The secondary assessment completes the full patient evaluation and identifies both life-threatening and non-life threatening injuries. It includes reassessing vital signs, taking a history, conducting a physical exam, monitoring the patient, providing treatment, making transport decisions, communicating with the receiving facility, and documenting findings. For critical patients, the secondary assessment may be abbreviated or postponed to focus on primary assessment and stabilization. The extent of the secondary assessment depends on the situation and patient condition.
This document discusses special considerations in EMS, including pediatrics, geriatrics, burns, multiple patients, and trauma resuscitation. It notes that pediatric and geriatric patients have unique anatomical differences that require modified care. Burns are serious injuries that involve multiple organ systems, and smoke inhalation can be life-threatening. Multiple patient situations may require triage to prioritize those most in need of immediate treatment. Trauma resuscitation policies allow withholding efforts in non-survivable injuries but require special consideration for hypothermia, immersion, and lightning victims. Overall, awareness of special populations and situations can optimize EMS patient management and outcomes.
Spinal injuries commonly occur in motor vehicle crashes, falls, and sports. Proper assessment and management is important to prevent permanent paralysis from secondary injury to the spinal cord. A full neurological exam assesses mental status, motor function, sensation, and reflexes. Secondary injuries from hypotension and hypoxia can be prevented by maintaining adequate oxygenation, circulation, and minimizing time on scene during transport to a suitable hospital.
The secondary assessment completes the full patient evaluation and identifies both life-threatening and non-life threatening injuries. It includes reassessing vital signs, taking a history, conducting a physical exam, monitoring the patient, providing treatment, making transport decisions, communicating with the receiving facility, and documenting findings. For critical patients, the secondary assessment may be abbreviated or postponed to focus on primary assessment and stabilization. The extent of the secondary assessment depends on the situation and patient condition.
The document discusses trauma, including terminology, epidemiology, types of trauma, and the roles of trauma nurses. It outlines the ABCDE approach for primary and secondary trauma surveys, emphasizing airway, breathing, circulation, disability, and exposure. It stresses the importance of the golden hour for aggressive resuscitation to improve survival chances and restoring normal function. Trauma nurses play important roles as care providers, educators, and managers working to improve emergency healthcare and prevent injuries.
The document summarizes a randomized controlled trial that assessed the effectiveness of arm ergometer training for improving spasticity, range of motion, and motor control in patients with sub-acute and chronic stroke. 40 patients were divided into two groups - one that received conventional therapy alone and one that received conventional therapy plus arm ergometer training. The results showed that the group receiving arm ergometer training in addition to conventional therapy had significantly greater reductions in spasticity, as well as greater improvements in range of motion and gross motor function compared to the conventional therapy alone group. The study concluded that conventional therapy combined with arm ergometer treatment was effective for reducing spasticity and improving motor outcomes in sub-acute and chronic stroke
Prehospital care in trauma is as important as in hospital care. The presentation addresses simple and basic approach to care a polytrauma victim in platinum 10 minutes based on BTLS.
This document provides an overview of cardiac rehabilitation, including its aims, components, eligibility criteria, benefits, exercise prescription guidelines, nutrition management, smoking cessation, managing psychosocial issues, and phases. The key points are:
1) Cardiac rehabilitation aims to optimize physical, psychological and social functioning for patients with cardiovascular disease through improving health behaviors and slowing disease progression.
2) It includes medical evaluation, exercise training, education, and psychological/social support to facilitate recovery and promote long-term prevention strategies.
3) Regular exercise as part of cardiac rehabilitation reduces mortality and improves health outcomes for eligible patients with conditions like heart attacks, heart failure, and angina.
This document provides an introduction to the book "Cardiac Rehabilitation: A Guide to Practice in the 21st Century". It summarizes that the book provides an updated resource on cardiac rehabilitation practice based on scientific research since 1995. It translates scientific recommendations into practical applications to improve the quality of cardiac rehabilitation. The intended audience includes cardiologists, surgeons, physicians and other healthcare professionals who can refer patients to these important secondary prevention services.
This document discusses special considerations in EMS, including pediatrics, geriatrics, burns, multiple patients, and trauma resuscitation. It notes that pediatric and geriatric patients have unique anatomical differences that require modified care. Burns are serious injuries that involve multiple organ systems, and smoke inhalation can be life-threatening. Multiple patient situations may require triage to prioritize those most in need of immediate treatment. Trauma resuscitation policies allow withholding efforts in non-survivable injuries but require special consideration for hypothermia, immersion, and lightning victims. Overall, awareness of special populations and situations can optimize EMS patient management and outcomes.
