About this video

• Video Title: EMT Lecture: Patient Assessment
• Channel: Summit Healthcare Education
• Speakers: None explicitly named, but speaker appears to be an instructor.
• Duration: 2:50:57

Overview

This video provides a comprehensive lecture for EMTs on patient assessment, covering the fundamental steps and considerations involved in evaluating a patient's condition. It details the importance of scene size-up, primary and secondary assessments, history taking, and reassessment, differentiating between signs and symptoms, and explaining various assessment techniques and vital signs.

Key takeaways

• Patient assessment is crucial: EMTs must master the assessment process, which is used in every patient encounter.
• Five key components of assessment: Scene size-up, primary assessment, history taking, secondary assessment, and reassessment form the core of the patient evaluation process.
• Signs vs. Symptoms: Symptoms are what the patient feels and tells you (e.g., nausea, pain), while signs are objective conditions you can observe (e.g., bleeding, sweating).
• Scene Size-up: This involves evaluating the situation, ensuring safety, and gathering information from dispatch and the environment to anticipate potential hazards and patient conditions.
• Mechanism of Injury vs. Nature of Illness: Understanding the difference helps predict potential injuries in trauma (MOI) and diagnose medical conditions (NOI).
• Primary Assessment: The goal is to identify and treat immediate life threats, focusing on ABCs (Airway, Breathing, Circulation) and the patient's level of consciousness (AVPU scale: Alert, Verbal, Pain, Unresponsive).
• History Taking: This includes using mnemonics like SAMPLE (Signs/Symptoms, Allergies, Medications, Past Medical History, Last Oral Intake, Events leading up) and OPQRST (Onset, Provocation/Palliation, Quality, Region/Radiation, Severity, Timing) to gather detailed patient information.
• Secondary Assessment: This involves a more hands-on, systematic head-to-toe or focused assessment using inspection, palpation, and auscultation to identify hidden injuries or problems.
• Reassessment: Regularly re-evaluating the patient's condition and the effectiveness of interventions is vital, with different frequencies for stable (15 minutes) and unstable (5 minutes) patients.
• Special Considerations: The lecture touches upon handling special patient populations and sensitive situations, including communication barriers, emotional distress, and the importance of professionalism.

EMT Course & NREMT Certification Study Guide Topics

Here's a breakdown of key topics typically covered in EMT courses and tested on the NREMT certification exam, based on the provided transcript and general EMT curriculum:

I. Foundations of EMS & Patient Assessment

• Role of the EMT: Scope of practice, legal and ethical considerations, professionalism.
• Patient Assessment Process:
  • Scene Size-Up: Safety, dispatch information, mechanism of injury/nature of illness, number of patients, additional resources.
  • Primary Assessment: General impression, Level of Consciousness (AVPU), Airway, Breathing, Circulation (ABCs), identifying and treating life threats, transport decision.
  • History Taking: SAMPLE (Signs/Symptoms, Allergies, Medications, Past Medical History, Last Oral Intake, Events Leading Up To), OPQRST (Onset, Provocation/Palliation, Quality, Region/Radiation, Severity, Timing).
  • Secondary Assessment: Systematic Head-to-Toe or Focused Assessment (Inspection, Palpation, Auscultation), vital signs, specific system assessments.
  • Reassessment: Frequency (stable vs. unstable patients), comparing to baseline, evaluating interventions.
• Medical Terminology & Communication: Understanding common medical terms, patient communication, documentation.

II. Medical Emergencies

• Respiratory Emergencies:
  • Anatomy and physiology of the respiratory system.
  • Assessment: signs of distress, breath sounds (wheezing, crackles, ronchi, stridor), respiratory rate, depth, and quality.
  • Management: Oxygen therapy, airway adjuncts (OPA, NPA), positive pressure ventilation (BVM), assisting with inhalers.
  • Conditions: Asthma, COPD, pneumonia, pulmonary edema, anaphylaxis.
• Cardiovascular Emergencies:
  • Anatomy and physiology of the heart and circulatory system.
  • Assessment: Pulse rate, rhythm, and quality; blood pressure (auscultation/palpation); skin condition (color, temperature, moisture, capillary refill); cardiac arrest assessment.
  • Conditions: Myocardial Infarction (heart attack), angina, heart failure, cardiac dysrhythmias, shock (hypovolemic, cardiogenic, obstructive, distributive).
• Neurological Emergencies:
  • Anatomy and physiology of the nervous system.
  • Assessment: Level of Consciousness (AVPU, GCS), orientation (Person, Place, Time, Event), pupil assessment (PERRL), motor and sensory function, stroke assessment (FAST).
  • Conditions: Stroke, seizures, altered mental status, syncope, headache, head injuries.
• Endocrine Emergencies:
  • Hormonal regulation, particularly insulin and glucose.
  • Assessment: Blood glucose monitoring.
  • Conditions: Diabetes Mellitus (hypoglycemia, hyperglycemia), diabetic ketoacidosis (DKA).
• Gastrointestinal Emergencies:
  • Anatomy and physiology of the digestive system.
  • Assessment: Abdominal quadrants (inspection, palpation for tenderness, rigidity, guarding), listening for bowel sounds.
  • Conditions: Abdominal pain, nausea, vomiting, diarrhea, constipation, gastrointestinal bleeding.
• Genitourinary Emergencies:
  • Anatomy and physiology of the urinary and reproductive systems.
  • Assessment: Pain assessment, vital signs, observing for urinary output if applicable.
  • Conditions: Urinary tract infections (UTIs), kidney stones, renal failure, hernias.
• Musculoskeletal Emergencies:
  • Anatomy of bones, joints, and muscles.
  • Assessment: Deformity, contusions, abrasions, puncture wounds, burns, tenderness, lacerations, swelling (DCAP-BTLS), crepitus, symmetry, pulse and motor/sensory function distal to injury.
  • Conditions: Fractures, dislocations, sprains, strains, amputations.
• Integumentary System Emergencies:
  • Anatomy and physiology of the skin.
  • Assessment: Skin color, temperature, moisture, turgor, wounds.
  • Conditions: Burns (degree, depth, percentage of body surface area), allergic reactions, rashes.
• Behavioral Emergencies:
  • Recognizing and managing agitated or violent patients.
  • Techniques: Verbal de-escalation, situational awareness, safety protocols, reporting abuse.
  • Mental health conditions: Depression, anxiety, psychosis.

