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Patient Assessment Miscellaneous Notes

  • goal of primary assessment-identify and rapidly reat all life-threatening conditions
  • most effective method of assessing quality of air moment in lungs is auscultation with stethoscope
  • if patient is unconscious, check pulse at carotid artery
  • if no pulse is found, immediately begin CPR 
  • CRT (Capillary Refill Time) in an infant should be 2 sec.
    • not often used in adults (not as reliable).  CTC or BP should be used instead.  
  • pertinent negative -negative findings that warrant no care or intervention.
    • ex. strong chest pain but no shortness of breath
  • vasoconstriction, loss of red blood cells, anemia, or bleeding may cause an inaccurate pulse oximeter reading. 
  • When to perform full-body scan:
    • significant MOI
    • Unresponsive patient
  • In reassessment, repeating the primary assessment is the most urgent part
  • When treating cardiac arrest patient, may not end up taking the time to do vital signs (may pass in favor of other parts of assessment)
  • if patient complains of severe pelvic pain, do NOT palpate the pelvis
  • you should trauma strip patients clothes in ambulance, en route to hospital (during detailed exam)
  • elderly woman, shortness of breath, history of congestive heart failure and hypertension.  Should expect to hear wheezing in all parts of lungs. 
  • if patient suffers a broken limb, assess PMS (Pulse, Motor, Sensory) function on the limb
  • tension pneumothorax on the right side=tracheal deviation to the left side