Assessment 1 – Written Assignment: Part B A major component of the care Paramedics provide is the assessment of a patient’s physical status, which is the ground for any further treatment. The assessment method that an Advanced Care Paramedic follows is a systematic assessment referred to as the Primary Survey. The aim of this fundamental assessment is to give an initial diagnosis of the patient as well as identifying any imminent threats to the patient. This assessment is used so that a Paramedic can decide how to treat the patient while staying within the boundaries of their scope of practice. Throughout this essay the concept of a primary survey within the scope of practice of an Advanced Care Paramedic will be understood. Additionally …show more content…
The pulse is an indication of an individual’s heart rate. When checking for a pulse in the primary survey, begin with palpating the patient’s radial or carotid artery (Basic Patient Care 2012, p. 50). This may reveal a normal (60-100 beats/min), tachycardia (<100 beats/min), bradycardia (> 60 beats/min) or asystole heart rate. Additionally, the capillary refill may also provide details about a patient’s cardiovascular status. This is performed by applying pressure to the nail bed and calculating the time it to takes to refill to a normal color, which should take no more then a few seconds otherwise suggesting capillary closure (Mick J Sanders, 2012, p. 1400). An additional accessory to Circulation is Hemorrhages, these involve more through examinations of the pulse, blood pressure and warmth of peripheries of patients. Additionally, you must thoroughly look for indication of bleeding, specifically in the areas around the chest, abdomen and externally seen by the eye. Upon finishing the danger, response and circulation components of the primary survey the next step is the assessment and maintenance of a patient’s airway. This is a crucial stage as a clear airway allows for air to move in and out of the lungs (Primary Survey Airway Evaluation, 2015). Patients in particular may have less ability to maintain their airway, including the tongue, or liquids
Click here to unlock this and over one million essaysGet Access
As I did the physical exam I explained to the patient that I would listen to the arteries with a stethoscope for an abnormal sound which will let me know if there is poor circulation due to plaque? I also explained to the patient that by checking the pulse in the ankle and legs it would also indicate if
Through basic observations, health professionals are able to evaluate the performance of an individual’s health status. In relation to Casey, it is noted in her Observation Chart that in the time span of two hours the patient’s health status had changed from being relatively normal (to the patient) to an increased respiratory rate, heart rate and temperature as well as a decrease in blood pressure. It is also noted that the patient has a score of 8 in the pain scale (compared to the score of zero two hours previously), relating to the lower abdomen. Programs such as Between the Flags acknowledges the fact that the early recognition of deterioration of patients can reduce harm to patients through designing and implementing systems which provide a structural response in the event of a deteriorating patient, such as Rapid Response and Clinical Review. There are two phases involved in the rapid response, which includes the afferent phase and the efferent phase. The afferent phase focuses on the overall monitoring and recognising the deteriorating patient whereas
An evaluation of Mrs Smith circulation was the next step carried out by the nurse, as in the breathing assessment Mrs Smith pallor was noted as being flushed and the patient appeared confused this could be associated with poor cardiac output. The nurse recorded the patient’s blood pressure using a dinamap it was measured at 88/50, it was then rechecked manually to ensure accuracy. The pulse was checked manually for rate and rhythm it was recorded as 98 beats per minute. Capillary refill was checked, was found to be normal.
Pulse oximeter used to check his oxygen saturation level, which was 98% on air with no central or peripheral cyanosis. Since Mr Devi, does not seem to have any sign of abnormal respiration. The next assessment is circulation, where there are many physical signs to look for. The colour of the hand and digits, are they blue, pink, pale or mottled. Also need to measure for capillary refill time (CRT) by applying cutaneous pressure for 5 Sec on a fingertip held at heart level of Mr. Devi. The normal value of CRT is usually less than 2 second prolonged CRT suggests poor peripheral perfusion. Measure his Blood Pressure (B/P), count pulse rate by listening to the heart with a stethoscope or palpate peripheral and central pulses, assessing for the presence, rate, quality, regularity and equality. All of this assessment indicates the cardiovascular system in the patient is within the normal range or is there any emergency measures should take (Resus.org.uk 2016). However, Mr Devi’s circulation is a concern because his HR was 110bpm which is higher than normal range, the normal heart beat for adults ranges from 60-100bpm. Also his BP was 190/99mmhg with mean arterial pressure (MAP) of
A focused assessment is an assessment that centers directly on the chief complaint that a patient presents with when they arrive to seek out care. In this case, our assessment is focused on a potential deep vein thrombosis (DVT). A DVT is a essentially a ball of blood cells that are clumped together impeding blood flow which can cause irritation to the vein and potentially more dangerous problems. If the thrombus moves, it can travel through the body and into the lungs and impeded breathing which is not good. Therefore, it is essential to catch DVT’s right away and treat them to prevent them from moving. The first thing that needs to be assessed when a patient presents with a suspected DVT is their level of consciousness and their vital signs including the heart rate, blood pressure, respirations, temperature and oxygen saturation. Next, assess the site of the expected DVT, and perform a neurovascular assessment which comparing to the same site on the opposite side of the patients body. Check for adequate circulation by assessing for pink color distal to the site. While performing this assessment, you want the area distal to the site to be pink to ensure there is adequate blood flow. If it is whitish in color, this is a sign of a DVT and needs to be documented. While assessing color, also assess the site directly for any color deviation from the clients natural skin color. If the
The Author will firstly discuss why the ‘Vital Signs’ would be; followed by both the immediate treatment that should be given and the intervention needed from more advanced medical personnel.