III. Trauma Emergencies

• Trauma Scene Management:
  • Mechanism of Injury (MOI): Identifying forces involved (blunt, penetrating), predicting injury patterns.
  • Types of Trauma: MVCs, falls, assaults, penetrating injuries, burns.
• Bleeding Control and Shock Management:
  • Types of bleeding: Arterial (bright red, spurting), venous (dark red, steady flow), capillary (slow ooze).
  • Control methods: Direct pressure, pressure dressings, tourniquets, hemostatic agents.
  • Shock: Pathophysiology (pump, pipes, fluid), types of shock, signs and symptoms, management (oxygen, keeping warm, fluid replacement if ALS).
• Specific Trauma Assessments:
  • Rapid Trauma Survey: Quick head-to-toe scan for obvious life threats (used in primary assessment).
  • Detailed Physical Exam (Secondary Assessment): Systematic head-to-toe assessment for trauma patients using DCAP-BTLS.
  • Spinal Motion Restriction (SMR): Indications, techniques for immobilization (c-collar, backboard/scoop stretcher).
• Chest Trauma:
  • Assessment: Inspecting for symmetry, palpating for tenderness/deformity, listening to breath sounds.
  • Conditions: Flail chest, pneumothorax, hemothorax, cardiac tamponade.
• Abdominal Trauma:
  • Assessment: Inspecting for distention/ecchymosis, palpating for tenderness/rigidity/guarding in quadrants.
  • Conditions: Organ injury (liver, spleen, kidneys), internal bleeding.
• Extremity Trauma:
  • Assessment: DCAP-BTLS, PMS (Pulse, Motor, Sensory) before and after splinting.
  • Management: Splinting techniques for fractures, dislocations, and sprains.

IV. Special Patient Populations & Situations

• Pediatrics: Anatomy and physiology differences, common emergencies, communication techniques, pediatric vital signs.
• Geriatrics: Age-related physiological changes, common conditions, communication challenges.
• Obstetrics and Gynecology: Pregnancy assessment, common complications (ectopic pregnancy), delivery.
• Special Needs/Developmental Disabilities: Communication strategies, patient advocacy.
• Multi-Casualty Incidents (MCIs) & Incident Command System (ICS): Triage (START method: Green, Yellow, Red, Black), resource management, role within the ICS.
• Hazardous Materials (HazMat) & WMDs: Recognizing potential exposure, scene safety, decontamination principles.
• Public Health & Prevention: Disease transmission, standard precautions, scene safety (BSI/PPE).

V. Airway Management & Respiration

• Anatomy & Physiology: Upper and lower airway, mechanics of breathing.
• Airway Opening Maneuvers: Head-tilt/chin-lift, jaw-thrust.
• Airway Adjuncts: Oropharyngeal (OPA) and Nasopharyngeal (NPA) airways.
• Artificial Ventilation: Bag-Valve-Mask (BVM) technique, pocket mask, barrier devices, ventilating rates.
• Suctioning: Indications and techniques.
• Oxygen Administration: Nasal cannula, non-rebreather mask, CPAP.
• Respiratory Distress vs. Arrest: Recognizing the continuum of respiratory failure.

VI. Pharmacology

• Basic principles: Routes of administration, drug classifications.
• Commonly Administered Medications: Aspirin, oral glucose, activated charcoal, epinephrine auto-injector, nitroglycerin, albuterol inhaler.
• Understanding Patient Medications: Importance of knowing patient's prescribed medications.

VII. EMS Operations

• Ambulance Operations: Vehicle safety, driving techniques, patient loading.
• Incident Command System (ICS): Roles, responsibilities, communications.
• Medical-Legal and Ethical Issues: Consent (expressed, implied, informed), patient refusal, confidentiality, mandatory reporting.
• Documentation: Accurate and thorough patient care reports (PCRs).

This list provides a solid foundation. Remember to review specific protocols and guidelines relevant to your local area and the NREMT examination content. Good luck with your studies!

Alright, let's test your knowledge! I'll ask questions based on the EMT lecture transcript.

1. What are the five main components of a patient assessment?
2. When assessing a patient's responsiveness, what does the "V" in the AVPU scale stand for?
3. What is the difference between a symptom and a sign, and can you give an example of each?
4. What are the three methods used during a secondary assessment to examine a patient?
5. Give me topics and tags to explore this video in detail.