Based off chapters 12 and 13 of Nancy Carolines Emergency Care in the Streets.
The amount of alcohol consumed if often overstated
The patient often gives a reliable and accurate history
Alcohol can mask any number of signs and symptoms
Suspicions of alcohol intoxication must be documented
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Patients name and chief complaint
Chief complaint and patients address
Patients name and family physician
Chief complaint and the patients sex
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Efficiently executing a patient care plan
Quickly identifying your patients problem
Definitely diagnosing the patients problem
Establishing your priorities of patient care
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Cancer
An infection
Viral replication
An allergic state
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Lethargic
Semiconscious
Disoriented
Unresponsive
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Shock
Hypoxemia
Dehydration
Elastin deficiency
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Abducens
Olfactory
Trigeminal
Trochlear
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An acute change in mental status
Characteristic of alzheimers disease
More common in elderly population
A gradual deterioration in cognitive function
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Appear to be a seamless process
Yield a definitive field diagnosis
Only focus on his or her complaint
Not deviate at all from a strict format
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The patient is a male who was involved in an assault
Assessing geriatric patients who fear losing their independence
The patient is critically ill or injured and is semiconscious
Cultural differences exist between the patient and paramedic
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Remain professional and nonjudgmental when asking the patient
Reassure the patient that you can be trusted and will not tell anyone
Question the patient in the presence of a trusted family member
Tell the patient that withholding such information from you is illegal
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Vital signs
Medications
Chief complaint
Medical history
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Determine his or her name
Properly introduce yourself
Establish a rapport with him or her
Perform a physical assessment
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Speaking slowly and slightly more loudly to the patient
Using paper and pencil to write down your questions
Addressing the patient face to face if he or she can read lips
Using an interpreter who knows american signs language
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It is highly unlikely that you will obtain a reliable medical history
You may have to obtain the medical history from a family member
Your priority should be to transport the patient to a psychiatric facility
You should speak to the patient as though he or she is younger in age
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By auscultating the lungs
By looking at the abdomen
With his or her prior knowledge
For a minimum of 30 seconds
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Let the patient guide the questions that you can ask in order to build a cohesive rapport on which you can build
Develop and cultivate your own style of assessment and an overall strategy for evaluating an providing care
Approach every patient care in the same fashion with the realization that patient assessment in the field is a static process
Strictly adhere to you departments standard operating procedures so that they become a rote series of actions.
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Tell the patient that the pain will subside in time
Note how distressed the patient appears to be
Document your perception of the patients pain
Ask the patient if he or she would like an analgesic
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Prioritize the patients complaints
Perform a complete head to toe exam
Address all complaints simultaneously
Assume that all complaints are linked
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A hollow sound
A dull sound
A high pitched note
Hyperresonance
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Continue providing care as usual
Ensure that a witness is present at all times
Ask your partner to assume care of the patient
Threaten the patient with a sexual harassment lawsuit
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Observed by the patient
Perceived by the patient
Unable to quantified
Based on fact or observation
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Justify his or her treatment to the patient
Report his or her findings to the physician
Determine which treatment protocol to use
Decide on the appropriate receiving hospital
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Tell the patient to be more specific
Document water pill using quotation marks
Ask the patient the dose of the medication
Attempt to clarify the name of the medication
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Facial and eye movements
Hearing and balance perception
Swallowing and gland secretion
Tongue and neck movements
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Multiple injuries that are various stages of healing
A patient who refuses to allow a family member to speak for him or herself
Injuries that are inconsistent with the history that you are given
A husband who towers over his wife and answers your questions for her
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Make the patient feel comfortable in disclosing personal information to you
Leave no doubt in the patients mind that you are truly a professional caregiver
Establish positive patient rapport and encourage honest, open communication
Help you gain the trust of the patients family more than the trust of the patient
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Review the patients transfer paperwork
Document at least two sets of vital signs
Call a radio report to the extended care facility
Presume that the patient will not with to speak
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Severity
Quality
Region
Progression
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Use a snellen chart
Examine each eye in isolation
Check both eyes simultaneously
Remove any corrective lenses the patient is wearing
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Can qualify that a patient is indeed sick
Determine how far away the hospital is
Perform a detailed physical examination
Are able to qualify how sick a patient is
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Immediately depart the scene and notify law enforcement personnel
Ignore the family members departure and continue to assess your patient
Have your partner follow the person, while working to defuse the situation
Ask the patient to follow the person in an attempt to reason with him or her
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Stroke volume and heart rate
Left ventricular ejection fraction and afterload
Cardiac output and peripheral vascular resistance
Right atrial preload and ventricular stroke volume
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Place your hand of his or her shoulder ( if appropriate) and reassure him or her that you are in control of the situation
Tactfully advise the patient that you cannot effectively help him or her if he or she continues to cry
Have one family member calm the patient as you gather the medical history from another family member
Administer a sedative medication, which will calm the patient and facilitate your gathering of th medical history
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Hypersension
Cold temperature
Carbon monoxide
Sick cell disease
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Closure of the mtiral and tricuspid valves
The sound heard at the end of diastole
Closure of the aortic and pulmonic valves
The sound heard at the end of systole
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Just anterior to the ear, in the temporal region
Inferior to the ear, slightly below the earlobe
Slightly superior to the ear, in the temporal region
Posterior to the ear, directly over the mastoid bone
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Fifth intercostal space, over the apex of the heart
Second intercostal space, over the base of the heart
Third or fourth intercostal space
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Must be assumed to have an altered mental status until proven otherwise
Should immediately be asked another question to facilitate gathering data
Should have the question repeated back to him or her using different terms
May be deciding if he or she can trust you enough to answer the question
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A lawsuit lodged against you by the patient or his or her family
The patients choice not to share as much information with you
Causing the patients family members severe emotional distress
Emotional distress when the physician tells the patient otherwise
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Frown
Maintain balance
Clench his or her jaw
Swallow without difficulty
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Do you ever experience dizziness and chest pain when exerting yourself
How long has it been since you were thoroughly examined by a physician
Do you feel any pain or discomfort when touch your abdomen or chest
Has your doctor ever told you that you have a heart, lung or brain problem
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Retinitis
Conjuctivitis
Cataracts
Macular degeneration
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The reason why the patient called EMS is the first place
A chronological account of the patients signs and symptoms
Your perception of the severity of the patients condition
A past medical problem that is causing the chief complain.
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Is the pain sharp or dull
Can you describe the pain
Do you have a cardiac history
Does the pain radiate to your arm
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1+
2+
3+
4+
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Is a normal finding in up to 40% of the population
Indicates a significant ocular or neurologic pathology
Is normal when light is shined into one of the pupils
Must be assessed in the context of the patients overall presentation
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Little information can be gained from the patient without a hands on assessment
It is not uncommon for patients in severe pain to present with a quiet and still affect
The environment in which the patient is found is more significant that his or her appearance
The general patient survey begins as you perform the initial assessment of the patient
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