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RC EMR – CH5 Assessment With Accurate Answers (A+)
what should you do when arriving on scene after ensuring personal and the safety of others?
- Identify any life threatening injury's or conditions during the primary assessment
What is included when conducting the primary assessment?
- LOC
- ABCs
- SOAPD
- Transport decision
- Critical intervention
What does the assessments flow chart included?
- Scene assessment
- primary assessment
- reassessment
- secondary assessment a) consider medications after vitals b) ISBAR
- treatment / interventions
- documentations and findings
- ongoing assessment
What should you do when approaching the Pt
- Consider the MOI for clues as to what may have caused the emergency
If the MOI indicated potential spinal injury, what should you do on approach before stabilizing the head?
- Approach from an angle which allows pt to see you without moving their head
Is it okay to relocate the Pt before the primary assessment?
- Yes, as long as you assess the risk and relocating is an urgent necessity
What are some examples of situations where relocating the pt is necessary?
- Moving pt away from dangerous materials or situation
- Moving pt with minor injuries to reach pt with life threatening injuries
- In order to provide appropriate care
- Or you may ask the pt to move themselves somewhere safer for you
What does Verbal on AVPU mean?
- Pt responds to commands
- can seem to be lapsing into unresponsiveness until questioned
What does painful on AVPU mean?
- Pt exhibits facial grimace, extension, withdrawal, or moans / groan.
What is the height that may determine a spinal injury? 1 meter
During the ABCs, what are some ways to determine if the Pt is experiencing dyspnea?
Also, what does dyspnea mean?
- Dyspnea means shortness of breath
- The ways to determine are:
a) Inadequate rise and fall of the chest
b) Increased breathing effort
c) Very slow or very fast respiratory rates
What are some indications of agonal respirations? MIAN INDICATIONS
- gaping mouth
- Snorting
- gurgling
- gasping for air
OTHERS INDICATIONS
- moaning
- laboured breathing
What artery should you check if the pt is unresponsive? carotid
How should you reset your two fingers when assessing the carotid?
- Reset by relocating to the Adams apple and slide back into place
Higher partial pressure is located where?
what does higher partial pressure mean when relating to effectiveness of bonding?
- It is located in the lungs
- it allows for easier bonding of oxygen molecules to hemoglobin
Where is the bonding of hemoglobin and oxygen weakened? And what does it mean?
- When the hemoglobin travels through the bodies tissues
- this means the oxygen is released into the cells of the body
What affects the binding of hemoglobin to oxygen?
- Blood ph
- temperature
- presence of carbon monoxide
- hemoglobin disorders
What percent of spo2 (equal or lower than) is considered insufficient to support life?
- 80 percent
Visualize the chart that containins the ranges of pulse oximetry.
what are the ranges, values, and treatments of each percent?
- normal is 95 to 100 with no treatment needed
- mild hypoxia is 91 to 94 with LFO2 via nasal cannula
- moderate hypoxia is 86 to 90 with HFO2 via NRB or BVM
- severe is equal to or lower than 85 with HFO2 via NRB or BVM
Smokers may have what percent when breathing room air?
- 94 to 96 percent
People with chronic lung disease may have SPO2 reading what percentage?
- As low as 90 percent
What should the responder record when relating to the SPO
- The first reading should be noted down as room air saturation
(can be written as RA)
- decreased circulation to extremities
- cardiac arrest (absent perfusion to fingers)
- excessive motion
- fingernail polish
- carbon monoxide poisoning
- hypothermia or other related cold illness
- sickle cell disease or anemia (fewer red blood cells)
- smoking cigarettes
- edema (swelling)
- and ambient light that can affect the responder from reading the equipment.
When can you consider reducing the oxygen flow rate?
- When the pts SPO2 reads 100 percent
A pt who uses low flow regularly for chronic conditions such as COPD should?
- Be kept on low flow unless higher levels are required
If you discover the need for a critical intervention during the RBS what should you do?
- Pause the RBS and perform the Intervention
True or false, you should gently push down on the iliac crests during the RBS?
- False
Are you only allowed to decide on transport after the RBS?
- No, if you arrive and see the pt has an obvious life threatening injury such as limb amputation, you may call for RTC early on
A patients who receive hospital care within one hour are considered significantly more likely to survive which is also referred to as what?
- Golden hour
Examples of RTC conditions include what
- Decreased LOC
- Abnormal abdominal distention
- severe or multi trauma
- chest pain (if disorder or heart attack is suspected)
- neurological deficits, instability of absence of ABC
- ongoing seizures
- Trendelenburg
what is Trendelenburg, can it be flipped, and why would you flip it?
- when the pt has their legs elevated higher than the head and the body
- yes
- it is used for the TBI protocol to mitigate increased ICP
when should you reassess the ABCs
- when the pt is moved
- when finished the RBS
what does the OPQRST table look like?
What are some examples of vital signs that must be taken
- Level of responsiveness (AVPU/Glasgow Coma Scale)
- Respiration
- Pulse.
- Skin characteristics
- Pupils, Blood pressure
- SpO
- Body temperature
- Blood glucose level (BGL) / Capillary blood glucose.
What are the different times needed to take vitals for stable and unstable pts
- Stable is every 5 minutes
- unstable is every 15 minutes
What does the GCS table look like:
What is an adults normal breathing rate
- Between 12 and 20
During the secondary assessment you are concerned with these attributes for respirations
What can cyanosis skin look like for folks with darker skin
- Ashen-grey
- yellow-brown
- greyish-green
How long should you check HR for a pt with severe hypothermia
- 60 seconds
Pupils should be
- Equal, round, and reative to light
What are the two pumping actions of the heart
- Contracting (working)
- refilling (resting)
What indicates serious TBI or illness in relation to pupils
- Unequal
- fully dilated
- fully constricted
- unresponsive to light
What is a more accurate indicator of a pts condition than a single blood pressure result
- Multiple results to see how blood pressure has changed over time
How would stress inhibit findings of blood pressure
- The initial result may be unusually high where later in the call stress may be lowered and blood pressure may do the same.
Before taking blood pressure you should check for abnormalities such as:
- Swollen lymph nodes (in cancer pts)
- dialysis fistula
- trauma
What units is blood pressure measured in
- Millimetres of mercury (mmHg)
What are the two different numbers measured during the blood pressure assessment
- when the pulse returns (this is the systolic pressure)
What is the systolic average difference between palpitation and auscultation?
- systolic is 10 to 20 mmHg lower when using auscultation
How would you express a systolic pressure of 130 when using the palpitation technique
- 130/P
What else should you record when taking blood pressure other than the findings of systolic and diastolic?
- Whether or not the pt was sitting or lying down
What can you do before auscultation to help give better results
- Create a baseline by doing the palpation technique first
What is the device used to extrude blood during the CBG test
- Lancet
Where should you place the lancet after using it
- In the biological waste container
What is blood glucose measured in?
- Millimoles per litre (mmol/L)
What is a normal CBG/BGL reading
- 4 to 8
During the H2T how can you confirm a finding is abnormal
- Compare it to the other side of the body
What should you look for on the head during the H2T
- Blood or clear fluid in or around the ears, nose, and mouth
What should you have the pt do during the H2T to check shoulder impairment
- Shrug
What is the imaginary line running parallel to the body's midline and passing through the midpoint of the clavicle called
- The mid-clavicular line
The fourth or fifth intercostal space (the space between the ribs) is combined with what line on the body to auscultate