A recently graduated working paramedic is referred to as an Advanced Care Paramedic, or an ACP. An ACP follows a clinical structure, the first aspect of the format is called a primary survey which collects all emergency patient information. This compulsory technique aims to identify and control catastrophic medical events to ensure patients have the best outcome possible (Hodegetts et al., 2011). When conducting a primary survey of a patient an ACP would follow the basic structure of danger, response, airway, breathing and circulation; usually shortened into the acronym DRABC (Woo, 2000).
In my voluntary work as a first aider, I often need to make critical decisions based on assessing both seen and unseen signs and symptoms regarding someone health, while in the clinic I need to consider longer-term judgments about someone's wellness. The ongoing structured training I have undertaken and adhering to guidelines means that I can make these decisions in s consistent, fair and repeatable manner, which keeps everyone safe. Having an understanding of evaluating the short-term or long-term outcomes according to established or agreed criteria, is crucial to decisions based on assessing evidence.
The pulse ox should be placed on baby’s right hand and either foot. If it is a negative screen, the baby passes. If the rate falls within the 90-94% rage, the baby is to be tested again in one hour. If it happens again, the baby is to be tested again. Based on that result, the baby will pass or fail. If the rate falls on 89% or lower, the baby has a positive screen, and fails the screening. From there, an echocardiogram is requested and a diagnosis is to be
Assessment is described as”The first stage of the nursing process, in which data about the patient’s health status is collected” (Oxford dictionary of nursing, 2003, p23), following this phase a care plan can be devised.
It is appreciated that the given case study contains other factors such as psychological trauma and the impact of blood loss. However this essay is going to explore the efficacy of pre hospital immobilisation utilising cervical collars and extrication/ orthopaedic stretchers, reflecting on an account from the paramedic’s practice. A modified framework of Gibbs Reflective cycle (1988) will be used. Including Description, Feelings, Evaluation, Conclusion and Action Plan. This essay is supported throughout using relevant evidence and seminal work.
During inspection of the heart assessment observe abnormal finding. Inspect the jugular vein and the carotid artery. Note pallor or cyanotic skin color, temperature, turgor, texture, and clubbing of finger. Observe for swelling, edema and ulceration. Clubbing is a sign of chronic hypoxia caused by a lengthy cardiovascular or respiratory. Poor cardiac output and tissue perfusion is noted by cyanosis and pallor. For dark-skinned, inspect his mucous membranes for pallor. Decreases or absent of pulse with cool, pale, and shiny skin, and hair loss to the area, and the patient may have pain in the legs and feet may indicate arterial insufficiency. Ulcerations typically occur in the area around the toes, and the foot usually turns deep red when dependent
Pain management is a significant component of pre-hospital care practice, with one in five patients complaining of moderate to severe pain.1 However, as with most aspects of out-of-hospital care, the practice of pain management by paramedics is poorly described and supported by poor evidence. Adequate pain management in the pre-hospital setting appears to be at least as difficult and as challenging to achieve as in the emergency department. Developments
We are coming to a close for this course today. You guys have completed all seven modules and have finished your clinicals with a Community Paramedic preceptor. I have enjoyed learning with you guys and feel that the course went well. I commend you all for participating. Now, we will evaluate everything you learned over the past two weeks, covering all the objectives of the course by taking a written and practical test. The written test will have a total of 50 questions, with a mixture of multiple choice and short answers. The practical test will consist of three different scenarios. Both test will be individual test. Scores will be received up to 5 days after the test is taken. We will start with the practical test, then