Primary Patient Assessment Flashcards

During the primary assessment of a trauma patient, you notice bright red blood spurting from a deep laceration on their thigh. The patient is also moaning and appears confused. What is the EMR's IMMEDIATE priority?

Answer: Control the life-threatening hemorrhage.

In a trauma patient with obvious, life-threatening external hemorrhage, controlling the bleeding is the top priority, even before assessing the airway. This is often referred to as the ABC or XABC approach, where '' or 'X' stands for catastrophic or exsanguinating hemorrhage. An uncontrolled arterial bleed can lead to death more quickly than a compromised airway in some instances.

You are assessing an elderly patient who appears to be sleeping. When you speak to them, they do not respond. You then gently shake their shoulder and shout, and they moan but do not open their eyes. According to the AVPU scale, how would you classify this patient's level of consciousness?

Answer: Pain

The AVPU scale is a tool to quickly assess a patient's level of consciousness. This patient did not respond to verbal stimuli (speaking) but did respond to a painful stimulus (a shoulder shake or sternal rub). Therefore, their level of consciousness is classified as 'Pain'.

Which of the following is the primary purpose of the initial patient assessment?

Answer: To identify and manage immediate threats to the patient's life.

The primary survey, or initial assessment, is designed to help the Emergency Medical Responder rapidly detect and correct all immediate threats to life. These typically involve the patient's airway, breathing, and circulation (ABCs), as well as severe bleeding. Detailed history taking, a full physical exam, and baseline vitals are typically part of the secondary assessment, performed after life threats are managed.

When assessing breathing during the primary assessment of a conscious adult, an EMR should evaluate which of the following?

Answer: Respiratory rate, quality, and effort

During the primary assessment, assessing breathing involves looking for chest rise, listening for air movement, and feeling for exhaled air. The EMR should quickly evaluate the rate (fast or slow), quality (e.g., shallow, deep), and effort (e.g., labored, easy) of respirations. While auscultating lung sounds and obtaining a pulse oximetry reading are important, they are generally considered part of the secondary assessment or are performed after the initial ABC check is complete.

You arrive on scene to find an adult male lying motionless. He is not breathing and has no palpable carotid pulse. According to current guidelines, what is the most appropriate sequence of actions?

Answer: Begin high-quality chest compressions immediately.

For an unresponsive patient who is not breathing and has no pulse (in cardiac arrest), the recommended sequence of care is C-A-B (Circulation, Airway, Breathing). This prioritizes beginning immediate high-quality chest compressions to circulate oxygenated blood to the vital organs. Any delay in starting compressions worsens the patient's outcome.

During the 'Circulation' phase of the primary assessment for a responsive patient, what is the correct location to assess for a pulse?

Answer: Radial artery

For a conscious (responsive) patient, the radial pulse, located on the thumb side of the wrist, is the most appropriate pulse to check during the primary assessment. The carotid artery is typically assessed in an unconscious patient. The brachial artery is used for infants and for taking blood pressure, while the femoral artery is a central pulse not typically used for initial assessment in a conscious patient.