Spinal injuries commonly occur in motor vehicle crashes, falls, and sports. Proper assessment and management is important to prevent permanent paralysis from secondary injury to the spinal cord. A full neurological exam assesses mental status, motor function, sensation, and reflexes. Secondary injuries from hypotension and hypoxia can be prevented by maintaining adequate oxygenation, circulation, and minimizing time on scene during transport to a suitable hospital.
The secondary assessment completes the full patient evaluation and identifies both life-threatening and non-life threatening injuries. It includes reassessing vital signs, taking a history, conducting a physical exam, monitoring the patient, providing treatment, making transport decisions, communicating with the receiving facility, and documenting findings. For critical patients, the secondary assessment may be abbreviated or postponed to focus on primary assessment and stabilization. The extent of the secondary assessment depends on the situation and patient condition.
The document discusses trauma, including terminology, epidemiology, types of trauma, and the roles of trauma nurses. It outlines the ABCDE approach for primary and secondary trauma surveys, emphasizing airway, breathing, circulation, disability, and exposure. It stresses the importance of the golden hour for aggressive resuscitation to improve survival chances and restoring normal function. Trauma nurses play important roles as care providers, educators, and managers working to improve emergency healthcare and prevent injuries.
The document summarizes a randomized controlled trial that assessed the effectiveness of arm ergometer training for improving spasticity, range of motion, and motor control in patients with sub-acute and chronic stroke. 40 patients were divided into two groups - one that received conventional therapy alone and one that received conventional therapy plus arm ergometer training. The results showed that the group receiving arm ergometer training in addition to conventional therapy had significantly greater reductions in spasticity, as well as greater improvements in range of motion and gross motor function compared to the conventional therapy alone group. The study concluded that conventional therapy combined with arm ergometer treatment was effective for reducing spasticity and improving motor outcomes in sub-acute and chronic stroke
Prehospital care in trauma is as important as in hospital care. The presentation addresses simple and basic approach to care a polytrauma victim in platinum 10 minutes based on BTLS.
This document provides an overview of cardiac rehabilitation, including its aims, components, eligibility criteria, benefits, exercise prescription guidelines, nutrition management, smoking cessation, managing psychosocial issues, and phases. The key points are:
1) Cardiac rehabilitation aims to optimize physical, psychological and social functioning for patients with cardiovascular disease through improving health behaviors and slowing disease progression.
2) It includes medical evaluation, exercise training, education, and psychological/social support to facilitate recovery and promote long-term prevention strategies.
3) Regular exercise as part of cardiac rehabilitation reduces mortality and improves health outcomes for eligible patients with conditions like heart attacks, heart failure, and angina.
This document provides an introduction to the book "Cardiac Rehabilitation: A Guide to Practice in the 21st Century". It summarizes that the book provides an updated resource on cardiac rehabilitation practice based on scientific research since 1995. It translates scientific recommendations into practical applications to improve the quality of cardiac rehabilitation. The intended audience includes cardiologists, surgeons, physicians and other healthcare professionals who can refer patients to these important secondary prevention services.
Nursing management of critically ill patient in intensive care unitsANILKUMAR BR
Critical care nursing: it is the field of nursing with a focus on the utmost care of the critically ill (or) unstable patients.
Critically ill patients : critically ill patients are those who are at risk for actual (or) potential life threatening health problems.
Admission QGeneral appearance (consciousness)
Airway: Patency Position of artificial airway (if present)
Breathing: Quantity and quality of respirations (rate, depth, pattern, symmetry, effort, use of accessory muscles) Breath sounds Presence of spontaneous breathing.
Circulation and Cerebral Perfusion: ECG (rate, rhythm, and presence of ectopy) Blood pressure Peripheral pulses and capillary refill Skin, color, temperature, moisture Presence of bleeding Level of consciousness, responsiveness.
quick Check Assessment in CCU.
The document discusses patient assessment for emergency medical responders. It covers performing a scene size-up to ensure safety and identify hazards. The primary assessment involves evaluating a patient's level of consciousness, airway, breathing, and circulation to identify life threats. A medical history is then obtained. The secondary assessment is a more thorough examination of all body systems to locate and treat non-life threatening injuries or illnesses. Vital signs including respiration, pulse, and capillary refill are assessed. Reassessment of the patient periodically is also recommended.
