NREMT EMT 8: Psychomotor Skills Stations - Patient Assessment, Medical, Simulated Medical Patient

What This Is

Patient Assessment – Medical (simulated medical patient) is the process of gathering information about a patient's condition to determine the best course of action. This is crucial in emergency situations where every minute counts. Think of it like trying to solve a puzzle with missing pieces – you need to gather the right information to figure out what's going on and how to fix it.

Key Steps / Core Facts

• Airway: The airway is like a drinking straw – if it's blocked, nothing else works. Check for a patent airway by looking for signs of breathing, such as chest rise and fall. (AVPU)
  • Oxygen saturation: Normal range is 95-100% ( below 90% is a red flag).
  • Respiratory rate: Normal range is 12-20 breaths per minute ( above 30 is a red flag).
• Breathing: Check for abnormal breathing patterns, such as agonal breathing ( not normal breathing – start CPR).
  • Breath sounds: Listen for abnormal sounds, such as wheezing or stridor.
• Circulation: Check for signs of circulation, such as a pulse and blood pressure.
  • Pulse: Normal range is 60-100 beats per minute ( below 60 is a red flag).
  • Blood pressure: Normal range is 90-140/60-90 mmHg ( below 90/60 is a red flag).
• Disability: Check for signs of neurological impairment, such as altered mental status or weakness.
  • Glasgow Coma Scale: Normal range is 15 ( below 8 is a red flag).
• Exposure: Check for signs of environmental exposure, such as hypothermia or heat stroke.
  • Body temperature: Normal range is 97.7-99.5°F ( below 95°F is a red flag).
• Medical history: Ask about the patient's medical history, including allergies and medications.
  • Medications: Ask about medications the patient is currently taking.
• OPQRSTI: Use this mnemonic to assess the patient's pain ( pain is a red flag).
  • O: Onset (sudden or gradual)
  • P: Provocation (what makes the pain worse)
  • Q: Quality (sharp, dull, etc.)
  • R: Region (where the pain is located)
  • S: Severity (mild, moderate, severe)
  • T: Time (when the pain started)
  • I: Intensity (how long the pain lasts)
• SAMPLE: Use this mnemonic to assess the patient's medical history.
  • S: Symptoms (what the patient is experiencing)
  • A: Allergies (what the patient is allergic to)
  • M: Medications (what the patient is currently taking)
  • P: Past medical history (the patient's medical history)
  • L: Last meal (when the patient last ate)
  • E: Events (what led up to the emergency)

What Laypeople Can Do

• If someone collapses, first check for danger (oncoming traffic, fire). Then shout and tap their shoulder.
• If someone is having a seizure, turn them onto their side to prevent choking.
• If someone is experiencing chest pain, call 911 and stay with them until help arrives.

Common Mistakes

• Mistake: Failing to check the patient's airway before assessing breathing.
  • Fix: Always check the airway first to ensure the patient can breathe.
• Mistake: Not using a pulse oximeter to check oxygen saturation.
  • Fix: Use a pulse oximeter to quickly check oxygen saturation.
• Mistake: Not asking about the patient's medical history.
  • Fix: Always ask about the patient's medical history to get a better understanding of their condition.

Quick Practice Scenarios

• A patient comes in with a severe headache and vomiting. What should you do first?
  • Answer: Check the patient's airway and breathing.
  • Reason: The patient's symptoms could be related to a neurological issue, and you need to ensure their airway and breathing are stable before assessing their condition.
• A patient is experiencing chest pain and shortness of breath. What should you do first?
  • Answer: Call 911 and stay with the patient until help arrives.
  • Reason: Chest pain and shortness of breath are symptoms of a heart attack, and you need to get medical help as quickly as possible.
• A patient is having a seizure and is unresponsive. What should you do first?
  • Answer: Turn the patient onto their side to prevent choking.
  • Reason: Turning the patient onto their side will help prevent them from choking on their tongue or saliva.

Last-Minute Exam Cram

• Normal vital sign ranges: 12-20 breaths per minute, 60-100 beats per minute, 90-140/60-90 mmHg.
• Drug doses: always check the patient's medical history before administering medications.
• Mnemonics: AVPU, SAMPLE, OPQRSTI.
• Assessment sequences: Airway, Breathing, Circulation, Disability, Exposure.
• Common "trick" questions: agonal breathing is not normal breathing – start CPR.
• below 90% oxygen saturation is a red flag.
• below 60 beats per minute is a red flag.
• below 90/60 mmHg is a red flag.