Patient Assessment And Management

1
Patient Assessment And Management
By Ethan Bjorklund Dave Furey Grant Riedemann
IV SKILL STATION
1
IHCC EHS
REVIEW
2
Airway with C-Spine Control

• Takes or directs manual inline immobilization of
  the head
• This is done to prevent any injury to the neck
• Opens and assesses airway
• This is done to make sure airway is clear of any
  foreign abject.
• Inserts airway adjunct
• This is done to keep an unconscious patients
  tongue from closing off the airway.

3
Breathing

• Assesses breathing
• Initiates appropriate oxygen therapy
• Assures adequate ventilation of the patient.
• Manages any injury that may compromise the
  breathing.

4
Circulation

• Checks pulse
• Assesses peripheral perfusion
• Assess either skin color, temperature, or
  capillary refill.
• Assesses and controls any major bleeding
• Takes Vital signs
• Blood pressure, pulse and respiration's are the
  three vitals.

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Circulation (continued)

• Volume replacement
• Click here for an IV Insertion Presentation
• This is where you determine if an IV is needed
• Initiates first IV line
• Initiates second IV line
• Selects appropriate catheters
• Selects appropriate IV solutions and
  administration sets
• Infuses at appropriate rate

6
Performs Neuro Exam

• Determine if the patient has any neurological
  problems.
• Use the AVPU scale
• A- Alert., is the patient alert and talking to
  you and aware of his surroundings
• P-Pain, does the patient respond to pain
• V-verbal, does the patient respond to your verbal
  commands.
• U-unresponsive, is the patient unresponsive .
• Applies cervical collar.

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Expose

• Removes clothing to expose any unseen injuries.
• This is where you look for DCAP BTLS
• D- deformities
• C-contusions
• A-abrasions
• P-punctures and perforations

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Expose (continued)

• B-bruising
• T-tenderness
• L-lacerations
• S-swelling

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Status

• This is were you get to make the call as the
  emergency health care provider of whether or not
  to immediately transport the patient..
• OR

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SECONDARY SURVEY

• This is done if you decide to stay on scene or,
  if time permits, while enroute to the hospital
  with a critical patient.

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HEAD

• Check the mouth, nose, facial area for any DCAP
  BTLS signs.
• Inspect and palpate the scalp and ears for DCAP
  BTLS signs.
• Check the pupils to see if they are equal, round
  and reactive to light.

12
NECK

• Check for tracheal deviation.
• Check for jugular veins distension.
• Palpate the cervical spine.

13
CHEST

• View chest for any signs of DCAP-BTLS.
• Palpate the chest for any trauma.
• Auscultate chest for lung sounds.
• Lung sounds should be clear and equal
  bilaterally.

14
ABDOMEN/PELVIS

• Inspect and palpate abdomen for any signs of
  DCAP-BTLS.
• Assess pelvis for and signs of DCAP-BTLS.

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LOWER EXTREMITIES

• Inspect and palpate the LEFT and RIGHT leg for
  any signs of DCAP-BTLS.
• Check each leg for Distal Circulation, Motor,and
  Sensory (CMS) function.
• Identify and treat minor wounds/fractures
  appropriately

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UPPER EXTREMITIES

• Inspect and palpate the LEFT and RIGHT arm for
  any signs of DCAP-BTLS.
• Check each leg for Distal Circulation, Motor,and
  Sensory (CMS) function.
• Identify and treat minor wounds/fractures
  appropriately

17
POSTERIOR THORAX/LUMBARBUTTOCKS

• Inspect and palpate posterior thorax, lumber, and
  buttocks areas for any signs of DCAP-BTLS.
• Identify and treat minor wounds/fractures
  appropriately.

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Critical Criteria

• These are actions that will result in automatic
  failure of station!
• Click here for a link to the National Registry
  Checklist (This is a PDF file, your computer must
  have Adobe Acrobat to read it).
• Failure to initiate or call for transport of the
  patient within 10 minutes.
• Failure to take or verbalize Body Substance
  Isolation Precautions.
• Failure to initiate or maintain spinal
  stabilization.

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Critical Criteria (continued)

• Failure to provide high concentration oxygen.
• Failure to find and evaluate all conditions
  related to the ABCs.
• Failure to appropriately manage the ABCs or
  treatment for shock.
• Failure to assess transportation priority.
• Failure to treat threats to the ABCs before
  doing the Secondary Survey.