Glimpse of Cardiac rehabilitation for health care professionals to update themselves, with aim of helping people with or without disease. Focus on primary, secondary, tertiary prevention.
The document summarizes the student's observation of the trauma center at Abilene Regional Hospital. It describes various medical cases seen including abdominal pain, chest pain, and injuries from an automobile accident. It discusses the goals of triage in the trauma center to prioritize patients based on need. It also outlines safety guidelines followed in the trauma center including security protocols and monitoring systems. Finally, it describes the critical role of trauma nurses in providing fast, knowledgeable care under stressful conditions to stabilize patients and prevent further health deterioration.
Cardiac rehabilitation programs have evolved significantly over the past century from strict bed rest to structured exercise-based programs. Exercise-based cardiac rehabilitation is associated with lower risks of cardiovascular death and hospitalization. It can improve cardiac outcomes through mechanisms such as lipid and blood pressure lowering, smoking cessation, reduced inflammation, and improved ventricular function. While cardiac rehabilitation completion is associated with improved survival, utilization rates remain low at only 10-20% due to various barriers.
1. Cardiac rehabilitation aims to optimize a cardiac patient's physical, psychological, and social functioning through medical, exercise, educational, and psychosocial interventions.
2. It is divided into 4 phases - the acute hospitalization phase focuses on early mobilization; phase 2 occurs post-discharge and focuses on health education and resuming activity; phase 3 incorporates ongoing education and exercise training; and phase 4 focuses on long-term lifestyle changes and monitoring.
3. Exercise prescription for cardiac patients follows general principles but is adjusted based on each patient's clinical status and risk factors. Intensity is progressed over time from low to moderate levels based on symptoms.
This document provides an overview of surgical principles and concepts. It discusses the basics of anatomy, cells, the essentials of life, causes of injury, and the body's response to injury. It then reviews each body system. Key concepts covered include the perioperative process, different types of surgical care, principles of examination and diagnosis, and approaches to patient management. Complications are discussed as well as the goals and modalities of treatment. Safety, quality improvement, and post-operative care are also summarized.
This document provides guidelines for exercise prescription during Phase I cardiac rehabilitation for myocardial infarction patients. Phase I involves inpatient rehabilitation with a focus on patient education, counseling, and low-intensity exercises like range of motion, ankle exercises, and walking. Exercises are progressed over time in terms of intensity, duration, and type to prepare patients for discharge and continued rehabilitation in an outpatient setting. Factors like heart rate, blood pressure, symptoms, and perceived exertion are monitored during sessions to ensure safety.
Introduction to exercise electrocardiographyJavidsultandar
Exercise electrocardiography is a Non- invasive tool to evaluate the cardio vascular system's response to exercise under carefully controlled conditions.
Exercise is the body’s most common physiologic stress- most practical test of cardiac perfusion and function.
During exercise body increases its metabolic rate to greater than 20 times that of rest; cardiac out put as much as six fold. (depends on age,sex,type of exercise,size etc)
Evaluation of functional capacity, heart rate changes, burden of ectopy, and dynamic electrocardiographic changes during and after exercise have emerged as powerful prognostic indicators
Cardiac rehabilitation aims to restore patients with cardiovascular disease to their optimal physiological and psychosocial status through a multiphase process. It focuses on exercise training, education, and risk factor reduction to improve outcomes such as exercise tolerance, symptoms, and quality of life while reducing mortality. Exercise begins conservatively in the inpatient phase and progresses in intensity through outpatient phases focused on maintenance.
This document discusses strategies to ensure the safety and wellness of paramedics and their patients. It addresses key threats like motor vehicle crashes, back injuries, and disease transmission. It emphasizes the importance of proper lifting techniques, infection control, health and wellness, and stress management for paramedic safety. For patient safety, it highlights risks of improper transfer or communication, medication errors, airway issues, and ambulance crashes. The document stresses the legal and ethical responsibilities of paramedics to adhere to standards of care, patient rights, and reporting requirements. Finally, it provides an overview of cellular metabolism and the importance of maintaining cellular integrity in emergency medical treatment.
Role of nurse in organ donation, retrievel and banking RakhiYadav53
Nurses play a vital role in organ donation, from facilitating potential donors to supporting families. They begin by identifying potential donors and managing their care until donation. Nurses guide families through the difficult process, obtain consent, and initiate the donor protocol according to hospital policy. After retrieval, organs are preserved and transported to recipients. Nurses coordinate multiple teams and care for donors and recipients through all stages of donation and transplantation. Their role is critical in this complex process.
