ffyour ffteam ffto ffenter ffthe ffscene ffand
ffapproach ffand ffmanage ffthe ffpatient, ffdo ffwhat ffyou ffcan ffto ffmake ffit ffsafe ffor ffcall fffor
ffadditional ffresources.
a. ffFirefighters
b. ffUtility ffworkers
c. ffHazardous ffmaterials fftechnicians
d. ffLaw ffenforcement ffpersonnel
3. ffTypically ffthe ffway ffyou ffenter ffan ffarea ffis ffalso ffthe ffway ffyou ffwill ffleave, ffwith ffa
ffstretcher, ffa ffpatient, ffpatient ffcare ffequipment, ffand ffpersonnel ffbelongings.
a. ffConsider ffdifficult ffterrain.
4. ffConsider fftraffic ffsafety ffissues ffand ffissues ffrelated ffto ffscene ffsafety ffif ffyou ffmust
ffapproach ffa ffpatient ffon ffa ffworking ffroadway.
a. ffWear, ffat ffa ffminimum, ffa ffhigh-visibility ffClass ff2 ffor ff3 ffsafety ffvest ffapproved ffby
ffthe ffAmerican ffNational ffStandards ffInstitute.
b. ffOther fftraffic-incident ffmanagement fftechniques ffmay ffbe ffappropriate.
ffi. ffPersonnel
ffii. ffTraffic ffmarkers ff(cones, ffflares, ffsigns)
ffiii. ffStrategic ffpositioning ffof ffemergency ffvehicles
5. ffConsider ffenvironmental ffconditions ffat ffthe ffscene.
a. ffYour ffpatient ffmay ffbe ffoutdoors, ffindoors, ffor ffin ffa ffpublic ffplace.
b. ffBe ffaware ffof ffthe ffweather ffand ffthe ffphysical ffterrain.
6. ffWorking ffin ffunfavorable ffconditions ffand ffon ffunstable ffsurfaces ffis ffa fflarge ffpart ffof
ffprehospital ffcare.
a. ffA ffgood ffrule ffto ffuse ffwhen fffaced ffwith ffa ffwide ffvariety ffof ffpossibilities ffis ffthat ffany
ffactions ffyou ffmay fftake ffto ffprotect ffyourself ffshould ffalso ffbe ffconsidered fffor ffthe
ffpatient.
7. ffIf ffappropriate, ffhelp ffprotect ffbystanders fffrom ffbecoming ffpatients ffas ffwell.
8. ffSome ffforms ffof ffhazards:
a. ffEnvironmental
b. ffPhysical ff(sharp ffmetal, ffbroken ffglass, ffslip-and-fall ffhazards)
c. ffChemical ff(hazardous ffmaterials)
d. ffElectrical
e. ffWater
f. ffFire
g. ffExplosions
h. ffPhysical ffviolence
, 9. ffBe ffaware ffof ffscenes ffthat ffhave ffthe ffpotential fffor ffviolence
Determine ffmechanism ffof ffinjury ff(MOI)/nature ffof ffillness ff(NOI). ff- ffAnswer ff1.
ffVirtually ffall ffcalls fffor ffassistance ffto ffwhich ffyou ffmay ffrespond ffcan ffbe ffcategorized
ffas ffmedical ffconditions, fftraumatic ffinjuries, ffor ffboth.
ffa. ffA ffmedical ffproblem ffcan fflead ffto ffa fftraumatic ffinjury.
ffb. ffYou ffwill ffneed ffto ffbe ffable ffto ffidentify ffthe ffgeneral ffclassification ffand ffunderlying
ffissues(s) ffof ffthe ffemergency ffto ffwhich ffyou ffrespond.
2. ffTraumatic ffinjuries ffare ffthe ffresult ffof ffphysical ffforces ffapplied ffto ffthe ffoutside ffof
ffthe ffbody, ffusually fffrom ffan ffobject ffstriking ffthe ffbody ffor ffthe ffbody ffstriking ffan
ffobject.
ffClassified ffaccording ffto ffthe fftype ffor ffamount ffof ffforce, ffhow fflong ffit ffwas ffapplied,
ffand ffwhere ffit ffwas ffapplied ffto ffthe ffbody
This ffis ffdescribed ffas ffthe ffmechanism ffof ffinjury ff(MOI). ff
3. ffCertain ffparts ffof ffthe ffbody ffare ffmore ffeasily ffinjured ffthan ffothers. ff
ffa. ffFragile ffand ffeasily ffinjured ffareas ffinclude ffthe ffbrain, ffspinal ffcord, ffand ffeyes.
ffb. ffAn ffunderstanding ffof ffanatomy ffand ffphysiology ffwill ffhelp ffEMTs ffto ffidentify
fftimes ffwhen ffa ffmechanism ffof ffinjury ffmay fflead ffto ffinjury ffto ffparts ffof ffthe ffbody ffnot
ffdirectly ffimpacted. ff
4. ffWith ffblunt fftrauma, ffthe ffforce ffof ffthe ffinjury ffoccurs ffover ffa ffbroad ffarea, ffand ffthe
ffskin ffis ffsometimes ffnot ffbroken.
a. ffHowever, ffthe fftissues ffand fforgans ffunderneath ffthe ffarea ffof ffimpact ffmay ffbe
ffdamaged.
5. ffWith ffpenetrating fftrauma, ffthe ffforce ffof ffthe ffinjury ffoccurs ffat ffa ffspecific ffpoint ffof
ffcontact ffbetween ffthe ffskin ffand ffthe ffobject.
a. ffIt ffis ffan ffopen ffwound ffwith ffhigh ffpotential fffor ffinfection.
5. ffFor ffmedical ffpatients, ffdetermine ffthe ffnature ffof ffillness ff(NOI).
a. ffThere ffare ffsimilarities ffbetween ffthe ffMOI ffand ffthe ffNOI.
i. ffBoth ffrequire ffyou ffto ffsearch fffor ffclues ffregarding ffhow ffthe ffincident ffoccurred.
b. ffTo ffquickly ffdetermine ffthe ffNOI, fftalk ffwith ffthe ffpatient, fffamily, ffor ffbystanders.
c. ffUse ffyour ffsenses ffto ffcheck ffthe ffscene fffor ffclues ffas ffto ffthe ffpossible ffproblem.
6. ffBe ffaware ffof ffscenes ffwith ffmultiple ffpatients ffwho ffare ffexhibiting ffsimilar ffsigns ffor
ffsymptoms.
a. ffCould ffindicate ffan ffunsafe ffscene fffor ffyou ffand ffyour ffpartner ffas ffwel
The ffImportance ffof ffMOI/NOI ff- ffAnswer ff1. ffConsidering ffthe ffMOI ffor ffNOI ffearly ffcan
ffbe ffof ffvalue ffin ffpreparing ffto ffcare fffor ffyour ffpatient.
2. ffDuring ffyour ffprehospital ffassessment, ffyou ffmay ffbe fftempted ffto ffcategorize ffyour
ffpatient ffimmediately ffas ffa fftrauma ffor ffmedical ffpatient.
a. ffRemember, ffthe fffundamentals ffof ffa ffgood ffpatient ffassessment ffare ffthe ffsame
ffdespite ffthe ffunique ffaspects ffof fftrauma ffand ffmedical ffcare.
Take ffstandard ffPRecautions ffduring ffscene ffsize-up ff- ffAnswer ff1. ffStandard
ffprecautions ffand ffpersonal ffprotective ffequipment ff(PPE) ffneed ffto ffbe ffconsidered
ffand ffadapted ffto ffthe ffprehospital fftask ffat ffhand.
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