Primary Assessment

Primary Assessment

Information Covered:

  1. Primary Survey/Primary Assessment
    1. Initial General Impression – Based on the Patient’s Age-Appropriate Appearance
      1. Appears stable
      2. Appears stable but potentially unstable
      3. Appears unstable
    2. Level of Consciousness
      1. While approaching the patient or immediately upon patient contact attempt to establish level of consciousness
        1. Speak to the patient and determine the level of response
        2. EMT should identify himself or herself
        3. EMT should explain that he or she is there to help
      2. Patient response
        1. Alert
          1. the patient appears to be awake
          2. the patient acknowledges the presence of the EMT
        2. Responds to verbal stimuli
          1. the patient opens his/her eyes in respond to the EMT’s voice
          2. the patient responds appropriately to a simple command
        3. Responds to painful stimuli
          1. the patient neither acknowledges the presence of the EMT nor responds to loud voice
          2. patient responds only when the EMT applies some form of irritating stimulus
            1. when an irritating stimulus is encountered, the human body will either attempt to move away from the stimulus or will attempt to move the stimulus away from the body
            2. acceptable stimuli
              1. pinch the patient’s ear
              2. trapezius squeeze
              3. others
        4. Unresponsive – the patient does not respond to any stimulus
    3. Airway Status
      1. Unresponsive patient
        1. Medical patients
          1. open and maintain the airway with head-tilt, chin-lift technique
          2. see the current American Heart Association guidelines for the steps in performing this procedure for victims of all ages
        2. Trauma patients
          1. open and maintain the airway with modified jaw thrust technique while maintaining manual cervical stabilization
          2. see the current American Heart Association guidelines for the steps in performing this procedure for victims of all ages
      2. Responsive patient
        1. If the patient speaks, the airway is functional but may still be at risk -- foreign body or substances in the mouth may impair the airway and must be removed
          1. finger sweep (solid objects)
          2. suction (liquids)
        2. If the upper airway becomes narrowed, inspiration may produce a high-pitched whistling sound known as stridor
          1. foreign body
          2. swelling
          3. trauma
        3. Airway  patency must be continually reassessed
    4. Breathing Status
      1. Patient responsive
        1. Breathing is adequate (rate and quality)
        2. Breathing is too fast (>24 breaths per minute)
        3. Breathing is too slow (<8 breaths per minute)
        4. Breathing absent (choking)
      2. Patient unresponsive
        1. Breathing is adequate (rate and quality)
        2. Breathing is inadequate
        3. Breathing is absent
    5. Circulatory Status
      1. Radial pulse present (rate and quality)
        1. Normal rate
        2. Fast
        3. Slow
        4. Irregular rate
      2. Radial pulse absent
      3. Assess if major bleeding is present
      4. Perfusion status
        1. Skin color
        2. Skin temperature
        3. Skin moisture
        4. Capillary refill (as appropriate)
    6. Identifying Life Threats
      1. Assess patient and determine if the patient has a life-threatening condition
        1. Unstable – if a life threatening condition is found, treat immediately
        2. Stable – assess nature of illness or mechanism of injury
    7. Assessment of Vital Functions
  2. Integration of Treatment/Procedures Needed to Preserve Life
  3. Evaluating Priority of Patient Care and Transport
    1. Primary Assessment: Stable
    2. Primary Assessment: Potentially Unstable

Primary Assessment: Unstable

 

Content Creator: James Stone

CAPCE Course Number: 17-EMTP-F3-8302

Total CE Hours: 0.75

Level: Basic

EMT-CE uses the NEMSES guidelines as the foundation for every course outline.