Chapter 012[1]
Upcoming SlideShare
Loading in...5
×
 

Chapter 012[1]

on

  • 816 views

 

Statistics

Views

Total Views
816
Views on SlideShare
816
Embed Views
0

Actions

Likes
2
Downloads
15
Comments
0

0 Embeds 0

No embeds

Accessibility

Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

Chapter 012[1] Chapter 012[1] Presentation Transcript

  • Chapter 12 Focused History and Physical Examination for Medical PatientsCopyright © 2007, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 1
  • Overview Responsive Medical Patients  Patient History  Rapid Assessment  Vital Signs  Emergency Care Unresponsive Medical Patients Copyright © 2007, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 2
  • Focused History and Physical Examination: Medical Patients Every patient receives a focused history and physical exam Copyright © 2007, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 3
  • Focused History and Physical Examination: Medical Patients Unresponsive medical patients are treated as are unresponsive trauma patients Copyright © 2007, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 4
  • Focused History and Physical Examination: Medical Patients Proceed to the focused history and physical exam after completing the scene size-up and initial assessment Copyright © 2007, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 5
  • Responsive Medical PatientsCopyright © 2007, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 6
  • Responsive Medical Patients Assess the patient’s history Assess complaints and signs or symptoms Use the techniques of physical exam learned in the Focused History and Physical Examination: Trauma Patients Copyright © 2007, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 7
  • Responsive Medical PatientsO-P-Q-R-S-T acronym  The O-P-Q-R-S-T acronym is useful for remembering whatOnset questions should be asked.ProvocationQuality  Not all the questions will alwaysRadiation have to be asked, nor will theySeverity need to be asked in this order.Time  O-P-Q-R-S-T is primarily used to evaluate pain but can also be used for other medical conditions. Copyright © 2007, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 8
  • OPQRST Acronym Onset  What was the patient doing when the signs/symptoms started? Copyright © 2007, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 9
  • OPQRST Acronym Provocation/Palliation  What makes the signs and symptoms better or worse? Copyright © 2007, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 10
  • OPQRST Acronym Quality  The patient’s description of the symptom Copyright © 2007, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 11
  • OPQRST Acronym Radiation  Is there radiation of the symptoms? Copyright © 2007, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 12
  • OPQRST Acronym Severity  An opportunity for the patient to quantify the pain  Typically done with a 1-10 scale • The Wong-Baker Scale Copyright © 2007, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 13
  • OPQRST Acronym Time  How long have the signs and symptoms been present? Copyright © 2007, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 14
  • Responsive Medical Patients Remember that a physical exam is required for all patients In the responsive patient, assess the body systems associated with the chief complaint Copyright © 2007, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 15
  • Responsive Medical PatientsD-C-A-P-B-T-L-S acronym Deformities Contusions Reminder of injuries Abrasions and signs of injuries Penetrations to look for while Burns Tenderness assessing. Lacerations Swelling Copyright © 2007, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 16
  • Responsive Medical Patients Assess the head, as necessaryCopyright © 2007, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 17
  • Responsive Medical Patients Assess the neck, as necessaryCopyright © 2007, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 18
  • Responsive Medical Patients Assess for JVD, as necessary Copyright © 2007, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 19
  • Responsive Medical Patients Assess the patient’s chest, as necessary Copyright © 2007, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 20
  • Responsive Medical Patients Assess the breath sounds Copyright © 2007, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 21
  • Responsive Medical Patients Assess the abdomen, as necessaryCopyright © 2007, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 22
  • Responsive Medical Patients Assess the four quadrants of the abdomen, as necessary Copyright © 2007, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 23
  • Responsive Medical Patients Assess the pelvis Copyright © 2007, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 24
  • Responsive Medical Patients Assess the lower extremities, as necessary Copyright © 2007, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 25
  • Responsive Medical Patients Assess pulse, motor, and sensation in the lower extremities, as necessaryCopyright © 2007, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 26
  • Responsive Medical Patients Assess the upper extremities, as necessary Copyright © 2007, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 27
  • Responsive Medical Patients Log-roll the patient and assess the posterior, as necessary Copyright © 2007, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 28
  • Patient HistoryCopyright © 2007, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 29
  • Patient’s History Assess SAMPLE History S Signs and Symptoms A Allergies M Medications P Past medical history L Last oral intake E Events leading to injury or illness Copyright © 2007, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 30
  • Vital SignsCopyright © 2007, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 31
  • Vital Signs Assess baseline vital signs  Breathing  Skin  Pupils  Blood pressure Copyright © 2007, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 32
  • Emergency Care forUnresponsive Medical PatientsCopyright © 2007, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 33
  • Unresponsive Medical Patients Complete a rapid head-to-toe assessment, as in the Focused History and Physical Examination: Trauma Patients Copyright © 2007, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 34
  • Summary Responsive Medical Patients  Patient History  Rapid Assessment  Vital Signs  Emergency Care Unresponsive Medical Patients Copyright © 2007, 2005 by Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved. Slide 35