Initial Assessment Question

[benasack2000]

Hi everybody. I've got a question. I'm flipping through my old EMR textbook and it says that in the Initial Assessment, to not to waste time to count the rate of breathing and pulse. It says to rather note if it is irregular, slow, fast to determine if the patient is unstable. It says to wait until the physical exam to actually check vital signs (noting the rate). Is this correct? This doesn't seem right to me.

 

[DesertMedic66]

Yes. All you are looking at is if it is to fast, to slow, or regular. The actual number should be obtained when you are taking vital signs (later in the assessment)

 

[benasack2000]

Yes. All you are looking at is if it is to fast, to slow, or regular. The actual number should be obtained when you are taking vital signs (later in the assessment)

Thank you!

 

[avdrummerboy]

It is correct, the initial assessment is just a quick glance at the patient to see what is obviously going on. All you really need is that they do indeed have a pulse and are breathing, no need yet for rate.

 

[Akulahawk]

Exactly. The initial assessment is done mostly to see if the patient is alive and if there are any immediate and obvious life threats. Once you get practiced at it, you might be amazed what you can pick up on in less than 10 seconds...

 

[wadford]

The initial assessment is basically to determine priority. What you see, hear, smell. All of these things help you to determine if you need to get that patient on your cot and go, or if you have a bit more time to sit and talk with them and see what's going on. Some cases, you'll have a patient who is stable, but the environment may not be conducive to getting all of the right information, so you get them in your truck and try to make them feel safe. Some cases will require you to both manage the scene (family members, bystanders) and assess your patient. Like Akulahawk said, once you get practiced at it, it will become second nature, so much so that you'll find yourself doing it even when you aren't on shift.

 

[epicEMT]

The main focus of the initial assessment is to find and fix immediate life threats first.

 

[Rick Tresnak]

Yes back in the day we called it the 4 foot assessment, then primary assessment now initial assessment. Your secondary assessment is when you dig in and figure those things out.