PATIENT ASSESSMENT

LEARNING OBJECTIVES

Understand the purpose of the scene size-up in

patient assessment
Identify immediate life threats and recognize the
need for immediate transport
Define and describe techniques to determine the
Chief Complaint
Understand the use of vital signs as a measure of
the patients health status
Distinguish the need for a full-body scan or
focused assessment

PREHOSPITAL EMERGENCY
CARE

Patient assessment is the basis for

decisions regarding treatment and
transport
Every patient you encounter will require
some form of assessment

PATIENT ASSESSMENT
PROCESS
Scene Size-Up
Primary Assessment
History Taking
Secondary Assessment
Reassessment

PATIENT ASSESSMENT

Scene Size-Up
Ensure scene safety
Determine mechanism of injury or nature
of illness
Take standard precautions
Determine number of patients
Consider additional/specialized resources
Primary Assessment
History Taking
Secondary Assessment
Reassessment

WHAT IS THE SCENE SIZE-UP?

An ongoing assessment of the
scene and surroundings that will
provide you with information about
scene safety

SCENE SAFETY

Is it safe to approach the patient?

If the scene is not safe, can it quickly be
made safe?
Are additional resources necessary?

POTENTIAL HAZARDS: OVERVIEW

CRASH OR RESCUE SCENES

Roger Nomer/AP (http://www.cbc.ca/gfx/images/news/photos/2008/05/10/wideshot-usweather-cp-23311.jpg)

UNSTABLE SURFACES: SLOPES, ICE,

WATER

CRIME SCENES AND VIOLENCE

TOXIC SUBSTANCES OR
HAZMAT

ENVIRONMENTAL
CONSIDERATIONS

ACTIONS FOR PROTECTION

MOI AND NOI

Consider Mechanism of Injury (MOI) or

Nature of Illness (NOI) to predict the
extent of injury or cause of illness

MECHANISM OF INJURY

The physical event that caused an injury

E.g. Fall, motor vehicle accident

Consider

Amount of force applied to the body

Length of time force was applied
Area(s) of body involved

NATURE OF ILLNESS

The medical condition or complaint

causing suffering

E.g. Chest pain, abdominal pain, difficulty

breathing, etc.

Consider

The patients symptoms

The patients medical history
The patients surroundings

STANDARD PRECAUTIONS

Always remember to take appropriate

precautions to assure your own safety!

BODY SUBSTANCE ISOLATION

Nitrile or vinyl gloves should always be

worn during patient contact
Eye protection should be used if
splattering is possible
Mask and gown should be used as
needed

GLOVES

MASK AND EYE PROTECTION

RESPIRATOR MASK

GOWN

NUMBER OF PATIENTS

Identify how many

patients require care
More than one
seriously ill or injured
patient will require
additional resources
For multiple patients,
triage is used to
determine who is in
greatest need

ADEQUACY OF RESOURCES

Number of patients?
ALS or air medical support?
Hazardous materials?
Fire or rescue?
Unusual or violent situations?
Contact additional resources before
beginning your assessment

REVIEW

List potential hazards you may find at the

scene and the appropriate additional
resources you would request for each
Describe a situation that would require:
gloves, goggles, gown, mask, HEPA
respirator
Explain the difference between MOI and
NOI

PATIENT ASSESSMENT
Scene Size-Up

Primary Assessment
Form a general impression
Assess level of consciousness
Assess the AIRWAY; identify and treat life threats
Assess BREATHING; identify and treat life threats
Assess CIRCULATION; identify and treat life threats
Perform rapid scan
Determine priority of patient care and transport
History Taking
Secondary Assessment
Reassessment

GENERAL IMPRESSION

Age, Sex, Race

Level of distress

Good, bad, ugly?

Overall appearance

Need for spinal

immobilization?

ASSESSING LEVEL OF
CONSCIOUSNESS

Responsiveness

Alertness and response to external stimuli

Orientation

Thought process and memory function

ASSESS RESPONSIVENESS
AVPU
Alert
Not alert but responds to:
Verbal stimulus
Painful stimulus
Unresponsive

MENTAL STATUS: ALERT

MENTAL STATUS: VERBAL STIMULUS

MENTAL STATUS: PAINFUL

STIMULUS
Pinch the earlobe

Or the neck muscles

RESPONSE TO STIMULI

Response to questions or commands may

be APPROPRIATE or INAPPROPRIATE
Response to painful stimulus:

Normal is to withdraw from pain

Abnormal: Decorticate: Flexion of arms
toward the core - into the body
Abnormal: Decerebrate: Extension of arms &
legs outward from body

MENTAL STATUS:
UNRESPONSIVE

ORIENTATION
1.