This document discusses cardiac rehabilitation and the effects of exercise. It describes 3 phases of cardiac rehabilitation: phase I focuses on early ambulation and low-intensity activities in the hospital; phase II involves incremental physical activity as an outpatient; and phase III emphasizes long-term community-based or home-based exercise. The benefits of habitual physical activity and exercise are summarized, including increased cardiac output and reduced heart rate, blood pressure, and mortality risks. Contraindications for exercise are also outlined.
This article reviews chest physical therapy techniques used in the intensive care unit (ICU) to clear pulmonary secretions and improve lung function in critically ill patients. Chest physical therapy typically includes postural drainage, percussion, vibration, cough stimulation, breathing exercises, suctioning, and patient mobilization. While studies on the efficacy of chest physical therapy in ICU patients are limited, the resolution of atelectasis and improvements in oxygenation seen in some studies suggest it may help patients in the ICU by removing retained secretions and improving lung function. The article describes indications for treatment and provides details on appropriate chest physical therapy techniques for critically ill patients in the ICU.
this power point presentation provides main emphasis on the phases of the rehabilitation post op. it will enhance the knowledge about do's and dont's during the rehabilitation phases in brief. U may ask the questions if you have in your mind in the comment section. this ppt includes upper extremity as well as lower extremity exercises and also provides easy understanding with the help of suitable and intresting diagrams
The document summarizes the St Georges Respiratory Questionnaire (SGRQ), which is a disease-specific quality of life assessment tool validated for use in COPD and asthma. The SGRQ consists of 76 items divided into three parts measuring symptoms, activity limitation, and social/emotional impact. It provides an overall score from 0-100 with higher scores indicating a worse quality of life. Administration involves having the patient complete the questionnaire themselves while an administrator is available to answer any questions. The questionnaire takes approximately 10 minutes to complete.
This document provides information on assessing and managing neonatal emergencies. It discusses key topics including epidemiology, terminology, transitioning from in utero to extrauterine life, and the mnemonic "ABCs" for assessing airway, breathing, and circulation. For breathing issues, the document recommends positive pressure ventilation with a bag-valve mask. For circulation problems unresponsive to ventilation, chest compressions at a 3:1 ratio are advised. Hypoglycemia and hypothermia are also addressed. A case study example applies these concepts to an unresponsive 3-week-old infant.
The document discusses invasive airway management and the controversies surrounding endotracheal intubation by paramedics. It emphasizes the importance of the paramedic using good clinical decision making to select the most appropriate airway intervention for each patient. While endotracheal intubation can be very effective when performed correctly, it also carries risks, and success rates for paramedics have been reported as low. The document suggests paramedics can help preserve their ability to perform endotracheal intubation by improving patient selection, confirmation of proper tube placement, and ongoing training.
This lesson covers key principles for safely managing patients at an emergency scene and during transport. It emphasizes:
1) Ensuring safety, assessing scene needs and identifying life threats as top priorities.
2) Properly managing airway, breathing, circulation and disability to stabilize the patient.
3) Rapidly extricating and transporting patients to the appropriate facility while communicating clearly with staff.
Scene assessment involves evaluating safety, pre-arrival information, arrival on scene, available resources, and mechanism of injury. The primary assessment evaluates airway, breathing, circulation, disability, and environment/exposure to identify life-threatening conditions. This assessment determines if the patient is sick, not yet sick, or not sick. Based on these assessments, the responder decides if immediate transport is needed, if further assessment is required, how to package the patient, the transport method, and receiving facility.
Nursing management of critically ill patient in intensive care unitsANILKUMAR BR
Critical care nursing: it is the field of nursing with a focus on the utmost care of the critically ill (or) unstable patients.
Critically ill patients : critically ill patients are those who are at risk for actual (or) potential life threatening health problems.
Admission QGeneral appearance (consciousness)
Airway: Patency Position of artificial airway (if present)
Breathing: Quantity and quality of respirations (rate, depth, pattern, symmetry, effort, use of accessory muscles) Breath sounds Presence of spontaneous breathing.
Circulation and Cerebral Perfusion: ECG (rate, rhythm, and presence of ectopy) Blood pressure Peripheral pulses and capillary refill Skin, color, temperature, moisture Presence of bleeding Level of consciousness, responsiveness.
quick Check Assessment in CCU.
