PATIENT ASSESSMENT

• Scene Size-up → Primary Survey → History Taking → Past Medical History → Secondary Assessment → Vital Signs → Reassessment

Scene Size-Up

Initial evaluation of the scene• Continues throughout the scene

Part I SCENE SIZE-UPDefined:

Begins with dispatchInitial evaluation of the scene

Goals:Ensure scene safety

To determine if patient is medical or traumaDetermine total number of patients

Patient Assessment• Scene Size-upBegins with Dispatch

demographics: residence - Pull to curbside in front of house

Always remember, scene safety is a component of Scene Size-up

Nature of illness: Breathing problemsNumber of patients: 68 year old femaleConsiders stabilization of spineRequests additional help if necessary: ALS

Scene Safety

Personal protection• Always perform your own size-up• Observe as you approach and before getting

out of the truck

Primary Survey

Primary Survey

Primary Survey

• General ImpressionDetermine Is this an Illness InjuryThen determine NOI MOIAge, sex, raceLife Threats

• Determine Responsiveness/level of consciousnessA V P U

• Chief complaint or apparent life threatsAirway• Patent airway• Insert adjunct when indicated

Primary Survey

Breathing•Assess breathing•Adequate Ventilation•Appropriate oxygen therapy

Primary Survey

Circulation•Check for pulse•Assess skin condition

color, temperature, condition•Assess for and control major bleeding •Assess and treat for shock if present

Past Medical History

Past Medical History•S A M P L E

History Taking

History taking; history of present illnessO P Q R S T

Secondary Assessment•Rapid•Head-to-toe

• ReassessmentTrending

• Verbal report to transporting unit

Unresponsive Medical Patient•Rapid Secondary Assessment•Hx.•VSResponsive Medical Patient•Focused Secondary Assessment•Hx.•VS

Vital Signs and interventions•Base-line vital signs•Field impression

include ALS or BLS transport decision•Interventions