Transcript SECTION 2

8: Patient Assessment
Scene Size-up
Objectives (1 of 2)
Cognitive
3-1.1 Recognize hazards/potential hazards.
3-1.2 Describe common hazards found at the scene of
a trauma and a medical patient.
3-1.3 Determine if the scene is safe to enter.
3-1.4 Discuss common mechanisms of injury/nature of
illness.
3-1.5 Discuss the reason for identifying the total number
of patients at the scene.
3-1.6 Explain the reason for identifying the need for
additional help or assistance.
Scene Size-up
Objectives (2 of 2)
Affective
3-1.7 Explain the rationale for crew members to
evaluate scene safety prior to entering.
3-1.8 Serve as a model for others explaining how
patient situations affect your evaluation of
mechanism of injury or illness.
Psychomotor
3-1.9 Observe various scenarios and identify potential
hazards.
Initial Assessment
Objectives (1 of 7)
Cognitive
3-2.1 Summarize the reasons for forming a general impression of
the patient.
3-2.2 Discuss methods of assessing altered mental status.
3-2.3 Differentiate between assessing the altered mental status in
the adult, child, and infant patient.
3-2.4 Discuss methods of assessing the airway in the adult, child,
and infant patient.
3-2.5 State reasons for management of the cervical spine once the
patient has been determined to be a trauma patient.
Initial Assessment
Objectives (2 of 7)
3-2.6 Describe methods used for assessing if a
patient is breathing.
3-2.7 State what care should be provided to the adult,
child, and infant patient with adequate breathing.
3-2.8 State what care should be provided to the adult,
child, and infant patient without adequate
breathing.
3-2.9 Differentiate between a patient with adequate
and inadequate breathing.
3-2.10 Distinguish between methods of assessing
breathing in the adult, child, and infant patient.
Initial Assessment
Objectives (3 of 7)
3-2.11 Compare the methods of providing airway care
to the adult, child, and infant patient.
3-2.12 Describe the methods used to obtain a pulse.
3-2.13 Differentiate between obtaining a pulse in an
adult, child, and infant patient.
3-2.14 Discuss the need for assessing the patient for
external bleeding.
3-2.15 Describe normal and abnormal findings when
assessing skin color.
3-2.16 Describe normal and abnormal findings when
assessing skin temperature.
Initial Assessment
Objectives (4 of 7)
3-2.17 Describe normal and abnormal findings when
assessing skin condition.
3-2.18 Describe normal and abnormal findings when
assessing skin capillary refill in the infant and child
patient.
3-2.19 Explain the reason for prioritizing a patient for
care and transport.
Initial Assessment
Objectives (5 of 7)
Affective
3-2.20 Explain the importance of forming a general
impression of the patient.
3-2.21 Explain the value of performing an initial
assessment.
Initial Assessment
Objectives (6 of 7)
Psychomotor
3-2.22 Demonstrate the techniques for assessing
mental status.
3-2.23 Demonstrate the techniques for assessing the
airway.
3-2.24 Demonstrate the techniques for assessing if
the patient is breathing.
3-2.25 Demonstrate the techniques for assessing if
the patient has a pulse.
Initial Assessment
Objectives (7 of 7)
3-2.26 Demonstrate the techniques for assessing the
patient for external bleeding.
3-2.27 Demonstrate the techniques for assessing the
patient's skin color, temperature, condition, and
capillary refill (infants and children only).
3-2.28 Demonstrate the ability to prioritize patients.
Focused History and Physical
Exam: Trauma
Objectives (1 of 3)
Cognitive
3-3.1 Discuss the reasons for reconsideration
concerning the mechanism of injury.
3-3.2 State the reasons for performing a rapid trauma
assessment.
3-3.3 Recite examples and explain why patients
should receive a rapid trauma assessment.
3-3.4 Describe the areas included in the rapid trauma
assessment and discuss what should be evaluated.
