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6. Patient Assessment. ADVANCED PATIENT ASSESSMENT Objectives. Six Phases of Patient Assessment ABCDE Primary Survey Secondary Assessment Four Vital Signs Medical History. ADVANCED PATIENT ASSESSMENT Phases of Patient Assessment. Pre-arrival Scene Survey Primary Assessment

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Presentation Transcript
advanced patient assessment objectives
ADVANCED PATIENT ASSESSMENTObjectives
  • Six Phases of Patient Assessment
  • ABCDE Primary Survey
  • Secondary Assessment
  • Four Vital Signs
  • Medical History
advanced patient assessment phases of patient assessment
ADVANCED PATIENT ASSESSMENTPhases of Patient Assessment
  • Pre-arrival
  • Scene Survey
  • Primary Assessment
  • Secondary Assessment
  • Vital Signs
  • Patient History
advanced patient assessment scene survey
ADVANCED PATIENT ASSESSMENTScene Survey
  • Hazards
  • Mechanism of Injury
  • Summon Backup as Needed
  • Locate Patients
advanced patient assessment
ADVANCED PATIENT ASSESSMENT
  • What are “Universal Precautions?”
  • When are they initiated?
advanced patient assessment1
ADVANCED PATIENT ASSESSMENT

“ABCs” vs. “ABCDEs”

What is the “Goal”

of the

Primary Assessment?

advanced patient assessment2
ADVANCED PATIENT ASSESSMENT
  • Airway
  • Breathing
  • CardiovascularFunction
  • Disability(Neurological Exam)
  • Expose
advanced patient assessment3
ADVANCED PATIENT ASSESSMENT

Look

Airway Listen

Feel

Look

Breathing Listen

Feel

advanced patient assessment4
ADVANCED PATIENT ASSESSMENT

Look

CirculationListen

Function Feel

Look

Disability Listen

Feel

(AVPU)

Look

Expose Listen

Feel

advanced patient assessment5
ADVANCED PATIENT ASSESSMENT

Differences

In Primary Survey

Of

“Trauma”

vs.

“Medical”

Patients

advanced patient assessment6
ADVANCED PATIENT ASSESSMENT

“Trauma” vs. “Medical” Patients

When is Treatment Initiated?

advanced patient assessment7
ADVANCED PATIENT ASSESSMENT

Stabilization

vs.

“Load and Go”

?

advanced patient assessment secondary assessment
ADVANCED PATIENT ASSESSMENTSecondary Assessment
  • Inspection
  • Palpation
  • Auscultation
  • Percussion
  • Head-to-Toe Exam
advanced patient assessment head face
ADVANCED PATIENT ASSESSMENTHead & Face
  • Battle’s Sign
  • Raccoon Eyes
  • Dysconjugate Gaze
  • Doll’s Eye Response
advanced patient assessment chest
ADVANCED PATIENT ASSESSMENTChest
  • Stridor
  • Rhonchi
  • Wheezes
  • Rales
advanced patient assessment abdomen
ADVANCED PATIENT ASSESSMENTAbdomen
  • Cullen’s Sign
  • Grey Turner’s Sign
  • Rebound Tenderness
  • Ascites
advanced patient assessment compromised limb findings
ADVANCED PATIENT ASSESSMENTCompromised Limb Findings
  • Absent Pulse
  • Cyanosis
  • Limb Cool
  • Slow/Absent Capillary Refill
advanced patient assessment8
ADVANCED PATIENT ASSESSMENT

Repeat Neurological Exam

Why?

Alert & Oriented x 3

Glasgow Coma Scale

advanced patient assessment vital signs
ADVANCED PATIENT ASSESSMENTVital Signs
  • Blood Pressure
  • Pulse
  • Respirations
  • “Skin Vitals”
advanced patient assessment patient history
ADVANCED PATIENT ASSESSMENTPatient History
  • Chief Complaint
  • History of Present Illness/Incident
  • Past Medical History (PMH)
  • “AMPLE”
advanced patient assessment chief complaint
ADVANCED PATIENT ASSESSMENTChief Complaint
  • Open-ended Questions
  • Aggravation/Alleviation
  • Location/Quality
  • Intensity/Duration
  • Onset (Time of/Activity)
advanced patient assessment past medical history ample
ADVANCED PATIENT ASSESSMENTPast Medical History (AMPLE)
  • Allergies
  • Medications
  • PastHistory
  • LastOral Intake
  • EventsPrior to Now
advanced patient assessment assessment communication
ADVANCED PATIENT ASSESSMENTAssessment Communication

Radio Notification

Patient Care Transferred to ED

Documentation

advanced patient assessment summary
ADVANCED PATIENT ASSESSMENTSummary
  • Six Phases of Patient Assessment
  • ABCDE Primary Survey
  • Secondary Assessment
  • Four Vital Signs
  • Medical History