Emergency Patient Assessment

Overview

This lecture covers the assessment and management of medical emergencies encountered by EMTs, common infectious diseases, and patient assessment techniques in pre-hospital settings.

Types of Emergencies

• Medical emergencies result from illness or disease, while trauma emergencies are caused by physical injury.
• Common medical emergencies include respiratory, cardiovascular, neurological, gastrointestinal, urologic, endocrine, hematologic, immunologic, toxicological, behavioral, and gynecological conditions.
• Patients may present with both medical and traumatic problems simultaneously.

Patient Assessment

• Medical assessment focuses on the nature of illness (NOI), symptoms, and chief complaint.
• Do not let injuries distract from underlying medical issues; avoid tunnel vision.
• Remain professional and unbiased, even with uncooperative or frequent patients.

Scene Size-Up and Primary Assessment

• Ensure scene safety, use standard precautions, determine number of patients, and need for additional help.
• Identify NOI and consider spinal immobilization if indicated.
• Perform a rapid primary exam; assess airway, breathing, circulation (ABCs), and level of consciousness.
• Apply oxygen for patients with shock, breathing difficulties, or SpO2 < 94%.

History Taking

• Gather a thorough patient history using SAMPLE (Symptoms, Allergies, Medications, Past history, Last oral intake, Events).
• Use OPQRST (Onset, Provocation, Quality, Radiation, Severity, Time) to assess chief complaint.
• Bring patient medications to the hospital if possible.

Secondary Assessment

• Perform focused or full-body exams as needed, depending on patient’s consciousness and chief complaint.
• Assess vital signs: pulse, respirations, blood pressure, glucose, and pulse oximetry.

Reassessment and Transport

• Reassess patient’s status and vital signs (every 5 minutes if unstable, 15 if stable).
• Consider ALS backup and adjust treatments as needed.
• Transport rapidly if the patient is unstable, has altered mental status, airway/breathing/circulatory problems.
• Choose transport mode and destination based on patient needs and local resources.

Infectious Diseases Overview

• Assess and manage infectious diseases as other medical complaints, with an emphasis on standard precautions and exposure history.
• Notable diseases: Influenza, Herpes simplex, HIV/AIDS, Hepatitis (A, B, C), Meningitis, Tuberculosis (TB), Pertussis, MRSA, COVID-19, MERS, Ebola.
• Ask about recent travel and exposure history for travel-associated diseases.

Key Terms & Definitions

• Trauma Emergency — injury from physical force.
• Medical Emergency — illness or disease process requiring EMS.
• Nature of Illness (NOI) — the underlying medical cause of a patient’s complaint.
• Chief Complaint — main reason the patient called for help.
• SAMPLE — mnemonic for medical history questions.
• OPQRST — mnemonic for symptom assessment.
• Tunnel Vision — focusing on one issue, missing other important conditions.

Action Items / Next Steps

• Review assessment techniques and disease characteristics in your textbook.
• Complete assigned review questions for Chapter 15.
• Practice using SAMPLE and OPQRST mnemonics in scenarios.
• Stay up to date with current infectious disease guidelines via CDC resources.