Focused History and Physical
Exam: Trauma
Objectives (2 of 3)
3-3.5 Differentiate when the rapid assessment may
be altered in order to provide patient care.
3-3.6 Discuss the reason for performing a focused
history and physical exam.
Affective
3-3.7 Recognize and respect the feelings that patients
might experience during assessment.
Focused History and Physical
Exam: Trauma
Objectives (3 of 3)
Psychomotor
3-3.8 Demonstrate the rapid trauma assessment that
should be used to assess a patient based on
mechanism of injury.
Focused History and Physical
Exam: Medical Patients
Objectives (1 of 3)
Cognitive
3-4.1 Describe the unique needs for assessing an
individual with a specific chief complaint with no known
prior history.
3-4.2 Differentiate between the history and physical
exam that are performed for responsive patients with
no known prior history and responsive patients with a
known prior history.
3-4.3 Describe the needs for assessing an individual who
is unresponsive.
Focused History and Physical
Exam: Medical Patients
Objectives (2 of 3)
3-4.4 Differentiate between the assessment that is
performed for a patient who is unresponsive or has
an altered mental status and other medical patients
requiring assessment.
Affective
3-4.5 Attend to the feelings that these patients might
be experiencing.
Focused History and Physical
Exam: Medical Patients
Objectives (3 of 3)
Psychomotor
3-4.6 Demonstrate the patient care skills that should
be used to assist a patient who is responsive with
no known history.
3-4.7 Demonstrate the patient care skills that should
be used to assist a patient who is unresponsive or
has an altered mental status.
Detailed Physical Exam
Objectives (1 of 2)
Cognitive
3-5.1 Discuss the components of the detailed physical
exam.
3-5.2 State the areas of the body that are evaluated
during the detailed physical exam.
3-5.3 Explain what additional care should be provided
while performing the detailed physical exam.
3-5.4 Distinguish between the detailed physical exam
that is performed on a trauma patient and that of the
medical patient.
Detailed Physical Exam
Objectives (2 of 2)
Affective
3-5.5 Explain the rationale for the feelings that these
patients might be experiencing.
Psychomotor
3-5.6 Demonstrate the skills involved in performing
the detailed physical exam.
Ongoing Assessment
Objectives (1 of 2)
Cognitive
3-6.1 Discuss the reason for repeating the initial
assessment as part of the ongoing assessment.
3-6.2 Describe the components of the ongoing
assessment.
3-6.3 Describe trending of assessment components.
Affective
3-6.4 Explain the value of performing an ongoing
assessment.
Ongoing Assessment
Objectives (2 of 2)
3-6.5 Recognize and respect the feelings that patients
might experience during assessment.
3-6.6 Explain the value of trending assessment
components to other health professionals who
assume care of the patient.
Psychomotor
3-6.7 Demonstrate the skills involved in performing
the ongoing assessment.
Patient Assessment
• Scene size-up
• Initial assessment
• Focused history and physical exam
– Vital signs
– History
• Detailed physical exam
• Ongoing assessment
Patient Assessment Process
Scene Size-up
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Dispatch information
Inspection of scene
Scene hazards
Safety concerns
Mechanism of injury
Nature of illness/chief complaint
Number of patients
Additional resources needed
Body Substance Isolation
• Assumes all body fluids present a
possible risk for infection
• Protective equipment
– Latex or vinyl gloves should always be
worn
– Eye protection
– Mask
– Gown
– Turnout gear
Scene Safety:
Potential Hazards
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Oncoming traffic
Unstable surfaces
Leaking gasoline
Downed electrical lines
Potential for violence
Fire or smoke
• Hazardous
materials
• Other dangers at
crash or rescue
scenes
• Crime scenes
Scene Safety
• Park in a safe area.
• Speak with law
enforcement first if
present.
• The safety of you
and your partner
comes first!
• Next concern is the
safety of patient(s)
and bystanders.
