preview of emt/emr secondary assessment training powerpoint presentation
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PREVIEW OF
EMT/EMR SECONDARY ASSESSMENT
POWERPOINT TRAINING PRESENTATION
CHIEF COMPLAINT
Major sign or symptom reported by patientSymptom
What patient tells you is wrongSign
What you can see, hear, feel, smell or measure about patient
MINOR LOCALIZED INJURY
A cut finger would not require a Secondary Exam
PERFORM A PHYSICAL EXAMINATIONTO GATHER ADDITIONAL INFORMATION
Compare one side of the body to the other
BRIEFLY ASSESS THE BODY FROM HEAD TO TOE
Systematically inspect and palpate, look and/or feel for the following examples of injuries or signs of injury
Deformities ContusionsAbrasions Punctures/penetrationsBurns TendernessLacerations SwellingCrepitus
IMMEDIATELY TREAT LIFE-THREATENING PROBLEMS FOUND IN SECONDARY SURVEY
BASELINE VITAL SIGNS
May consist ofBreathingPulseSkin perfusionPupilsBlood pressureLevel of consciousness
BREATHING
Assessed by observing the patient's chest rise and fallRate is determined by counting
the number of breaths in a 30‑second period and
multiplying by 2Care should be taken not to inform the patient, to avoid influencing the rate
NORMAL RATES
Adult 12-20 Respirations/min11-14 years 12-20 Respirations/min6-10 years 15-30 Respirations/min3-5 years 20-30 Respirations/min1-3 years 20-30 Respirations/min6-12 months 20-30 Respirations/min0-5 months 25-40 Respirations/minNewborn 30-50 Respirations/min
BREATHING
Quality of breathing can be determined while assessing the rate Quality can be placed in 1 of 4 categories:
Normal Shallow or deepLaboredNoisy
PULSE
Initially a radial pulse should be assessed in all patients one year or older
In patients less than one year of age a brachial pulse should be assessed
PULSE POINTS Carotid
Radial
Brachial
Femoral
Popliteal
PULSE
If the pulse is present, assess rate and qualityRate is the number of beats felt in
30 seconds multiplied by 2 (or 15 seconds multiplied by 4)
PULSE
If peripheral pulse is not palpable, assess carotid pulseUse caution, avoid excess pressure on geriatricsNever attempt to assess carotid pulse on both sides at one time
SKIN
The patient's color should be assessed in the nail beds, oral mucosa, and conjunctivaIn infants and children, palms
of hands and soles of feet should be assessed
Normal-pink
CAPILLARY REFILL
Normal capillary refill in infants and children is < 2 secondsAbnormal capillary refill in infants and children is > 2 seconds
BLOOD PRESSURE
Should be taken on patients over three years old
The pressure exerted by circulating blood upon the
walls of the blood vessels
Cuff with bladder
Gauge
Squeeze bulb
Ear piece
Bell
Tubing
SYSTOLIC BLOOD PRESSUREForce exerted against the arteries when the heart is contractingThis is the first distinct sound of blood flowing
through the artery as the pressure in the blood pressure cuff is releasedThis is a measurement of the force exerted against the walls of the arteries during contraction of the heartNormal adult systolic blood pressure-120
APPEARANCE & BEHAVIOR
UnresponsiveComaState of profound unconsciousnessAbsence of spontaneous eye movementsNo response to verbal or painful stimuliPatient cannot be aroused by any
stimuli
APPEARANCE & BEHAVIOR
Observe posture and motor behaviorFacial expression
AnxietyDepressionAngerFearSadnessPain
PELVIS
PELVIC REGION
Check for SymmetryTenderness
LOWER EXTREMITIES
OverviewSymmetrySurface findings
General physical findingsRange of motionSensoryMotor functionCirculatory function
BRAVE TRAINING SOLUTIONS
PREVIEW OF EMT SECONDARY ASSESSMENT
POWERPOINT TRAINING PRESENTATION
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LOWER EXTREMITIES
Peripheral vascular systemTendernessTemperature of lower legsDistal pulses
UPPER EXTREMITIESOverview
Symmetry StrengthSurface findings
General physical findingsRange of motion SensoryMotor function Circulatory functionArm drift
ScalpSkullFace
Symmetry of expressionAppropriate facial expression
HEAD
HEAD
Drainage or bleedingNoseEars
Objects or swelling in mouthVomit, bloodTeeth
EARS
DrainageBloodCerebral Spinal Fluid
EYES
Blood in anterior chamberPupil size, shape, and response
Normal – equal and reactive to lightAbnormalConstrictedDilatedUnequalConjunctiva color and hydration
EYES
Reactivity is whether or not the pupils change in response to the lightReactive - change when exposed to lightNon‑reactive - do not change when exposed to lightEqually or unequally reactive
NOSE
Drainage (Blood, Cerebral Spinal Fluid)Symmetry
MOUTH
BurnsOdorsSwollen or lacerated tongueCondition of teeth or denturesHydration
CHEST
Breath SoundsPresentAbsentEqual
BACK
Roll with spinal precautions and assess posterior aspect of body, inspect and palpate for injuries or signs of injury
ABDOMEN
OverviewPosition patient for examinationShape and sizePalpation method
Four quadrantsPalpate affected area last
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