Person
Tells you his/her name

2.

Place
Identifies location

3.

Time
Year, month, approximate date

4.

Event
MOI/NOI, what happened

ASSESS THE AIRWAY

Patent

Open and maintained by the patient

Patient is responsive, speaking

Potentially obstructed

Obvious trauma or other obstruction

Noisy or absent breathing
Patient is unresponsive

OPEN AND MAINTAIN AIRWAY

Head-Tilt Chin Lift

Modified Jaw Thrust

ASSESS BREATHING

LOOK, LISTEN & FEEL

Rate,
Rhythm,
Quality
Breath and
Lung
Sounds
Injuries

BREATH SOUNDS
Mid-clavicular

Mid-axillary

BREATHING

Give high-concentration oxygen if:

Respirations are adequate but faster than

24/minute or slower than 8/minute
Patient has difficulty breathing
Patient shows signs of hypoxia

Assist with ventilations if:

Patient is unable to breathe adequately

Patient has injuries to the chest

ASSESS CIRCULATION

Pulse
Bleeding
Skin

CHECK PULSE
Conscious: Radial Pulse

Unresponsive: Carotid Pulse

INFANTS: CHECK BRACHIAL

PULSE

CHECK SKIN

Color
Temperature
Moisture

INFANTS/CHILDREN: CAPILLARY
REFILL

CAPILLARY REFILL

IDENTIFY EXTERNAL BLEEDING

CONTROL SEVERE BLEEDING

(CHECK FOR DISABILITY)

If the patient has altered mental status,

perform a brief neurological exam:

Pupils
CSMs
Posturing

ASSESSING PUPILS

Normal pupils are

PERRL
Pupils
Equal
Round
Regular in size
Reactive to Light

ABNORMAL PUPIL CONDITIONS

CIRCULATION, SENSATION,
MOVEMENT

CSMs are used to test distal perfusion and

neurological function

Is there blood flow distal to an injury?

Are sensory and motor functions intact?

CIRCULATION

CIRCULATION

ASSESS SENSATION IN ALL

EXTREMITIES

ASSESS MOTOR FUNCTION

STRENGTH & EQUALITY OF GRIP

ASSESS STRENGTH & MOTION

POSTURING

http://www.paramedicine.com/pmc/AVPU_files/droppedImage.jpg

RAPID SCAN

Quickly assess the patient to identify

injuries that must be managed or
protected immediately
Use the mnemonic DCAP-BTLS to recall
the kinds of injuries you may find

DEFORMITIES

CONTUSIONS

ABRASIONS

PUNCTURES/PENETRATIONS

BURNS

TENDERNESS

LACERATIONS

SWELLING

RAPID SCAN

Treat any life threatening injuries as you

find them

Airway/Breathing compromise
Uncontrolled bleeding
Unstable injuries

Scanning should take no more than

90 seconds

CHECK HEAD, HOLD C-SPINE

NECK

SIZE AND APPLY C-COLLAR

CHEST

ABDOMEN

PELVIS

LEGS, THEN ARMS

LOG-ROLL, CHECK BACK

TRANSPORT DECISION

What priority is the patient?

When will you go?
How should the patient go?
Where are you going?
Who is going with you?

THE GOLDEN PERIOD

REVIEW

List the steps of the primary assessment

Explain how to assess a patients level of
responsiveness using AVPU
Explain how to assess airway, breathing,
and circulation during the primary
assessment
Describe how to identify priority patients

PATIENT ASSESSMENT
Scene Size-Up
Primary Assessment

History Taking
Investigate the chief complaint
(History of Present Illness)
Obtain SAMPLE history
Secondary Assessment
Reassessment

HISTORY TAKING

SAMPLE

Signs/Symptoms
Allergies
Medications
Pertinent past medical history
Last oral intake
Events leading up to the injury/illness

SIGNS & SYMPTOMS

Signs are objective

Cyanosis, dilated pupils

Symptoms are subjective

I think Im going to throw up

I cant feel my feet

CHIEF COMPLAINT

Ask whats wrong? or what happened?

Usually the symptom bothering the patient

most is the Chief Complaint

Record in the patients own words

Im having chest pain.

OPQRST

History of Present Illness can be assessed

using the mnemonic:

Onset
Provocation/Palliation
Quality
Region/Radiation
Severity
Time

HISTORY OF PRESENT
ILLNESS

Onset

How did the problem start, gradually or

rapidly?