The document discusses patient assessment for emergency medical responders. It covers performing a scene size-up to ensure safety and identify hazards. The primary assessment involves evaluating a patient's level of consciousness, airway, breathing, and circulation to identify life threats. A medical history is then obtained. The secondary assessment is a more thorough examination of all body systems to locate and treat non-life threatening injuries or illnesses. Vital signs including respiration, pulse, and capillary refill are assessed. Reassessment of the patient periodically is also recommended.
Glimpse of Cardiac rehabilitation for health care professionals to update themselves, with aim of helping people with or without disease. Focus on primary, secondary, tertiary prevention.
The document summarizes the student's observation of the trauma center at Abilene Regional Hospital. It describes various medical cases seen including abdominal pain, chest pain, and injuries from an automobile accident. It discusses the goals of triage in the trauma center to prioritize patients based on need. It also outlines safety guidelines followed in the trauma center including security protocols and monitoring systems. Finally, it describes the critical role of trauma nurses in providing fast, knowledgeable care under stressful conditions to stabilize patients and prevent further health deterioration.
Cardiac rehabilitation programs have evolved significantly over the past century from strict bed rest to structured exercise-based programs. Exercise-based cardiac rehabilitation is associated with lower risks of cardiovascular death and hospitalization. It can improve cardiac outcomes through mechanisms such as lipid and blood pressure lowering, smoking cessation, reduced inflammation, and improved ventricular function. While cardiac rehabilitation completion is associated with improved survival, utilization rates remain low at only 10-20% due to various barriers.
1. Cardiac rehabilitation aims to optimize a cardiac patient's physical, psychological, and social functioning through medical, exercise, educational, and psychosocial interventions.
2. It is divided into 4 phases - the acute hospitalization phase focuses on early mobilization; phase 2 occurs post-discharge and focuses on health education and resuming activity; phase 3 incorporates ongoing education and exercise training; and phase 4 focuses on long-term lifestyle changes and monitoring.
3. Exercise prescription for cardiac patients follows general principles but is adjusted based on each patient's clinical status and risk factors. Intensity is progressed over time from low to moderate levels based on symptoms.
This document provides an overview of surgical principles and concepts. It discusses the basics of anatomy, cells, the essentials of life, causes of injury, and the body's response to injury. It then reviews each body system. Key concepts covered include the perioperative process, different types of surgical care, principles of examination and diagnosis, and approaches to patient management. Complications are discussed as well as the goals and modalities of treatment. Safety, quality improvement, and post-operative care are also summarized.
This document provides guidelines for exercise prescription during Phase I cardiac rehabilitation for myocardial infarction patients. Phase I involves inpatient rehabilitation with a focus on patient education, counseling, and low-intensity exercises like range of motion, ankle exercises, and walking. Exercises are progressed over time in terms of intensity, duration, and type to prepare patients for discharge and continued rehabilitation in an outpatient setting. Factors like heart rate, blood pressure, symptoms, and perceived exertion are monitored during sessions to ensure safety.
Introduction to exercise electrocardiographyJavidsultandar
Exercise electrocardiography is a Non- invasive tool to evaluate the cardio vascular system's response to exercise under carefully controlled conditions.
Exercise is the body’s most common physiologic stress- most practical test of cardiac perfusion and function.
During exercise body increases its metabolic rate to greater than 20 times that of rest; cardiac out put as much as six fold. (depends on age,sex,type of exercise,size etc)
Evaluation of functional capacity, heart rate changes, burden of ectopy, and dynamic electrocardiographic changes during and after exercise have emerged as powerful prognostic indicators
Cardiac rehabilitation aims to restore patients with cardiovascular disease to their optimal physiological and psychosocial status through a multiphase process. It focuses on exercise training, education, and risk factor reduction to improve outcomes such as exercise tolerance, symptoms, and quality of life while reducing mortality. Exercise begins conservatively in the inpatient phase and progresses in intensity through outpatient phases focused on maintenance.
This document discusses strategies to ensure the safety and wellness of paramedics and their patients. It addresses key threats like motor vehicle crashes, back injuries, and disease transmission. It emphasizes the importance of proper lifting techniques, infection control, health and wellness, and stress management for paramedic safety. For patient safety, it highlights risks of improper transfer or communication, medication errors, airway issues, and ambulance crashes. The document stresses the legal and ethical responsibilities of paramedics to adhere to standards of care, patient rights, and reporting requirements. Finally, it provides an overview of cellular metabolism and the importance of maintaining cellular integrity in emergency medical treatment.
