Brady Emergency Care 12th Edition Chapter 11: Primary Assessment

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primary assessment
the portion of patient assessment that focuses only on life threats, specifically ABCs

2 terms that primary assessment are also known as
primary survey and initial assessment

if a patient shows signs of life, what order do you do ABCs?
ABCs

if a patient appears lifeless and has no pulse, what order do you do ABCs?
CAB

exsanguinating
very severe, life-threatening

how many parts make up a primary assessment?
6

what are the parts of primary assessment in order?
general impression
mental status/c-spine (when appropriate)
airway
breathing
circulation
priority

intervention
actions taken to correct or manage a patient’s problem

what do you do if you discover a life-threatening condition during primary assessment?
perform the appropriate intervention

general impression
first impression of the patient’s condition based off environment, chief complaint, and appearance

what are the 3 steps of airway in ABCs?
open the airway, suction if necessary, place an OPA or NPA if needed

what are the 3 steps of breathing in ABCs?
check for breathing
check to see if the breathing is adequate
check for hypoxia

what are the 3 steps of circulation in ABCs?
check for pulse
check the skin
check for life-threatening bleeding

after primary assessment, how would you handle a stable patient?
slower pace, more detailed secondary examination

after a primary assessment, how would you handle a potentially unstable patient?
expedite transport, fewer assessments and interventions

after a primary assessment, how would you handle an unstable patient?
rapid transport, only life-saving assessment and interventions on scene

what should you first do with a patient with suspected spinal injury?
apply manual stabilization of the head and neck

what can altered mental status indicate?
many underlying conditions such as hypoxia, shock, diabetes, overdose, or head trauma

how should you be concerned with altered mental status during primary assessment?
not with the cause, but with the impact it has on your patient

what are 3 indicators of possible shock?
anxiety, pallor, sweatiness

what can a patient in tripod position indicate?
significant difficulty breathing

Levine’s sign
the global position of heart attack; a fist clenched over the chest

chief complaint
the reason the EMS was called; usually in the patient’s own words

how is a general impression formed?
looking, listening, and smelling

clinical judgment
a judgment based on experience in observing and treating patients

mental status
a patient’s level of responsiveness

what does AVPU stand for?
alert, verbal response, painful response, unresponsive

ABCs
airway, breathing, and circulation

what do you do if a patient is in respiratory arrest?
perform rescue breathing

what do you do with a patient that is not alert and has inadequate breathing?
provide positive pressure ventilation with 100% oxygen

what do you do with a patient that is alert but has inadequate breathing?
assist ventilations with 100% oxygen, synchronizing ventilations to the patient’s to work together

what do you do with a patient that has adequate breathing but signs/symptoms of respiratory distress or hypoxia?
provide oxygen based on patient’s need as determined by examination, patient’s complaint, and pulse oximetry readings

how can chest injury affect the patient?
reduce the rate and depth of breathing, and functioning of lungs

flail chest
multiple broken ribs

how long do you take a pulse?
30 seconds, then multiply by two

priority
the decision regarding need for immediate transport vs further assessment and care at the scene

how do you classify a stable patient?
normal or slightly abnormal range vital signs
a stable airway
no immediate life-threats

how do you classify an unstable patient?
one with no immediate life-threats but may deteriorate over time due to the nature of their problem

what indicates a high priority transport?
conditions in which there is usually little or no treatment that can be given in the field and will make a difference in the patient’s well-being

give 5 examples of high priority conditions
poor general impression
unresponsive
shock
uncontrolled bleeding
severe pain anywhere

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