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119 Cards in this Set
- Front
- Back
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Six Basic Elements of Communication
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1. Sender/source
2. Encoding 3. Message 4. Channel 5. Receiver/decoder 6. Feedback |
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message
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information to be communicated
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encoding
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act of placing message into words or images
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receiver
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person or group for whom the senders message is intended (must decode)
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noise
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obscures, confuses or interferes with communication
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feedback
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response from the receiver, letting sender know message was received
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What is an emergency?
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An emergency is what the patient perceives it to be
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Regression
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return to an earlier or former development state
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Common Patient Responses to Illness or Injury
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-fear, anxiety
-embarrassment, frustration, anger -pain, sorrow, depression -regression -guilt, shame, blame -feeling powerless |
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Public space
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- >12 ft.
-impersonal space |
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Social Space
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-4ft.-12ft.
-impersonal business transaction; patient interview |
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Personal Space
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-1.5ft.-4ft.
-perceived as extension of self -interaction w/friends; physical exam |
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Intimate Space
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- <1.5ft.
-smell body odors/breath assess |
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Facilitation
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encourages patient to provide more information
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Silence
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Gives the patient more time to gather thought
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Reflection
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Echoing the patient's words back and using slightly different words
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Empathy
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Patient feels accepted and more open to talking
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Confrontation
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Focuses the patients attention on one specific factor of the interview
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Clarification
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Used when the patient uses a word which is confusing to the interviewer
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Interpretation
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Based on observation or conclusion; linking events, making association, or implying a cause
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Explanation
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informing the patient and sharing factual or objective information
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Summary
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Reviewing the interview by asking open-ended questions that allow the patient to clarify details
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Traps of Interviewing
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-false reassurance
-giving advice -dis/approving -using professional jargon -talking too much -changing the subject -asking accusatory "why" questions -leading/biased questions -distancing -interrupting |
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open-ended questions
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patient must respond with more than a yes or no
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closed/direct question
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require one or two-word responses
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chief complaint
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very brief description, usually in patients words, of the reason EMS was called
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field impression
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conclusion you reach about what is wrong with your patient; formed by listening to patient and asking questions
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history of the present illness (HPI)
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chronological record of the reason a patient is seeking medical assistance
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OPQRST
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Onset, Provocation/positioning, Quality, Radiation/region, Severity, Time
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Different frequency of symptoms
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-constant=90%-100% of time
-frequent=75% of time -intermittent=50% of time -occasional=25% of time |
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Wong-Baker FACES Pain Rating
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-children 3 years+
-face pictures relating to pain severity -no hurt-->worst hurt |
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pertinent positive
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affirmative ("yes") response to a question asked regarding and illness or injury
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pertinent negative
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"no" response to a question asked regarding and illness or injury
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SAMPLE
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-Signs & Symptoms
-Allergies -Medications -Pertinent Medical History -Last oral intake -Events leading up to injury/illness |
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Steps in Scene Size-up
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1. Standard BSI precautions
2. Evaluate scene safety 3. Determine MOI or NOI 4. Determine total number of patients 5. Determine need for additional resources |
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Scene safety
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an assessment of the entire scene and surroundings to ensure your well-being and that of other rescuers
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trauma patient
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patient who has experienced an injury from an external force; look for MOI
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medical patient
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patient whose condition is caused by an illness; look for NOI
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MOI
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-mechanism of injury
-way in which injury occurs and forces involved |
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kinetic energy
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-energy of motion
-influenced by mass and speed |
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kinematics
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science of analyzing the MOI and predicting injury patterns
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Kinetic MOIs
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-MVC
-motorcycle crashes -firearms -falls -assaults |
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Thermal MOIs
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-heat
-steam -fire |
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Radiant MOIs
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-rays of light (sun)
-sound waves (explosions) -electromagnetic waves (x-rays) -radioactive emissions |
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Chemical MOIs
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-plant/animal toxins
-chemical substances |
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Electrical MOIs
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-lightning
-exposure to wires, sockets, plugs |
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blunt trauma
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any MOI that occurs without actual penetration of the body; e.g. MVCs, falls, sports injuries
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penetrating trauma
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any MOI that causes cut/piercing of skin; e.g. stab, gunshot
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"down & under"
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-MVC crash
-knees hit dashboard -w/out seatbelt or w/shoulder only -injuries to knees/hips |
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"up & over"
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-MVC crash
-upper body strikes steering wheel -w/out seatbelt or w/only lap -injuries to head, chest, pelvis, spine |
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Types of MVCs
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-head-on
-lateral -rear-end -rotational -rollover |
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Head-on MVC injuries
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-below steering: leg/hip injuries
-above steering: head/brain |
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Lateral MVC injuries
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-head/c-spine
-chest/pelvis -internal injuries |
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Rear-End MVC injuries
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-head/brain/c-spine
-chest, abdomen -long bone, soft-tissue injuries |
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Rotational MVC injuries
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-head/c-spine
-internal injuries |
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Roll-over MVC injuries
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-head/c-spine
-crushing injuries -soft tissue, broken bones |
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MVC-Adult injuries
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-injuries to both lower legs
-secondary injuries -back/hip from turning away |
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MVC-Child injuries
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-lower extremity trauma