HISTORY OF PRESENT
ILLNESS

Provocation/Palliation

What makes the problem better or worse?

How are you most comfortable?

HISTORY OF PRESENT
ILLNESS

Quality

Describe what you are feeling.

Ex. Aching, burning, weakness, etc.

HISTORY OF PRESENT
ILLNESS

Region/Radiation

Where is the pain?

Does the pain move or hurt anywhere else?
Point to where the pain is worst.

HISTORY OF PRESENT
ILLNESS

Severity

How much does it hurt?

HISTORY OF PRESENT
ILLNESS

Time

How long have you had this problem?

Has this happened before?

What was it then?

What was done?

COMMON COMPLAINTS

Loss of Consciousness
Shortness of Breath
Chest Pain
Headache/Dizziness/Tingling/Weakness
Nausea/Vomiting/Diarrhea
Pain

PERTINENT NEGATIVES

Chief complaints often have associated

signs and symptoms
If the patient does not have these signs
and symptoms, they are pertinent
negatives

A patient has sub-sternal chest pain, but has

pink, warm, dry skin and denies radiating pain

ALLERGIES

Are you allergic to

anything?

Medications
Food
Environmental factors:
pollen, bees

What has happens

when you are
exposed to _____?

MEDICATIONS

What medications do
you take?
What are they for?

Prescription, Over-thecounter (OTC), Herbal,

Recreational

Have you taken them

as prescribed?
Have there have been
any recent changes?

PERTINENT PAST MEDICAL HISTORY

What medical
problems do you
have?
The patient may be
unable to give you an
accurate history

LAST ORAL INTAKE

What is the last thing you ate or drank?

When was that?

EVENTS LEADING TO THE PROBLEM

What were you doing when this started?

What do you think happened?

SENSITIVE TOPICS

Alcohol and drug use

Sexual history
Physical abuse and
violence

CHALLENGES TO
COMMUNICATION

Silent or overly talkative patients

Multiple symptoms or confusing history
Anxiety, anger, hostility, crying
Depression

CHALLENGES TO
COMMUNICATION

Impairments: Hearing, seeing, learning,

intoxication
Language barriers

REVIEW

Explain the purpose of the History of

Present Illness as it relates to the Chief
Complaint
List appropriate questions to ask patients
for each part of SAMPLE
Discuss challenges to communication,
and techniques to overcome them

PATIENT ASSESSMENT
Scene Size-Up
Primary Assessment
History Taking

Secondary Assessment
Assess vital signs using the appropriate
monitoring device
Systematically assess the patient
Full-body scan and/or Focused assessment
Reassessment

VITAL SIGNS

Key indicators used to evaluate patients

condition
Reflect changes in respiratory, circulatory,
and central nervous systems
The first complete set is called baseline
vitals

COMMON PREFIXES

A- (an-) not, without,

lacking, deficient
Dys- bad, difficult,
abnormal, incomplete
Hypo- below normal,
deficient, under,
beneath
Brady- slow

Bi- (di-) two, twice,

double, both

Hyper- above normal,

excessive

Tachy- fast

COMMON SUFFIXES

-cardia: Heart
-itis: Inflammation
-oxia: Oxygen
-pnea: Breath, breathing
-stasis: Stopping, controlling
-tension: Physiological stress or pressure

VITAL SIGNS

Respirations
Breath Sounds/Lung Sounds
Pulse
Skin
Blood Pressure
Pupils
*Oxygen saturation

ASSESSING RESPIRATIONS

Assess breathing by:

Observing a patients chest rise and fall

Feeling air be expelled
Listening to breath sounds and lung sounds
with a stethoscope

Chest rise and breath sounds should be

equal on both sides of the chest
E.g. Diminished Breath Sounds

RESPIRATORY RATE

Count the number in

respirations in a 30
second period and
multiply by 2
Count for 60 seconds
with irregular
breathing
Dont let the alert
patient know you are
counting!