• Request additional
resources if needed
to make scene safe.
Mechanism of Injury
• Helps determine the possible extent of
injuries on trauma patients
• Evaluate:
– Amount of force applied to body
– Length of time force was applied
– Area of the body involved
Nature of Illness
• Search for clues to
determine the nature of
illness.
• Often described by the
patient’s chief complaint
• Gather information from
the patient and people
on scene.
• Observe the scene.
The Importance of MOI/NOI
• Guides preparation for
care to patient
• Suggests equipment
that will be needed
• Prepares for further
assessment
• Fundamentals of
assessment are same
whether emergency
appears to be related to
trauma or medical
cause.
Number of Patients
• Determine the number of patients and
their condition.
• Assess what additional resources will
be needed.
• Triage to identify severity of each
patient’s condition.
Additional Resources
• Medical resources
– Additional units
– Advanced life support
• Nonmedical resources
– Fire suppression
– Rescue
– Law enforcement
C-Spine Immobilization
• Consider early during
assessment.
• Do not move without
immobilization.
• Err on the side of
caution.
Patient Assessment Process
Initial Assessment
• Develop a general
impression.
• Assess mental status.
• Assess airway.
• Assess the adequacy of
breathing.
• Assess circulation.
• Identify patient priority.
Develop a General Impression
• Occurs as you approach the scene and the patient
– Assessment of the environment
– Patient’s chief complaint
– Presenting signs and symptoms of patient
Obtaining Consent
• Introduce self.
• Ask patient’s name.
• Obtain consent.
Chief Complaint
• Most serious problem
voiced by the patient
• May not be the most
significant problem
present
Assessing Mental Status
• Responsiveness
– How the patient
responds to external
stimuli
• Orientation
– Mental status and
thinking ability
Testing Responsiveness
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A
V
P
U
Alert
Responsive to Verbal stimulus
Responsive to Pain
Unresponsive
Testing Orientation
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Person
Place
Time
Event
Caring for Abnormal Mental Status
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Complete initial assessment.
Provide high-flow oxygen.
Consider spinal immobilization.
Initiate transport.
Support ABCs.
Reassess.
Assessing the Airway
• 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
Signs of Airway Obstruction in the
Unconscious Patient
• Obvious trauma, blood, or other obstruction
• Noisy breathing such as bubbling, gurgling,
crowing, or other abnormal sounds
• Extremely shallow or absent breathing
Assessing Breathing
• Choking
• Rate
• Depth
• Cyanosis
• Lung sounds
• Air movement
Assessing Breath Sounds
High-Flow Oxygen Administration
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Breathing faster than 20 breaths/min
Breathing slower than 12 breaths/min
Breathing too shallow
Decreased level of consciousness
Respiratory distress
Poor skin color
Positioning the Patient
• Position of comfort
– Sitting up with feet dangling
– High Fowler’s position
• Spinal precautions if possible spinal injury
Assessing the Pulse
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Presence
Rate
Rhythm
Strength
Normal Pulse Rates in Infants and
Children
Age
Infant: 1 month to 1 year
Range
(beats/min)
100 to 160
Toddler: 1 to 3 years
90 to 150
Preschool-age: 3 to 6 years
80 to 140
School-age: 6 to 12 years
70 to 120
Adolescent: 12 to 18 years
60 to 100
Assessing and Controlling External
Bleeding
• Assess after clearing the airway and stabilizing
breathing.
• Look for blood flow or blood on floor/clothes.
• Controlling bleeding
– Direct pressure
– Elevation
– Pressure points
Assessing Perfusion
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Color
Temperature
Skin condition
Capillary refill
Priority Patients
• Difficulty breathing
• Poor general
impression
• Unresponsive with no
gag reflex
• Severe chest pain
• Signs of poor perfusion
• Complicated childbirth
• Uncontrolled bleeding
• Responsive but unable
to follow commands
• Severe pain
• Inability to move any
part of the body
Transport Decision
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Patient condition
Availability of advanced care
Distance to transport
Local protocols
Patient Assessment Process
Goals of the Focused History and Physical Exam
• Understand the circumstances surrounding
the chief complaint.
