vitals

billycorgi

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Hello,
When is it best to take vitals from a patient that needs to be boarded. Before you log roll them on to the board and secure them or after you get them on the board and in to the ambulance?
 

DrankTheKoolaid

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Lots of variables here. It truly is situationally dependent
 

Akulahawk

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I usually get vitals when the opportunity presents itself. Could be before or after they're on the board... or even when they've been loaded into the ambulance...
 

TheLocalMedic

Grumpy Badger
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If it's a trauma, why would you waste time getting vitals on scene? We can't fix trauma, so let's not waste time by checking blood pressures instead of transporting. Taking a pulse isn't fixing their injuries...
 

DesertMedic66

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Lots of variables here. It truly is situationally dependent
I usually get vitals when the opportunity presents itself. Could be before or after they're on the board... or even when they've been loaded into the ambulance...
These.

There is no one answer. It all depends on what is going on. Generally we have enough providers on scene (fire=3-5 ambulance=2-4) to get it done without wasting time.
 

Household6

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For a trauma and medical, primary assessment comes first, then secondary assessment, then vitals. You do your ABCs, treat life threats, load and go, then only if you're able to take the time to document vitals --only if taking those vitals does NOT impede your ABC interventions do you take vitals..

For example, if you're applying pressure on an arterial bleed, you're going to concentrate on that. That's the "C" part of ABCs. If you're providing ventilations, do that, that's your "B". If you have a pt who can't control their airway, you worry about the airway-- "A"...

These are what I go off:
Medical assessment

Trauma assessment
 

DesertMedic66

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For a trauma and medical, primary assessment comes first, then secondary assessment, then vitals. You do your ABCs, treat life threats, load and go, then only if you're able to take the time to document vitals --only if taking those vitals does NOT impede your ABC interventions do you take vitals..

For example, if you're applying pressure on an arterial bleed, you're going to concentrate on that. That's the "C" part of ABCs. If you're providing ventilations, do that, that's your "B". If you have a pt who can't control their airway, you worry about the airway-- "A"...

These are what I go off:
Medical assessment

Trauma assessment
That's great for a textbook or NREMT assessment and treatment. However real life calls are very different. Vitals can be incorporated into pretty much any part of the assessment.

For patients who are not breathing we still get vitals on them.
 

Household6

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That's great for a textbook or NREMT assessment and treatment. However real life calls are very different. Vitals can be incorporated into pretty much any part of the assessment.

For patients who are not breathing we still get vitals on them.
I think there's a difference between checking vitals and taking vitals, kwim? I'm not going to stop bagging to take 30 seconds worth of pulse or take a BP. Sure you CHECK vitals ---pulse? yes, there it is.. Same with breathing --look for even chest rise, listen for nasty things, feel for flail, then move on..

I think I'd get in trouble if I put a cuff on a busted humerus because I didn't do a proper secondary assessment of extremities.

I'm just assuming the OP is referring to a trauma pt because of the backboard..
 

Strap

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For a trauma and medical, primary assessment comes first, then secondary assessment, then vitals...
Having recently completed Advanced EMT, I was about to use my "advanced" knowledge to tell you you were wrong about the order of secondary assessment vs. vitals on trauma assessment, at least as far as NREMT is concerned. :)

But then I looked at the skill sheets on their website. For EMR and EMT trauma assessment, vitals comes AFTER secondary assessment. But for some reason, on the Advanced level (AEMT and Paramedic) skill sheets, vitals come BEFORE secondary assessment. That's weird...

EMR trauma assessment

EMT trauma assessment

Advanced level trauma assessment
 

DesertMedic66

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I think there's a difference between checking vitals and taking vitals, kwim? I'm not going to stop bagging to take 30 seconds worth of pulse or take a BP. Sure you CHECK vitals ---pulse? yes, there it is.. Same with breathing --look for even chest rise, listen for nasty things, feel for flail, then move on..

I think I'd get in trouble if I put a cuff on a busted humerus because I didn't do a proper secondary assessment of extremities.

I'm just assuming the OP is referring to a trauma pt because of the backboard..
The OP did not state anything about being the sole provider on scene.
 

TransportJockey

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Depends... if they are stable with an obvious fx (or displacement like hip), and the boarding is for *shudder* mechanism, I'll do vitals, a line, and pain meds before I get them into the truck. If it's for rapid extrication of an unstable patient (about the only real use for a LSB I can see) then I'll do it en route to the facility.
 

Akulahawk

EMT-P/ED RN
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I think there's a difference between checking vitals and taking vitals, kwim? I'm not going to stop bagging to take 30 seconds worth of pulse or take a BP. Sure you CHECK vitals ---pulse? yes, there it is.. Same with breathing --look for even chest rise, listen for nasty things, feel for flail, then move on..

I think I'd get in trouble if I put a cuff on a busted humerus because I didn't do a proper secondary assessment of extremities.

I'm just assuming the OP is referring to a trauma pt because of the backboard..
The OP did not state anything about being the sole provider on scene.
Here's the other "little" secret to getting things done on scene: Delegation. Will I check vitals? Sure. As part of my physical exam, I'm going to skin signs, location/character of pulses, resp rate (fast/slow/shallow/deep), and so on. While I'm doing something else that's necessary, I'll have someone get a set for me, at an appropriate time. In the meantime, I've probably figured out what else I need done or I'm working up a plan really darned fast based on what I've found so far.

It very well could be that the first time a set of vitals is taken is when I press the NIBP button on the monitor... at some point (literally) down the road. In that case, I've delegated the task to a machine...
 

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