NORMAL RESPIRATORY RATES

AGE

RANGE

Adults

12 20 breaths/min

Children

15 30 breaths/min

Infants

25 50 breaths/min

RESPIRATION RHYTHM

Irregular frequent variations and

changes in breathing interval
Regular breathing is consistent
Record when respirations are regular or
irregular

RESPIRATION QUALITY EFFORT

Normal breathing is
effortless
Labored breathing

Choppy speech
Patient position:
sniffing or tripod
Pursed lips, nasal
flaring
Accessory muscle use
Retractions

RESPIRATION QUALITY
NOISE

Normal breath sounds (by ausculation)

Air movement through bronchi

Soft, low-pitched murmur-like sound

Other sounds indicate a significant

problem
Fully obstructed airway

Wont make any sounds

BREATH SOUNDS

Assess with stethoscope

Midclavicular
Midaxilary
Check side to side for comparison

Determine whether or not air is moving in

the lungs
Are the sounds present and equal?

LUNG SOUNDS

Assess with stethoscope

Measure side to side at upper, middle, lower

fields (6 locations front or back)

Determine the quality of the air movement

Check for abnormal sounds

NOISY RESPIRATIONS

Bubbling or gurgling

Stridor

Fluid in the airway (suction!)

High-pitched crowing sound
Indicates partial upper airway obstruction

Wheezes and snoring

OTHER LUNG SOUNDS

Bone Crepitus
Crackles

Coarse (Rhonchi) inspiratory and expiratory

crackles
Fine (Rales) inspiratory crackles
Medium inspiratory and expiratory crackles
Medium inspiratory crackles with severe
expiratory wheezes

Subcutaneous Emphysema

RESPIRATION QUALITY
DEPTH

Air exchange during respiration depends

on respiratory rate and tidal volume
Breath depth (chest excursion) determines
whether tidal volume is:

Normal
Less than normal (shallow)
Greater than normal (deep)

INADEQUATE BREATHING

Rate:

Tachypnea: rapid respirations

Hyperpnea: abnormally rapid or deep breathing

Rhythm: May be irregular

Depth/Quality: Too shallow or too much effort

Dyspnea: shortness of breath or difficulty

breathing
Apnea: absence of breathing

ABNORMAL RESPIRATIONS

Cheyne Stokes Respiration

Biots Respiration
Kussmaul
Hyperpnea
Apneustic

CHEYNE-STOKES
RESPIRATION

Gradual increases and decreases in respirations

with periods of apnea

BIOTS RESIPIRATION

Abnormal pattern of rapid, shallow

inspirations (gasps) followed by regular or
irregular periods of apnea
Poor prognosis

KUSSMAUL RESPIRATION

Rapid, deep, and labored breathing, also

called "air hunger"
The patient feels an urge to breathe deeply,
and it appears almost involuntary

HYPERPNEA

Faster or deeper (hyper) breathing than

necessary, reducing the carbon dioxide
concentration of the blood below normal

APNEUSTIC RESPIRATION

Abnormal pattern of breathing

characterized by deep, gasping inspiration
with a pause at full inspiration followed by
a brief, insufficient expiration
Poor prognosis

PULSE

Pulse is the pressure wave that occurs

when the left ventricle contracts, sending a
surge of blood through the arteries
Most easily felt where major arteries lie
near the surface of the skin and against a
bone or other rigid structure

PALPATING THE RADIAL PULSE

Place index and

middle finger against
the radius near the
wrist
The radial artery lies
against the radius
Press gently against
the artery
Do not palpate with
your thumb

PALPATING THE CAROTID

PULSE

Place the tips of the

index and middle fingers
on the trachea
Slide fingers towards
yourself until you find the
groove lateral to the
trachea
Use gentle pressure
Dont press on both
sides of the neck
simultaneously

PALPATING THE BRACHIAL PULSE

Located at the underside

of the upper arm
Elevate the infants arm
over his or her head
The brachial artery lies
along the humerus
below the biceps
Press fingertips firmly to
palpate the brachial
artery

DETERMINING PULSE RATE

Count number of
pulses felt in 30 sec
and multiply by 2
Weak, irregular, or
extremely slow pulses
should be counted for
a full minute

AVERAGE PULSE RATES

Adult 60 100 bpm

Children 80 120 bpm
Toddlers 90 150 bpm
Newborns 120 160 bpm

QUALITY OF THE PULSE

Regularity (Rhythm)

Pulse should occur at a constant, regular

rhythm
Many elderly patients have irregular pulses

Strength (Quality)

Stronger than normal pulse is bounding

Faint or difficult to feel pulse is weak or
thready

SKIN

An easily observed indicator of

Peripheral circulation and perfusion

Blood oxygen levels
Body temperature

ASSESSING THE SKIN

Color
Temperature
Condition

ASSESSING SKIN COLOR

Pigmentation may hide changes in the

skins underlying color
Assess perfusion at the

Fingernail beds
Mucous membranes in the mouth, the lips
Underside of the arm and hand
The conjunctiva of the eye

