NREMT EMT 2: Primary Assessment - Identifying and Managing Immediate Life Threats, AVPU, ABCs

Identifying and Managing Immediate Life Threats (AVPU, ABCs)

What This Is

In an emergency, every minute counts. Identifying and managing immediate life threats is crucial to save lives. Think of it like a fire alarm – if you don't act fast, the situation can quickly get out of control. The AVPU and ABCs are like a checklist to help you prioritize and respond to life-threatening situations.

Key Steps / Core Facts

• AVPU (Alert, Voice, Pain, Unresponsive): A quick way to assess a person's level of consciousness. (AVPU)
  • Alert: Can they talk and respond normally? (e.g., "What's your name?")
  • Voice: Can they respond to voice commands? (e.g., "Can you hear me?")
  • Pain: Can they respond to pain? (e.g., "Can you feel this?")
  • Unresponsive: Can't respond to any of the above. (e.g., "They're not moving or responding")
• Airway: Keeping the airway open is like having a clear drinking straw – if it's blocked, nothing else works.
  • CPR compression depth: At least 2 inches – like pushing down a soda can (30:2 ratio)
  • CPR rate: 100-120 compressions per minute (AVPU)
• Breathing: Check for normal breathing patterns. Agonal breathing is NOT normal breathing – start CPR.
  • Normal breathing rate: 12-20 breaths per minute
• Circulation: Check for a pulse. If none, start CPR.
  • Normal pulse rate: 60-100 beats per minute
• Red flags: Look for danger signs like severe injuries, burns, or allergic reactions.
• OPQRSTI (Onset, Provocation, Quality, Region, Severity, Time, Insurance): A mnemonic to help you assess a patient's condition.
• SAMPLE (Size, Alliance, Mechanism, Allergies, Past medical history, Last oral intake): A mnemonic to help you assess a patient's medical history.

What Laypeople Can Do

• If someone collapses, first check for danger (oncoming traffic, fire). Then shout and tap their shoulder.
• If someone is choking, encourage them to cough or try the Heimlich maneuver (if trained).
• If someone is bleeding severely, apply pressure with a clean cloth or bandage.
• If someone is having a seizure, keep them safe and turn them onto their side.
• If someone is experiencing a heart attack or stroke, call 911 and try to keep them calm.

Common Mistakes

• Mistake: Not checking for a pulse before starting CPR.
  • Fix: Always check for a pulse before starting CPR – it's faster and more effective.
• Mistake: Not using the correct CPR compression depth.
  • Fix: Use at least 2 inches of compression depth – it's the standard and most effective.
• Mistake: Not calling 911 in an emergency.
  • Fix: Always call 911 or your local emergency number in a life-threatening situation – it's the fastest way to get help.

Quick Practice Scenarios

1. A friend collapses while exercising. What should you do first?

Answer: Check for danger and shout/tap their shoulder. Reason: Make sure it's safe to approach and try to rouse them.

1. A child is choking on a piece of food. What should you do first?

Answer: Encourage them to cough or try the Heimlich maneuver (if trained). Reason: Try to dislodge the object without causing further harm.

1. A family member is experiencing a heart attack. What should you do first?

Answer: Call 911 and try to keep them calm. Reason: Get medical help as soon as possible and try to reduce stress.

Last-Minute Exam Cram

• Normal pulse rate: 60-100 beats per minute
• Normal breathing rate: 12-20 breaths per minute
• CPR compression depth: at least 2 inches
• CPR rate: 100-120 compressions per minute
• AVPU: Alert, Voice, Pain, Unresponsive
• OPQRSTI: Onset, Provocation, Quality, Region, Severity, Time, Insurance
• SAMPLE: Size, Alliance, Mechanism, Allergies, Past medical history, Last oral intake
• Agonal breathing is NOT normal breathing – start CPR
• Always call 911 in a life-threatening situation