Chapter 3:

Patient Assessment

 

Lesson Objectives

After completing this lesson, participants should be able to:

•   Describe the health care provider’s tasks at the scene of an emergency to ensure his or her own personal safety and the safety of other rescuers and bystanders.

•   Describe the steps taken during the initial patient assessment.

•   Identify the steps to assess the patient’s level of responsiveness and the ABCs.

•   Demonstrate how to position an unresponsive but breathing patient.

Approximate Time: 20 minutes

Skill Practice: Yes

DVD Covers Points in Lesson: Yes

PowerPoint™ Presentation Supports Points in Lesson: Yes

 

Teaching Points

•   Your first task at the scene of an emergency is to recognize and avoid hazards that could threaten you, other providers, the patient, or any bystanders. Your responsibility to provide care begins once the scene is safe.

•   Scene assessments can also reveal possible causes of the patient’s condition, which may include items that are not obviously apparent.

•   If you are the person at the scene responsible for patient care, you must gain control of the scene (including distraught bystanders or family members), determine the emergency, and determine if you have adequate personnel and equipment to provide necessary patient care.

•   Take standard precautions before assessing the patient.

• Effective care depends on accurate assessment. Use the primary assessment format to quickly examine the nervous, respiratory, and circulatory systems and identify situations that pose immediate life threats.

•   Begin by checking responsiveness and breathing. If the patient is unresponsive, is breathing adequately, and is not suspected of having a spinal injury, place the patient in the recovery position and monitor his or her condition until help arrives.

•   If the patient is unresponsive and not breathing (or has agonal gasps), assess the pulse for 5 to 10 seconds. Check the pulse of an adult or child patient at the carotid artery in the neck muscle on the side of the patient’s neck nearest you. For an infant, feel the pulse at the brachial artery on the inside of the upper arm.

•   For a patient in respiratory arrest, open the patient’s airway and perform rescue breathing. If you do not suspect a spinal injury, use the head tilt-chin lift maneuver to open the airway. If you suspect a spinal injury, use the jaw-thrust maneuver. However, if the jaw thrust does not adequately open the airway, carefully perform a head tilt-chin lift.

•   If the patient is in cardiac arrest, perform 30 chest compressions, open the airway, and give two rescue breaths. Continue chest compressions and rescue breaths until an AED is available.

 

Application

•   Participants should demonstrate how they would check for responsiveness, breathing, and circulation and position the patient in the recovery position if necessary.

•   Participants should complete the “Check Your Knowledge” questions at the end of Chapter 3 in the textbook.

 

 

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