• Obtain objective measurements.
• Perform physical exam.
Components of Focused History
and Physical Exam
• Medical history
• Baseline vital signs
• Physical exam
Rapid Physical Exam
• 60-90 second head-totoe exam
• Performed on:
– Significant trauma
patients
– Unresponsive
medical patients
• Identifies undiscovered
conditions
DCAP-BTLS
• D Deformities
• B Burns
• C Contusions
• T Tenderness
• A Abrasions
• L Lacerations
• P Punctures/
Penetrations
• S Swelling
Components of a Rapid Physical
Exam (1 of 3)
• Maintain spinal immobilization while checking patient’s
ABCs.
• Assess the head.
• Assess the neck.
• Apply a cervical spine immobilization collar.
Components of a Rapid Physical
Exam (2 of 3)
• Assess the chest.
• Assess the abdomen.
• Assess the pelvis.
Components of a Rapid Physical
Exam (3 of 3)
• Assess all four extremities.
• Roll the patient with spinal precautions.
Focused Physical Exam
• Used to evaluate patient’s chief complaint
• Performed on:
– Trauma patients without significant MOI
– Responsive medical patients
Head, Neck, and Cervical Spine
• Feel head and neck for deformity,
tenderness, or crepitation.
• Check for bleeding.
• Ask about pain or tenderness.
Chest
• Watch chest rise and fall with
breathing.
• Feel for grating bones as
patient breathes.
• Listen to breath sounds.
Abdomen
• Look for obvious injury, bruises, or
bleeding.
• Evaluate for tenderness and any
bleeding.
• Do not palpate too hard.
Pelvis
• Look for any signs of obvious injury,
bleeding, or deformity.
• Press gently inward and downward
on pelvic bones.
Extremities
• Look for obvious injuries.
• Feel for deformities.
• Assess
– Pulse
– Motor function
– Sensory function
Posterior Body
• Feel for tenderness, deformity, and
open wounds.
• Carefully palpate from neck to pelvis.
• Look for obvious injuries.
Specific Chief Complaints
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Chest pain
Shortness of breath
Abdominal pain
Pain associated with
bones or joints
• Dizziness
Significant Mechanism of Injury
• Ejection from vehicle
• Death in passenger
compartment
• Fall greater than 15'-20'
• Vehicle rollover
• High-speed collision
• Vehicle-pedestrian
collision
• Motorcycle crash
• Unresponsiveness or
altered mental status
• Penetrating trauma to the
head, chest, or abdomen
Assessment Steps for
Significant MOI
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Rapid trauma assessment
Baseline vital signs
SAMPLE history
Reevaluate transport decision
Assessment Steps for Trauma
Patients Without Significant MOI
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Focused assessment
Baseline vital signs
SAMPLE history
Reevaluate transport decision
Responsive Medical Patients
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History of illness
SAMPLE history
Focused assessment
Vital signs
Reevaluate transport decision
Unresponsive Medical Patients
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Rapid medical assessment
Baseline vital signs
SAMPLE history
Reevaluate transport decision
Patient Assessment Process
Detailed Physical
Exam
• More in-depth exam based on focused
physical exam
• Should only be performed if time and
patient’s condition allows
• Usually performed en route to the hospital
Performing the Detailed
Physical Exam (1 of 10)
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Visualize and palpate using DCAP-BTLS.
Look at the face.
Inspect the area around the eyes and eyelids.
Examine the eyes.
Performing the Detailed
Physical Exam (2 of 10)
• Pull the patient’s ear forward to assess for bruising.
• Use the penlight to look for drainage or blood in the
ears.
Performing the Detailed
Physical Exam (3 of 10)
• Look for bruising and lacerations about the head.
