Patient Assessment E R C

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Emergency Medicine - 2009

Transcript of Patient Assessment E R C

Page 1: Patient Assessment E R C

Emergency Medicine - 2009

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Patient Assessment in Emergency Medicine

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Patient Assessment: Overview

General approach: Look, listen, feel, smell

(Inspection, Auscultation, Palpation, Olfaction)

Priorities: • Airway• Breathing• Circulation

History and exam

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Focused History

S: Symptoms

A: Allergies

M: Medications

P: Pertinent past medical history

L: Last oral intake

E: Events

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More details of Chief Complaint

O: Onset P: ProvocationQ: QualityR: RegionR: Radiation (of pain)R: Relieving factorsS: SeverityT:Time

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Examination

Primary Survey:

Airway: Open airway? Snoring? Struggling?

Breathing: Is patient breathing, in distress?

Circulation: Pulse present? Active bleeding? Skin perfusion?

Disability: Unresponsive? Paralyzed?

Major deficits?

Exposure: Remove or look under clothes

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Level of Consciousness

A: Alert

V: responds to Verbal stimuli

P: responds to Painful stimuli

U: Unresponsive

Alternative descriptions: Lethargic, obtunded, stuporous, comatose Glasgow Coma Scale

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Examination

Secondary Survey: History Vital signs:

Pulse rate, quality, location

Respiratory rate and effort

Blood pressure

Temperature

Head-to-toe quick exam

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Physical Exam Clues

Pulse:Rapid, full Early bleeding, fear, fever,

exercise, high BPRapid, weak Shock, allergic reaction,

failing heart, dehydrationSlow Airway problem, brain injury,

drug overdose, strokeIrregular Cardiac arrhythmia,

ischemiaNo pulse Cardiac arrest

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Physical Exam Clues

Skin:Cool, damp Shock, hemorrhage,

hypoglycemia, allergic rxnCold, dry Exposure to coldHot, wet Infection

Heat exposure / heat strokeHot, dry Heat stroke, infection,

some drug overdosesFlushed Infection, drugs, heat exposureBlue (cyanotic) Hypoxia—check A & B

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Physical Exam Clues

Pupils:Dilated, reactive Stimulant drugs

FearDilated, fixed Brain death

Atropine / eye dropsConstricted Narcotics

Pontine strokeUnequal CNS catastrophe

CongenitalGlass eye!

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Reassess the patient…

Symptoms: What patient tells you

Signs: What you find on exam

Serial exams are crucial!

Reassess patient after each intervention, and recheck vital signs every 5-10 min.

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Assessment and Patient Pathways

Assessment and Patient Pathways

Patient Health Assessment

Patient Health Assessment

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Assessment of aggressive patient

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Trauma Patient Assessment

Trauma Patient Assessment

Assessment of the Patient

Assessment of the Patient

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Reviving Your Patient Assessment - Dan Limmerdanlimmer.com/handouts/Revising Patient Assessment.pdf1 Reviving Your Patient Assessment Daniel Limmer, EMT-P Goals •Define early assessment

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Patient risk assessment Periodontal Diseases Patient risk assessment … › contentassets › 2ec6cb58e49846aebbe9f... · 2018-12-17 · Patient risk assessment Periodontal diseases

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