SKIN COLORS

Bluish gray color:

cyanosis

Flushed (red) skin: heat

illness

Signs of poor peripheral

circulation or Low
oxygenation

Can indicate other injuries

Yellow/orange: jaundice

Liver disease or
dysfunction

ASSESSING SKIN
TEMPERATURE

Feel the patients skin at the core

Normal skin is warm to the touch
Abnormal skin will be cold, cool, or hot

http://www.electronichealing.co.uk/resources/image/far-infrared-scan.jpg

SKIN CONDITION

Normal moisture is dry

Abnormal condition

Diaphoretic
Moist
Excessively dry

BLOOD PRESSURE

Systolic pressure (max)

Diastolic pressure (min)

pressure produced by the contraction of the

ventricles (Systole)
pressure remaining in arteries while the heart is
relaxing and refilling (Diastole)

Blood pressure is measured in millimeters

of mercury (mmHg)
Reported as a fraction (systolic / diastolic)

BLOOD PRESSURE AND PULSE

The minimum systolic blood pressure can be

estimated using distal pulses

Radial Pulse
Femoral Pulse
Carotid Pulse

Systolic BP > 80 mmHg

Systolic BP > 70 mmHg
Systolic BP > 60 mmHg

SPHYGMOMANOMETER

A BP cuff contains the

following:

Wide outer cuff to

fasten around arm/leg
A bladder sewn into
the cuff
A ball-pump and turnvalve that can be
closed

THREE SIZES OF BP CUFFS:

XL, normal, small

Use the appropriate
size cuff

If too small, readings

might be falsely high
If too large, readings
might be falsely low
Size is based on width
of cuff (not length)

TECHNIQUES FOR
MEASUREMENT
Palpation

Auscultation

APPLY CUFF

Extend patients arm

and place the cuff
with distal end at least
1 proximal to the
elbow
Secure Cuff

AUSCULATATION

Palpate the arm to

find the brachial pulse
This is where you will
auscultate

AUSCULTATION

Place stethoscope
over artery

If stethoscope has a
bell, use that side

Use as little pressure

as possible to hold
the stethoscope
against the arm

AUSCULTATION

Close valve
Inflate cuff until
sounds are no longer
heard

Sounds will not be

heard until cuff is
partly inflated

Inflate an additional
30 mmHg

AUSCULTATION

Slowly deflate the cuff

Note pressure at
which tapping or
whooshing sound
returns (systolic) and
then stops (diastolic)
Once sound has
stopped quickly
deflate cuff

PALPATION

Place fingertips on
radial artery and feel
the radial pulse
Inflate cuff 30mmHg
past point where
pulse disappears
Slowly release air
until pulse is felt
(record systolic
pressure)

NORMAL RANGES OF BLOOD

PRESSURE
AGE
Adults

RANGE
100 140 mmHg (systolic)
60 90 mmHg (diastolic)

Children (1 8 years) 80 110 mmHg (systolic)

Infants (Up to age 1)

60 mmHg (systolic)

HYPERTENSION

Elevated BP may indicate:

Stress
Chronic hypertension
Severe head injury
Increased risk for stroke or cardiac emergency

The body can attempt to reduce BP by:

Decreasing heart rate

Dilating the arteries
Dilating blood vessels in the skin and periphery
Increasing urine output

HYPOTENSION

A drop in BP may indicate:

Loss of blood
Loss of vessel tone
Cardiac pumping problem
Decrease in perfusion

The body can attempt to elevate BP by:

Increasing the heart rate

Constricting the arteries
Shunting blood away from the skin and periphery
Decreasing urine output

DECOMPENSATION

The bodys response mechanisms can no

longer maintain blood pressure
A drop in blood pressure is a late sign and
indicates a need for supportive treatment

ORTHOSTATIC BLOOD
PRESSURE

Indicates bodys ability to compensate for

postural change
Take BP in the supine, seated, and standing
positions

Take pressure within 60 seconds of posture

change

Measurements should not change more than

20 mmHg systolic/10mm diastolic

10 beats per minute

LIMB CONSIDERATIONS

Injured limbs

Do not assess BP, pulse, skin temperature, or

capillary refill on an injured limb for vital sign
purposes
Obtain vital signs on the uninjured side
Compare vitals found on uninjured side to
injured side
Useful in evaluating whether the injured side
has compromised circulation