• Palpate the zygomas.
Performing the Detailed
Physical Exam (4 of 10)
• Palpate the maxillae.
• Palpate the mandible.
Performing the Detailed
Physical Exam (5 of 10)
• Assess the mouth and nose for
obstructions and cyanosis.
• Check for unusual odors.
Performing the Detailed
Physical Exam (6 of 10)
• Look at the neck.
• Palpate the front and the back of the neck.
• Look for distended jugular veins.
Performing the Detailed
Physical Exam (7 of 10)
• Look at the chest.
• Gently palpate over the ribs.
Performing the Detailed
Physical Exam (8 of 10)
• Listen for breath sounds.
• Listen also at the bases and
apices of the lungs.
Performing the Detailed
Physical Exam (9 of 10)
• Look at the abdomen and pelvis.
• Gently palpate the abdomen.
• Gently compress the pelvis.
Performing the Detailed
Physical Exam (10 of 10)
• Gently press the iliac crests.
• Inspect all four extremities.
• Assess the back for tenderness or deformities.
Patient Assessment Process
Ongoing Assessment
• Is treatment improving the patient’s
condition?
• Has an already identified problem gotten
better? Worse?
• What is the nature of any newly
identified problems?
Steps of the Ongoing Assessment
• Repeat the initial assessment.
• Reassess and record vital signs.
• Repeat focused assessment.
• Check interventions.
Review
1. Assessment of an unconscious patient's breathing
begins by:
A. inserting an oral airway.
B. manually positioning the head.
C. assessing respiratory rate and depth.
D. clearing the mouth with suction as needed.
Review
Answer: B
Rationale: You cannot assess or treat an unconscious
patient’s breathing until the airway is patent—that
is, open and free of obstructions. Manually open
the patient’s airway (eg, head tilt-chin lift, jawthrust), use suction as needed to clear the airway
of blood or other liquids, insert an airway adjunct to
assist in maintaining airway patency, and then
assess the patient’s respiratory effort.
Review
1. Assessment of an unconscious patient's breathing begins
by:
A. inserting an oral airway.
Rationale: You insert an airway adjunct to assist in maintaining
airway patency after the head-tilt-chin-lift.
B. manually positioning the head.
Rationale: Correct answer
C. assessing respiratory rate and depth.
Rationale: After the airway is opened and suctioned, then
determine the patient’s respiratory effort by assessing the
respiratory rate and depth.
D. clearing the mouth with suction as needed.
Rationale: This is done after attempting to open the airway with
proper positioning.
Review
2. You arrive at the scene of an “injured person.” As
you exit the ambulance, you see a man lying on the
front porch of his house. He appears to have been
shot in the head and is lying in a pool of blood. You
should:
A. immediately assess the patient.
B. proceed to the patient with caution.
C. quickly assess the scene for a gun.
D. Retreat to a safe place and wait for law
enforcement to arrive.
Review
Answer: D
Rationale: Your primary responsibility as an EMT-B is
to protect yourself. Prior to entering any scene, you
must assess for potential dangers. In cases where
violence has occurred, you must retreat to a safe
place and wait for law enforcement personnel to
arrive.
Review
2. You arrive at the scene of an “injured person.” As you exit the
ambulance, you see a man lying on the front porch of his
house. He appears to have been shot in the head and is
lying in a pool of blood. You should:
A. immediately assess the patient.
Rationale: You must wait until the scene is safe.
B. proceed to the patient with caution.
Rationale: You must wait until the scene is safe.
C. quickly assess the scene for a gun.
Rationale: This is the responsibility of law enforcement.
D. Retreat to a safe place and wait for law enforcement to
arrive.
