Assessment
How long should a rapid scan take?
No more than 60-90 seconds
If a patient is doing this, you know they have an open airway immediately.
Talking, crying, screaming
Normal capillary refill time
Less than 2 seconds
Describe a possible unsafe scene
Lots of variety here, if it sounds unsafe points awarded
Discuss the components of the scene size-up portion of the NREMT Trauma Assessment
Determine the scene is safe
Determine the mechanism of injury/nature of illness
Determine the number of patients
Request additional EMS assistance
Consider stabilization of the spine
Give 3 examples of high priority transport patients
Unresponsive
Difficulty breathing
Uncontrolled bleeding
Severe chest pain
Signs of poor perfusion (pale skin)
Severe pain
Complicated childbirth
When should you give positive pressure ventilation to an adult patient?
If they are breathing less than 8 times a minute, or more than 28 breaths per minute
What should you do if you can't palpate a pulse in an unconscious patient?
Start CPR
What type of gear should you wear during roadways incidents?
Reflective vest/coat
What three components do you have to do during the assessing circulation portion of the NREMT Medical Assessment?
Assesses/controls major bleeding
Assesses skin
Checks pulse
What does SAMPLE stand for?
Signs/symptoms
Allergies
Medication
Past pertinent history
Last oral intake
Events leading up to..
What is the most common airway obstruction?
The tongue
Discuss the ways you can control bleeding
Direct pressure
If that doesn't work apply a tourniquet
What should you do if a scene is unsafe or becomes unsafe?
LEAVE, have police secure the scene before entering again
Walk me through the history taking portion of the NREMT Medical Assessment? (What type of questions do you have to ask?)
Onset
Provocation
Quality
Radiation
Severity
Time
Person
Place
Time
Event
Signs of obstruction in an unconscious patient
Obvious blood, trauma, or obstruction
Noisy breathing
Extremely shallow or absent breathing
How will poor circulation affect the skin? (What will it look like?)
Pale, white, ashen, or grey
What are the three components you should consider when thinking the mechanism of injury?
Type or amount of force
How long force was applied
Where it was applied to the body
During the circulation assessment portion of the NREMT Trauma Assessment, how would you initiate shock management?
Place the pt. supine
Apply high flow oxygen
Conserve body heat (Apply a blanket)
How should you handle assessment of a patient on drugs or alcohol?
What do you always have to do with these patients?
Do not judge the patient
Be professional
Understand that information gathered may be unreliable
ALWAYS take a BGL with these patients
What is the goal for oxygenation in patients?
94-99%
What does bleeding from a vein look like?
What does bleeding from an artery look like?
Vein- Steady flow of blood
Artery- Spurting flow of blood
What is the very first thing you HAVE to initiate on every single NREMT sheet?
BSI
IS MY SCENE SAFE?
Discuss the secondary assessment of the head, neck, and chest of the NREMT Trauma Assessment. (Components for each)
Head- Inspects and palpates scalp and ears, Assesses eyes, Inspects mouth, nose, and Assesses facial area
Neck-Check position of trachea, Check jugular veins, Palpate cervical neck
Chest- Inspects chest, Palpates chest, Auscultates chest