PUPILS

Normal pupils are

PERRL
Pupils
Equal
Round
Regular in size
Reactive to Light

ABNORMAL PUPIL CONDITIONS

Pinpoint pupils

Blown pupil

Constricted very small

Common with opiate use
Fully dilated and
unresponsive to light

Medication, injury, or
condition of the eye
may cause unequal
dilation or non-reaction

SPECIAL CONDITIONS

Anisocoria

Unequal pupil size

Can indicate a normal
physiological
difference or a range
of abnormal conditions

Glass eye

PULSE OXIMETRY*

Pulse oximeters
measure the
oxygenation of the blood
They can show the
effectiveness of
breathing or of
interventions on
oxygenation
Reported values can be
misleading

END-TIDAL CARBON DIOXIDE**

Measures carbon
dioxide released
during respiration to
measure ventilatory
status and
metabolism
Colorimetric devices
change color in
contact with CO2
http://www.ariamedical.com/

REASSESSMENT OF VITAL
SIGNS

Monitor for changes during care

Every 15 minutes in stable patient
Every 5 minutes in unstable patient
After every medical intervention
Record the time for each set

PHYSICAL ASSESSMENT

Full-body Scan

Systematic examination of the entire body

Identify injuries not found during rapid scan

Focused Assessment:

Assess based upon the patients chief

complaint
Anatomic region or system-based
assessment

FULL-BODY SCAN

The full-body scan assesses all the areas

of the rapid scan with additional detail
Use DCAP-BLTS to identify kinds of
injuries
Treat injuries as you find them

HEAD

CHECK EYES

CHECK PUPILS

CHECK BEHIND EARS

CHECK EARS FOR DRAINAGE

HALO TEST

Fold gauze in half and in

half again
Place corner of gauze in
fluid
Open and wait a few
minutes for result
Positive halo test will
create a ring that
resembles a bullseye, a
light yellow-colored fluid
will surround the spot of
blood

PALPATE HEAD

PALPATE FACIAL BONES

Zygomas

Maxillae

CHECK NOSTRILS

CHECK MANDIBLE

CHECK MOUTH

CHECK NECK

PALPATE CERVICAL SPINE

INSPECT THE CHEST

PALPATE THE CHEST

CHECK BREATH SOUNDS

PALPATE THE ABDOMEN

CHECK THE PELVIS

CHECK THE PELVIS AND

GENITALIA

CHECK ALL EXTREMITIES

CHECK THE BACK

CHECK LUNG SOUNDS

FOCUSED ASSESSMENT
Systems

Respiratory
Cardiovascular
Neurologic
Musculoskeletal

Anatomical Regions

Head and Neck

Chest
Abdomen
Pelvis and Genitalia
Extremities

FOCUSED ASSESSMENT:
RESPIRATORY

Check chest for

trauma and equal
expansion
Listen to breath and
lung sounds
Assess skin, pulse,
and blood pressure

FOCUSED ASSESSMENT:
CARDIOVASCULAR

Check chest for

trauma
Check skin, pulse,
and blood pressure
Compare distal
pulses
Assess any sites of
radiating pain

FOCUSED ASSESSMENT:
NEUROLOGIC

Check level of
consciousness,
pupils, CSMs
Perform the
Massachusetts Stroke
Scale (MASS)
Check grip strength
Check for unusual
odors on the breath

GLASGOW COMA SCALE

Assessment based on numeric scoring of a

patients response base on eye opening, verbal
response, and motor response

REVIEW

List normal findings for each vital sign

Describe the steps of a full-body scan
Discuss some common complaints and
the focused assessment that would be
appropriate for each

PATIENT ASSESSMENT
Scene Size-Up
Primary Assessment
History Taking
Secondary Assessment

Reassessment
Repeat the primary assessment
Reassess vital signs
Reassess the chief complaint
Recheck interventions
Identify and treat changes in the patients condition
Reassess patient
Unstable patients: every 5 minutes
Stable patients: every 15 minutes

REASSESSMENT CYCLE
Recheck Interventions

Are treatments working?

Are devices stable and secure?

Repeat Primary
Assessment

Reassess Chief Complaint

Reassess Vital Signs

Is treatment improving the patients

condition?
Is the patients condition changing?
Are there new problems?

Compare baseline vitals

Look for trends
Unstable 5 minutes
Stable 15 minutes

REVIEW

Explain the difference between a stable

and an unstable patient
Explain how the EMT should evaluate the
patients condition
Explain how the EMT should evaluate
interventions