Rationale: Correct answer
Review
3. During the scene size-up, you should routinely
determine all of the following, EXCEPT:
A. the mechanism of injury or nature of illness.
B. the ratio of pediatric patients to adult patients.
C. whether or not additional resources are needed.
D. if there are any hazards that will jeopardize safety.
Review
Answer: B
Rationale: Components of the scene size-up—after
taking BSI precautions—include determining if the
scene is safe for entry, determining the mechanism
of injury or nature of illness, determining the
number of patients, and determining if additional
resources are needed at the scene.
Review
3. During the scene size-up, you should routinely
determine all of the following, EXCEPT:
A. the mechanism of injury or nature of illness.
Rationale: This is part of the scene size-up.
B. the ratio of pediatric patients to adult patients.
Rationale: Correct answer
C. whether or not additional resources are needed.
Rationale: This is part of the scene size-up.
D. if there are any hazards that will jeopardize safety.
Rationale: This is part of the scene size-up.
Review
4. Findings such as inadequate breathing or an
altered level of consciousness should be identified
in the:
A. initial assessment.
B. focused physical exam.
C. ongoing assessment.
D. detailed physical exam.
Review
Answer: A
Rationale: The purpose of the initial assessment is to
identify and manage any life threats to the patient,
such as inadequate breathing, an altered level of
consciousness, or severe hemorrhage.
Review
4. Findings such as inadequate breathing or an altered level of
consciousness should be identified in the:
A. initial assessment.
Rationale: Correct answer
B. focused physical exam.
Rationale: The focused physical exam will help EMS to identify specific
problems, based upon the patient’s chief complaint.
C. ongoing assessment.
Rationale: This is performed during transport and will provide
information on other clues on how the current care plan is working.
D. detailed physical exam.
Rationale: This will provide EMS with more information about the
nature of the patient’s problem.
Review
5. A semiconscious patient pushes your hand away
when you pinch his earlobe. You should describe
his level of consciousness as:
A. alert.
B. unresponsive.
C. responsive to painful stimuli.
D. responsive to verbal stimuli.
Review
Answer: C
Rationale: Semiconscious patients are not alert, nor
or they unresponsive. The fact that the patient
pushes your hand away when you pinch his
earlobe indicates that he is responsive to painful
stimuli. If he opens his eyes or responds when you
speak to him, he would be described as being
responsive to verbal stimuli.
Review
5. A semiconscious patient pushes your hand away when you pinch
his earlobe. You should describe his level of consciousness as:
A. alert.
Rationale: This is when the patient’s eyes open spontaneously as
you approach.
B. unresponsive.
Rationale: This is when the patient does not respond to any
stimulus.
C. responsive to painful stimuli.
Rationale: Correct answer
D. responsive to verbal stimuli.
Rationale: This is when the patient’s eyes open with verbal stimuli
and tries to respond.
Review
6. Which of the following is considered a significant
mechanism of injury for a child?
A. Bicycle collision
B. Fall from higher than 5'
C. Slow-speed vehicle collision
D. Abrasion injury of the abdomen
Review
Answer: A
Rationale: Significant mechanisms of injury for a child
include falls from greater than 10’, bicycle
collisions, and medium-speed vehicle collisions,
among others.
Review
6. Which of the following is considered a significant mechanism
of injury for a child?
A. Bicycle collision
Rationale: Correct answer
B. Fall from higher than 5‘
Rationale: A significant mechanism of injury is a fall greater than
10 feet or 2 to 3 times the child’s height.
C. Slow-speed vehicle collision
Rationale: A significant mechanism of injury occurs with speeds
greater than 20 miles per hour.
D. Abrasion injury of the abdomen
Rationale: An abrasion is the result of an injury.
Review
7. An unresponsive patient with a possible spinal
injury and inadequate breathing should be placed:
A. on a backboard and given assisted ventilations.
B. in a PASG and given oxygen via nonrebreathing
mask.
C. in a semisitting position and given assisted
ventilations.
D. in the recovery position and given oxygen via
nonrebreathing mask.