-chest/ab trauma -head/face -turn towards the vehicle; front injuries |
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Adult Falls injuries
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-spine compression
-extremity trauma |
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Child Falls injuries
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-head, face, neck trauma
-extremity fractures |
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Bicycle crash injuries
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-head, face, spine, thorax (w/out helmet)
-extremity fractures -abdominal injuries |
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Motorcycle head-on injuries
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-extremity trauma
-extreme soft tissue/blood loss -head, face, neck on landing |
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Motorcycle lateral injuries
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-pelvic/lower extremity trauma
-crushing injuries |
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Motorcycle "laying down the bike" injuries
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-scrapes, burns
-lower extremity fractures |
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Penetrating trauma injuries
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-knife, etc: blood loss, injury @ penetration
-guns: injury larger than penetration, fluid-filled organs |
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NOI
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-nature of illness
-medical condition that resulted in the patient's 9-1-1 call |
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triage
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sorting of patients by the severity of their illness
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sign
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medical/trauma condition of the patient that can be seen, heard or smelled; objective findings
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symptom
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condition described by the patient; subjective findings
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vital signs
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pulse, respirations, blood pressure, pulse ox, skin temp/moisture, pupils
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baseline vital signs
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initial set of vital sign measurements
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stethoscope
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instrument to hear sounds within the body; e.g. respirations and blood pressure
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sphygmomanometer
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blood pressure cuff; take BP
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Central pulses
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-carotid=major artery in neck; check in unresponsive patient
-femoral=btwn thigh/pelvis; not often used b/c of clothing |
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Peripheral pulses
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-radial=wrist; responsive patient
-brachial=upper arm; always check in infants -posterior tibial=inside ankle -dorsalis pedis=top of foot |
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Newborn pulse rate
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120-160 bpm
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Infant pulse rate
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(1-12 months) 80-140 bpm
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Toddler pulse rate
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(1-3 yrs) 80-130 bpm
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Preschooler pulse rate
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(4-5 yrs) 80-120 bpm
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School-age pulse rate
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(6-12 yrs) 70-110 bpm
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Teen/adult pulse rate
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60-100 bpm
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Possible causes of a slow heart rate (8)
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-coughing, vomiting
-straining to have BM -heart attack -head injury -very low body temp -sleep apnea -some meds |
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Possible causes of a rapid heart rate (11)
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-fever
-fear -pain -anxiety -infection -shock -exercise -heart failure -caffeine, nicotine, etc -cocaine, meth, ecstasy -some meds |
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Newborn Resp. Rate
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30-50
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Infant Resp. Rate
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20-40
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Toddler Resp. Rate
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20-30
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Preschooler Resp. Rate
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20-30
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School-age Resp. Rate
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16-30
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Adolescent/Adult Resp. Rate
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12-20
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cyanosis
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blue-gray color of the skin or mucous membranes, suggests inadequate breathing or poor perfusion
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mottling
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irregular or patchy skin discoloration, usually mix of blue and white; seen in shock, hypothermia, or cardiac arrest
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capillary refill
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-used on children <6yrs.
-press on nail bed till it blanches, count secs until color returns -normal is <2secs |
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anisocoria
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-unequal pupils
-normal in 2%-4% of population -usually indicate head injury or stroke |
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constricted pupils
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-narcotics
-head injury, nerve agents |
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dilated pupils
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-trauma, fright
-poisoning -glacoma -meth, caffeine, cocaine |
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binaurals
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metal pieces of the stethoscope that connect the earpieces to the plastic or rubber tubing
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Newborn BP
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75/65
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Infant BP
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85/70
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Toddler BP
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100/70
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Preschooler BP
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100/70
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School-Age BP
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105/80
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Adolescent BP
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105/80
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Adult BP
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120/80
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primary survey
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rapid assessment to find and treat all life-threatening conditions
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secondary survey
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physical examination performed to discover medical conditions and/or injuries
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general impression
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an "across the room" assessment; based on observation of patient ("sick" or "not sick"
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SLABOCAB
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-Scene size-up/c-spine
-Level of consciousness -Airway -Breathing -Oxygen applied -Circulation -Arterial bleeding -Bare the chest |
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in-line stabilization
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keeping head and neck in line with body; must be maintained once started until patient is secure in backboard
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Pneumonic for Altered Mental Status causes
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AEIOU-TIPPS
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AEIOU-TIPPS
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-Alcohol, abuse
-Epilepsy -Insulin -Overdose -Uremia (kidney failure) -Trauma, temperature -Infection -Psych conditions -Poisoning -Shock, stroke |
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Glasgow Coma Scale
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-assessment of patients neurological status
-after circulation assess/treat -score in eye opening response(1-4), verbal response(1-4), and motor response (1-6) -total score from 3-15 |
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crepitation
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crackling sound/sensation caused by grating of broken bone ends
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ecchymosis
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bluish discoloration around the eyes known as racoon eyes
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Battle's sign
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bluish discoloration behind the ear; sign of possible skull fracture
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jugular vein distention
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-bulging of neck veins in upright patients
-back-up of blood from heart b/c fluid buildup from thorax problems |
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tracheal deviation
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-shifting of trachea from a midline position
-occurs when tension pneumothorax is present; trachea deviates away from injured lung |
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subcutaneous emphysema
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-air trapped beneath the skin
-suggests collapsed lung or ruptured bronchial tube |
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occlusive
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airtight dressings (often for chest wounds)
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peritonitis
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inflammation of abdominal lining
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