Role of nurse in organ donation, retrievel and banking RakhiYadav53
Nurses play a vital role in organ donation, from facilitating potential donors to supporting families. They begin by identifying potential donors and managing their care until donation. Nurses guide families through the difficult process, obtain consent, and initiate the donor protocol according to hospital policy. After retrieval, organs are preserved and transported to recipients. Nurses coordinate multiple teams and care for donors and recipients through all stages of donation and transplantation. Their role is critical in this complex process.
This document discusses cardiac rehabilitation and the effects of exercise. It describes 3 phases of cardiac rehabilitation: phase I focuses on early ambulation and low-intensity activities in the hospital; phase II involves incremental physical activity as an outpatient; and phase III emphasizes long-term community-based or home-based exercise. The benefits of habitual physical activity and exercise are summarized, including increased cardiac output and reduced heart rate, blood pressure, and mortality risks. Contraindications for exercise are also outlined.
This article reviews chest physical therapy techniques used in the intensive care unit (ICU) to clear pulmonary secretions and improve lung function in critically ill patients. Chest physical therapy typically includes postural drainage, percussion, vibration, cough stimulation, breathing exercises, suctioning, and patient mobilization. While studies on the efficacy of chest physical therapy in ICU patients are limited, the resolution of atelectasis and improvements in oxygenation seen in some studies suggest it may help patients in the ICU by removing retained secretions and improving lung function. The article describes indications for treatment and provides details on appropriate chest physical therapy techniques for critically ill patients in the ICU.
this power point presentation provides main emphasis on the phases of the rehabilitation post op. it will enhance the knowledge about do's and dont's during the rehabilitation phases in brief. U may ask the questions if you have in your mind in the comment section. this ppt includes upper extremity as well as lower extremity exercises and also provides easy understanding with the help of suitable and intresting diagrams
The document summarizes the St Georges Respiratory Questionnaire (SGRQ), which is a disease-specific quality of life assessment tool validated for use in COPD and asthma. The SGRQ consists of 76 items divided into three parts measuring symptoms, activity limitation, and social/emotional impact. It provides an overall score from 0-100 with higher scores indicating a worse quality of life. Administration involves having the patient complete the questionnaire themselves while an administrator is available to answer any questions. The questionnaire takes approximately 10 minutes to complete.
This document provides information on assessing and managing neonatal emergencies. It discusses key topics including epidemiology, terminology, transitioning from in utero to extrauterine life, and the mnemonic "ABCs" for assessing airway, breathing, and circulation. For breathing issues, the document recommends positive pressure ventilation with a bag-valve mask. For circulation problems unresponsive to ventilation, chest compressions at a 3:1 ratio are advised. Hypoglycemia and hypothermia are also addressed. A case study example applies these concepts to an unresponsive 3-week-old infant.
The document discusses invasive airway management and the controversies surrounding endotracheal intubation by paramedics. It emphasizes the importance of the paramedic using good clinical decision making to select the most appropriate airway intervention for each patient. While endotracheal intubation can be very effective when performed correctly, it also carries risks, and success rates for paramedics have been reported as low. The document suggests paramedics can help preserve their ability to perform endotracheal intubation by improving patient selection, confirmation of proper tube placement, and ongoing training.
This lesson covers key principles for safely managing patients at an emergency scene and during transport. It emphasizes:
1) Ensuring safety, assessing scene needs and identifying life threats as top priorities.
2) Properly managing airway, breathing, circulation and disability to stabilize the patient.
3) Rapidly extricating and transporting patients to the appropriate facility while communicating clearly with staff.
Scene assessment involves evaluating safety, pre-arrival information, arrival on scene, available resources, and mechanism of injury. The primary assessment evaluates airway, breathing, circulation, disability, and environment/exposure to identify life-threatening conditions. This assessment determines if the patient is sick, not yet sick, or not sick. Based on these assessments, the responder decides if immediate transport is needed, if further assessment is required, how to package the patient, the transport method, and receiving facility.