Review
Answer: A
Rationale: Use spinal motion restriction precautions
(eg, backboard, cervical collar, lateral
immobilization of the head) on any patient with a
possible spinal injury. If the patient is breathing
inadequately (eg, shallow [reduced tidal volume]
breathing, fast or slow rate), assist ventilations with
a bag-mask device and 100% oxygen.
Review
7. An unresponsive patient with a possible spinal injury and
inadequate breathing should be placed:
A. on a backboard and given assisted ventilations.
Rationale: Correct answer
B. in a PASG and given oxygen via nonrebreathing mask.
Rationale: Inadequate breathing is always managed with
assisted ventilations via a bag-mask device.
C. in a semisitting position and given assisted ventilations.
Rationale: Spinal injuries are secured to a long backboard.
D. in the recovery position and given oxygen via nonrebreathing
mask.
Rationale: Spinal injuries are not placed on the side but supine
on a long backboard and breathing is assisted in this
scenario.
Review
8. Which of the following would you NOT detect
during your general assessment of a patient?
A. Cyanosis
B. Gurgling respirations
C. Severe bleeding
D. Rapid heart rate
Review
Answer: D
Rationale: The general impression is what you first
notice as you approach the patient, but before
physical contact with the patient is made. It is what
you see, hear, or smell. A rapid heart rate
(tachycardia) would not be detected until you
actually perform the initial assessment; you cannot
see, hear, or smell tachycardia.
Review
8. Which of the following would you NOT detect during your
general assessment of a patient?
A. Cyanosis
Rationale: You can see cyanosis during the general assessment.
B. Gurgling respirations
Rationale: You can hear gurgling during the general assessment.
C. Severe bleeding
Rationale: You can see bleeding during your general assessment.
D. Rapid heart rate
Rationale: Correct answer
Review
9. You should call for additional help before you begin
to care for patients at a multiple-casualty incident
because:
A. a hazardous material may exist.
B. the incident may be the result of terrorism.
C. the patients will die if more help does not arrive
quickly.
D. you might get preoccupied with patient care and
forget to call.
Review
Answer: D
Rationale: If the call for additional resources is
delayed, it is very easy to become involved with
patient care. The tendency then is to complete the
assessment and treatment before turning to other
matters, such as re-evaluating the situation and
calling for help. This just delays the needed
resources that much longer.
Review
9. You should call for additional help before you begin to care for
patients at a multiple-casualty incident because:
A. a hazardous material may exist.
Rationale: This is also part of the scene size-up and scene safety.
B. the incident may be the result of terrorism.
Rationale: This is part of scene size-up and calling for help before
providing medical treatment.
C. the patients will die if more help does not arrive quickly.
Rationale: Patients may die during a multiple-casualty incident,
but help must be called in before treatment begins.
D. you might get preoccupied with patient care and forget to call.
Rationale: Correct answer
Review
10. Your initial assessment of an elderly woman who
fell reveals an altered level of consciousness and a
large hematoma to her forehead. After protecting
her spine and administering oxygen, you should:
A. obtain baseline vital signs.
B. perform a rapid trauma assessment.
C. transport the patient immediately.
D. perform a focused exam of her head.
Review
Answer: B
Rationale: If any life-threatening problems are
discovered in the initial assessment, they should be
addressed immediately. The EMT-B should then
perform a rapid trauma assessment (or rapid
medical assessment in unresponsive medical
patients) to look for other potentially life-threatening
injuries or conditions.
Review
10. Your initial assessment of an elderly woman who fell reveals
an altered level of consciousness and a large hematoma to
her forehead. After protecting her spine and administering
oxygen, you should:
A. obtain baseline vital signs.
Rationale: This is part of the initial assessment.
B. perform a rapid trauma assessment.
Rationale: Correct answer
C. transport the patient immediately.
Rationale: This is determined after the completion of a rapid
trauma assessment.
D. perform a focused exam of her head.
Rationale: This is completed not only on the head but on the
entire body.