–If not, determine if the patient understands who you are.–Keep questions straightforward and brief.–Use hand gestures.–Be aware of the language diversity in your community.
Special Challenges in Obtaining Patient History Special Challenges in Obtaining Patient History •Hearing problems–Ask questions slowly and clearly.–Use a stethoscope to function as a hearing aid.–Learn simple sign language during your career.–Use a pencil and paper.
Special Challenges in Obtaining Patient History Special Challenges in Obtaining Patient History •Visual impairments–Identify yourself verbally when you enter the scene.–Return any items that have been moved to their previous positions.–Explain to the patient what is happening in each step of the assessment and history-taking process.
Secondary Assessment (1 of 3)Secondary Assessment (1 of 3)•Performed at the scene, in the back of the ambulance en route to the hospital, or not at all•Purpose is to perform a systematic physical examination of the patient•May be a full-body scan or an assessment that focuses on a certain area of the body
Secondary AssessmentSecondary Assessment•Use the mnemonic DCAP-BTLS.–Deformities–Contusions–Abrasions–Punctures/penetration–Burns–Tenderness–Lacerations–Swelling
Assess Vital SignsAssess Vital Signs•Pulse oximetry –Measures the oxygen saturation of hemoglobin in the capillary beds–Patients with difficulty breathing should receive oxygen regardless of their pulse oximetry value.
Assess Vital Signs Assess Vital Signs •End-tidal carbon dioxide–Carbon dioxide is the by-product of aerobic cellular metabolism and reflects the amount of oxygen being consumed.–Capnography is a noninvasive method.–End-tidal CO2is the partial pressure or maximal concentration of CO2at the end of an exhaled breath.
Assess Vital Signs Assess Vital Signs •End-tidal carbon dioxide–The normal range is 35 to 45 mm Hg, or 5% to 6% CO2.–Colorimetric devices provide continuous end-tidal monitoring.–Capnometry and capnography provide a digital reading and waveform.
Full-Body ScanFull-Body Scan•Systematic head-to-toe examination•Goal is to identify injuries or causes missed during the primary assessment’s rapid scan.
Focused AssessmentFocused Assessment•Performed on patients who have sustained nonsignificant MOIs or on responsive medical patients•Based on the chief complaint•Goal is to focus your attention on the immediate problem
Focused Assessment Focused Assessment •Respiratory system–Expose the patient’s chest.–Look for signs of airway obstruction.–Inspect for symmetry.–Listen to breath sounds.–Measure the respiratory rate.–Reevalute pulse rate and skin and blood pressure.
Focused Assessment Focused Assessment •Cardiovascular system–Look for trauma to the chest.
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- pulse, airway obstruction, special challenges, Assess Circulation