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Ascites abdominal swelling(consider liver disease, CHF, renal failure)
Cullen's sign bruising around umbilicus(consider intra-abdominal bleeding)
field impression A field conclusion of the patient's problem based on the clinical presentation and the exclusion of other possible causes through considering the differential diagnoses
grey turner's sign bruising in flank area (consider intra-abdominal bleeding)
pitting edema depression left by pressure of finger(consider CHF, renal failure)
5 major components of a pt assessment scene size up primary assessment pt hx secondary assessment reassessment
Scene size up includes scene safety standard precautions MOI or NOI # of pts additional resources
Primary assessment components general impression C spine level of consciousness ABCs secondary assessment transport priority
pt hx components sample opqrst AS(associated symptons) PN(pertinent negatives)
secondary assessment techniques inspection palpations auscultation percussion
primary assessment tips begins as soon as you locate the pt purpose is to find and manage immediate life-threatening conditions takes seconds for conscious pts
secondary assessment tips should not delay transport designed to identify any remaining conditions or injuries can be detailed or focused
body system assessment HEENT chest & lungs abd(GI,GU) musculoskeletal neuro hematologic endocrine psychiatric
DCAP-BTLS-TIC deformities contusions abrasions penetrating injuries/paradoxical movement burns lacerations swelling palpate for: tenderness instability crepitus
baseline vitals respirations pulse BP temperature skin pupils pulse ox, ETCO2 blood glucose
reassessment tips purpose to monitor for changes in pt condition reassess stable pts every 15min & unstable every 5min repeat until transfer of care or conditions requires repeat of primary assessment
components of reassessment LOC ABCs C/C interventions vitals
general management of ALS pts ABCs o2 & PPV ECG, SpO2, ETCO2 blood glucose IV/ fluids rapid transport
infant assessment tips(<1yr) should be alert & engaged limbs move bilaterally should recognize parents R:30-60 HR:100-180 systolic BP:70-104
toddler assessment tips(1-3yrs) should walk by 18months should be disagreeable most trusting of parents may not want to be touched focus on vital areas R:24-40 HR:80-110 systolic BP:80+2(age in yrs)
Preschoolers assessment tips(3-6yrs) often distrust strangers may fear blood/injury answer questions honestly R:22-34 HR:70-110 systolic BP:80+2(age in yrs)
school age assessment tips(6-12yrs) often cooperative if they trust you often seek control offer choices may be modest, resist physical exam R:18-30 HR:65-110 systolic BP:80+2(age in yrs)
adolescent age assessment tips(13-18yrs) treat similar to adults can be extremely modest consider same sex provider if possible R:12-26 HR:60-90 systolic BP:110-130
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