NREMT EMT 8 Psychomotor Skills Stations Patient Assessment Trauma simulated multisystem trauma patient

What This Is

Patient Assessment – Trauma is evaluating a person who has been injured in a way that affects multiple body systems. This is like a puzzle with many pieces – you need to find out what's wrong and how bad it is. Imagine someone in a car crash – you need to figure out if they have broken bones, internal injuries, or other problems that need immediate attention.

Key Steps / Core Facts

• Primary Survey (ABCDE): Assess the patient's Airway, Breathing, Circulation, Disability, and Exposure. This order matters – if the patient can't breathe, you can't worry about other things. (AVPU)
  • Airway: Make sure the patient can breathe easily (e.g., no blockage). If not, use a Bag-Valve-Mask (BVM) device.
  • Breathing: Check for Adequate Ventilation (normal breathing rate and depth). If not, use a BVM device.
  • Circulation: Check for Pulse and Blood Pressure. If not, start CPR.
  • Disability: Check for Level of Consciousness (AVPU: Alert, Verbal, Pain, Unresponsive).
  • Exposure: Check for Injuries and Exposure to the environment.
• CPR Compression Depth: At least 2 inches – like pushing down a soda can. (30:2 ratio)
• CPR Rate: 100-120 compressions per minute – like a fast-paced song.
• Pulse Check: Check for Pulse in the Neck (carotid pulse) or Wrist (radial pulse).
• Breathing Rate: Normal is 12-20 breaths per minute – like a slow, steady pace.
• Blood Pressure: Normal is 90-120/60-80 mmHg – like a steady, gentle flow.
• Injury Assessment: Look for Red Flags like severe bleeding, difficulty breathing, or severe pain.
• Trauma Assessment: Use the OPQRSTI mnemonic to assess the patient's condition:
  • O: Onset (when did the injury happen?)
  • P: Pain (where is the pain?)
  • Q: Quality (what does the pain feel like?)
  • R: Radiation (does the pain spread?)
  • S: Severity (how bad is the pain?)
  • T: Timing (when does the pain get worse?)
  • I: Intensity (how often does the pain occur?)

What Laypeople Can Do

• If someone is injured, Call 911 or your local emergency number first.
• Check for danger (oncoming traffic, fire) before approaching the patient.
• Shout and tap their shoulder to try to wake them up.
• Apply pressure to any severe bleeding wounds with a clean cloth or gauze.
• Stay with the patient until help arrives.

Common Mistakes

• Mistake: Not checking the patient's airway first.
• Fix: Always check the airway before moving on to other assessments – if the patient can't breathe, you can't worry about other things.
• Mistake: Not using a BVM device for adequate ventilation.
• Fix: Use a BVM device if the patient is not breathing normally – it can help save their life.
• Mistake: Not checking for pulse and blood pressure.
• Fix: Always check for pulse and blood pressure – if the patient is not circulating blood, you need to start CPR.

Quick Practice Scenarios

1. A patient is lying on the ground, unconscious, and not breathing. What should you do first?

Answer: Check their airway for blockage and use a BVM device for adequate ventilation. Reason: You need to make sure the patient can breathe easily before moving on to other assessments.

1. A patient is bleeding severely from a wound. What should you do first?

Answer: Apply pressure to the wound with a clean cloth or gauze. Reason: Severe bleeding can lead to shock and death if not controlled.

1. A patient is complaining of severe chest pain. What should you do first?

Answer: Ask them about the onset, quality, radiation, severity, timing, and intensity of the pain using the OPQRSTI mnemonic. Reason: This will help you understand the patient's condition and determine the best course of action.

Last-Minute Exam Cram

• Normal breathing rate: 12-20 breaths per minute
• Normal pulse rate: 60-100 beats per minute
• Normal blood pressure: 90-120/60-80 mmHg
• CPR compression depth: at least 2 inches
• CPR rate: 100-120 compressions per minute
• AVPU: Alert, Verbal, Pain, Unresponsive
• OPQRSTI: Onset, Pain, Quality, Radiation, Severity, Timing, Intensity
• ⚠️ Agonal breathing is NOT normal breathing – start CPR
• ⚠️ Severe bleeding can lead to shock and death if not controlled
• ⚠️ Always check the patient's airway first
• ⚠️ Use a BVM device for adequate ventilation if the patient is not breathing normally