preview of emt/emr secondary assessment training powerpoint presentation
TRANSCRIPT
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PREVIEW OF
EMT/EMR SECONDARY ASSESSMENT
POWERPOINT TRAINING PRESENTATION
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CHIEF COMPLAINT
Major sign or symptom reported by patientSymptom
What patient tells you is wrongSign
What you can see, hear, feel, smell or measure about patient
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MINOR LOCALIZED INJURY
A cut finger would not require a Secondary Exam
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PERFORM A PHYSICAL EXAMINATIONTO GATHER ADDITIONAL INFORMATION
Compare one side of the body to the other
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BRIEFLY ASSESS THE BODY FROM HEAD TO TOE
Systematically inspect and palpate, look and/or feel for the following examples of injuries or signs of injury
Deformities ContusionsAbrasions Punctures/penetrationsBurns TendernessLacerations SwellingCrepitus
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IMMEDIATELY TREAT LIFE-THREATENING PROBLEMS FOUND IN SECONDARY SURVEY
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BASELINE VITAL SIGNS
May consist ofBreathingPulseSkin perfusionPupilsBlood pressureLevel of consciousness
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BREATHING
Assessed by observing the patient's chest rise and fallRate is determined by counting
the number of breaths in a 30‑second period and
multiplying by 2Care should be taken not to inform the patient, to avoid influencing the rate
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NORMAL RATES
Adult 12-20 Respirations/min11-14 years 12-20 Respirations/min6-10 years 15-30 Respirations/min3-5 years 20-30 Respirations/min1-3 years 20-30 Respirations/min6-12 months 20-30 Respirations/min0-5 months 25-40 Respirations/minNewborn 30-50 Respirations/min
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BREATHING
Quality of breathing can be determined while assessing the rate Quality can be placed in 1 of 4 categories:
Normal Shallow or deepLaboredNoisy
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PULSE
Initially a radial pulse should be assessed in all patients one year or older
In patients less than one year of age a brachial pulse should be assessed
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PULSE POINTS Carotid
Radial
Brachial
Femoral
Popliteal
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PULSE
If the pulse is present, assess rate and qualityRate is the number of beats felt in
30 seconds multiplied by 2 (or 15 seconds multiplied by 4)
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PULSE
If peripheral pulse is not palpable, assess carotid pulseUse caution, avoid excess pressure on geriatricsNever attempt to assess carotid pulse on both sides at one time
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SKIN
The patient's color should be assessed in the nail beds, oral mucosa, and conjunctivaIn infants and children, palms
of hands and soles of feet should be assessed
Normal-pink
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CAPILLARY REFILL
Normal capillary refill in infants and children is < 2 secondsAbnormal capillary refill in infants and children is > 2 seconds
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BLOOD PRESSURE
Should be taken on patients over three years old
The pressure exerted by circulating blood upon the
walls of the blood vessels
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Cuff with bladder
Gauge
Squeeze bulb
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Ear piece
Bell
Tubing
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SYSTOLIC BLOOD PRESSUREForce exerted against the arteries when the heart is contractingThis is the first distinct sound of blood flowing
through the artery as the pressure in the blood pressure cuff is releasedThis is a measurement of the force exerted against the walls of the arteries during contraction of the heartNormal adult systolic blood pressure-120
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APPEARANCE & BEHAVIOR
UnresponsiveComaState of profound unconsciousnessAbsence of spontaneous eye movementsNo response to verbal or painful stimuliPatient cannot be aroused by any
stimuli
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APPEARANCE & BEHAVIOR
Observe posture and motor behaviorFacial expression
AnxietyDepressionAngerFearSadnessPain
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PELVIS
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PELVIC REGION
Check for SymmetryTenderness
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LOWER EXTREMITIES
OverviewSymmetrySurface findings
General physical findingsRange of motionSensoryMotor functionCirculatory function
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BRAVE TRAINING SOLUTIONS
PREVIEW OF EMT SECONDARY ASSESSMENT
POWERPOINT TRAINING PRESENTATION
www.bravetraining.com
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LOWER EXTREMITIES
Peripheral vascular systemTendernessTemperature of lower legsDistal pulses
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UPPER EXTREMITIESOverview
Symmetry StrengthSurface findings
General physical findingsRange of motion SensoryMotor function Circulatory functionArm drift
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ScalpSkullFace
Symmetry of expressionAppropriate facial expression
HEAD
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HEAD
Drainage or bleedingNoseEars
Objects or swelling in mouthVomit, bloodTeeth
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EARS
DrainageBloodCerebral Spinal Fluid
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EYES
Blood in anterior chamberPupil size, shape, and response
Normal – equal and reactive to lightAbnormalConstrictedDilatedUnequalConjunctiva color and hydration
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EYES
Reactivity is whether or not the pupils change in response to the lightReactive - change when exposed to lightNon‑reactive - do not change when exposed to lightEqually or unequally reactive
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NOSE
Drainage (Blood, Cerebral Spinal Fluid)Symmetry
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MOUTH
BurnsOdorsSwollen or lacerated tongueCondition of teeth or denturesHydration
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CHEST
Breath SoundsPresentAbsentEqual
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BACK
Roll with spinal precautions and assess posterior aspect of body, inspect and palpate for injuries or signs of injury
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ABDOMEN
OverviewPosition patient for examinationShape and sizePalpation method
Four quadrantsPalpate affected area last
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