practical retest patient assessment

[M4st3rkr0n]

Hey I have my retest for the patient assessment in a couple weeks and I just want to see if I can do this from memory please correct any mistakes I might make

scene safety, BSI, Call for extra assistance if needed
have partner hold manual stabilization of spine
assess patients level of alertness (AVPU)
assess patients airway (make sure airway is patent)
assess patients breathing (check for adequate tidal and volume) if inadequate proceed with proper O2 intervention most likely NRB 15lpm
assess patients circulation (check carotid & radial for rate and rhythm) check skin colour temp and condition
control any major bleeding
and determine priority of patient and make transport decision

decide on assessment (focused or rapid)
collect baseline vital signs HR RR BP
collect SAMPLE history
S IGNS SYMPTOMS
A LLERGIES
M EDICATION
P AST MEDICAL HISTORY
L AST ORAL INTAKE
E VENTS LEADING UP TO

Begin detailed physical exam
HEAD - palpate scalp for DCAP-BTLS inspect ears for bleeding or fluid, inspect eyes for PEARL, inspect face including oral and nasal passages for DCAP-BTLS
NECK - inspect and palpate neck for DCAP-BTLS, check for JVD, assess for tracheal deviation
CHEST - inspect and palpate for DCAP-BTLS, auscultate lung sounds, use four person log roll count of 3 roll patient towards me and inspect patients back for DCAP-BTLS and auscultate lung sounds using four person log roll on count of 3 roll patient back
ABDOMEN and PELVIS - palpate in four quadrants to assess abdomen for pain swelling of distention, assess genitallia bloody discharge in females perpritism in males
EXTREMITIES - assess for DCAP-BTLS and asses patients motor, sensory, and circulation

manage any secondary injuries

reassess vitals every 5mins for unstable patients every 15mins for stable

TRANSPORT

so please tell me how i did and if i missed anything please be as hard as you can when picking this apart I want to know the smallest thing I might have did wrong. I am taking my test in MASS if that has any bearing on protocols. thanks and wish me luck

 

[Handsome Robb]

For testing purposes you're missing MOI/NOI and number of patients.

That's all I saw but I also just got my *** handed to me on shift and had a few beers when I got off work so take it with a grain of salt.

Assuming this is a trauma assessment otherwise you'd be missing OPQRST as well.

 

[leoemt]

Is this a medical or trauma assessment? There are slight differences in the two. Regardless MOI / NOI is going to determine your need for C-spine. That should be part of your general impression. Don't be afraid to ask the patient if their neck hurts. If they have no neck pain and MOI / NOI doesn't indicate then don't worry about C-spine.

Also, ask the pt if their abdomen hurts. If it does palpate the painful quadrant last and start in the quadrant furthest away from the pain.

Where I work we do a physical exam on every patient.

 

[M4st3rkr0n]

For testing purposes you're missing MOI/NOI and number of patients.

That's all I saw but I also just got my *** handed to me on shift and had a few beers when I got off work so take it with a grain of salt.

Assuming this is a trauma assessment otherwise you'd be missing OPQRST as well.

nope this is just trauma i am going to do medical at work tonight i want to have people pick apart both my assessments one at a time I do not want a repeat of my last deer in headlights moment I had my last test. Now about the MOI/NOI do I verbalize that at start of test and have tester give me the info how would i work that into my script?

 

[M4st3rkr0n]

Is this a medical or trauma assessment? There are slight differences in the two. Regardless MOI / NOI is going to determine your need for C-spine. That should be part of your general impression. Don't be afraid to ask the patient if their neck hurts. If they have no neck pain and MOI / NOI doesn't indicate then don't worry about C-spine.

Also, ask the pt if their abdomen hurts. If it does palpate the painful quadrant last and start in the quadrant furthest away from the pain.

Where I work we do a physical exam on every patient.

this is just my script for my trauma assessment I am going to do the medical script tonight at work so I can have them both picked apart in detail. but could u just explain the general impression part a little do i Just ask the tester about the general impression of patient and have them tell me what i see. I know this is a weird question but I have a hard time visualizing a general impression on a person who is just a test subject with no real injuries. thats how i got hung up before I am the kind of person that if the problem is right in front of me and I can see it I can fix it but when I have someone telling me what I am suppose to see and its not really there i begin to forget steps that I would have normally performed if the person was really hurt.

 

[bigbaldguy]

Looks pretty good and creating a script is a very good idea.

 

[M4st3rkr0n]

Can anyone give me any idea what scenarios they might give me for the practical exam. My last one they gave me a chest pain for medical and pedestrian hit by car for trauma.

 

[Handsome Robb]

Nope. You need to be able to recognize the issue and correct it by yourself.

 

[M4st3rkr0n]

Nope. You need to be able to recognize the issue and correct it by yourself.

Ok understandable.

 

[M4st3rkr0n]

Posted MEDICAL ASSESSMENT SCRIPT here http://www.emtlife.com/showthread.php?t=32528