Trauma is a leading cause of death worldwide and in the United States. Annually in the US, trauma results in over 179,000 deaths, 60 million injuries, 40 million emergency department visits, and $684 billion in economic costs. The goals of PHTLS are to reduce mortality and morbidity from trauma through providing appropriate prehospital care. It teaches a team-based approach and emphasizes clear communication and documentation. PHTLS is based on current trauma research and aims to teach assessment and treatment principles to enhance critical thinking and patient care.
The document discusses the process of patient assessment for EMTs. It covers the key components of patient assessment including scene size-up, primary assessment, history taking, secondary assessment, and reassessment. The primary assessment involves evaluating the patient's level of consciousness, airway, breathing, and circulation to identify any immediate life threats. Secondary assessment involves a more thorough examination of all body systems. Proper patient assessment is essential for EMTs to determine the patient's condition and priority for treatment and transport.
Definition
(Health, Assessment, evaluation and observation)
Health assessment steps
(Health History, Physical Examination & Documentation of Data)
Source of data
(primary or secondary)
Phases of the nursing process
(Assessment, Diagnosis, Planning, Implementation & evaluation)
Types of health assessment
(Comprehensive, Problem-based, Emergency, Episodic, Shift & Screening).
Chapter 1 Powerpoint - Emergency Medical ResponderJohn Campbell
The summary discusses the roles and responsibilities of an Emergency Medical Responder (EMR). It describes the typical sequence of events in an EMS system, from reporting of an incident to dispatch, emergency response, EMS vehicle response, and transport to a hospital. It outlines the goals of EMR training, which are to treat patients using limited equipment, know what not to do, use an EMR life support kit, improvise when needed, and assist other EMS providers. The summary also emphasizes the importance of documentation and maintaining patient confidentiality. It concludes by noting that an EMR's primary role is to provide immediate care and assist higher level personnel until the patient can be transferred to their care.
The document provides information on performing patient assessments, including initial and focused assessments. It discusses establishing control of the scene, assessing hazards, and determining the mechanism of injury during the initial assessment. The focused assessment involves a physical exam, checking vital signs using ABCDE (airway, breathing, circulation, disability, environment), and taking a SAMPLE history of the patient's symptoms, allergies, medications, medical history, last intake/output, and events surrounding the incident. Proper documentation of assessments using the SOAP format is also emphasized.
Clinical trials involve several phases to test a drug's safety and efficacy. Phase I trials test safety in healthy volunteers. Phase II trials test dosage and side effects in patients. Phase III trials test efficacy in large patient groups. Legal and procedural aspects require ethics committee approval, informed consent, and regulatory oversight. Clinical trials involve clinical investigators, institutions to host the trial, sponsors to fund the trial, and regulatory authorities to provide legal approval. The clinical trial protocol, informed consent process, and role of ethics committees are important to protect patient rights and welfare in clinical research.
This document discusses geriatric emergencies and the National EMS Education Standard Competencies related to assessing and treating elderly patients. It covers age-related changes to body systems like respiratory and cardiovascular and how those changes can impact assessment. Key points emphasized include taking a thorough history, addressing any life threats, communicating effectively with elderly patients, and considering environmental and social factors. The GEMS Diamond is introduced as a mnemonic to remember important issues to assess in geriatric patients.
This document outlines the process for completing a health assessment. It involves preparing equipment, environment, and the client. A health history is then taken, including biographical data, chief complaints, present/past/family medical histories, and reviews of systems. Both subjective data from the client and objective data from examinations are collected. Health histories can be comprehensive for new/nonemergent patients or focused for ongoing/emergency cases. Functional assessments are also performed.
This document discusses utilizing patient care data from clinical settings for clinical research purposes. It describes the types of data available, common barriers faced, and the need to obtain proper permissions. A variety of research study designs are possible using this data, including descriptive studies, interventional studies, qualitative research, and quality improvement projects. Case studies, case series, surveys and collaboration are recommended approaches. Addressing barriers like permissions and developing research skills can help facilitate use of this valuable data source.
This document provides an overview of clinical trials, including their purpose, classifications, terminology, design, phases, ethics, and protections for participants. Some key points:
- Clinical trials test interventions like drugs or procedures and compare them to standard practices or placebos. They progress through phases to test safety and effectiveness.
- There are three main types of research studies: observational studies that compare groups, analytic studies that test therapies, and clinical trials which are considered the "gold standard" experimental study.
- Protections like informed consent and institutional review boards ensure ethical treatment of human subjects and that risks are reasonable compared to potential benefits. Oversight protects participants' rights and welfare.
The document discusses the basic principles of epidemiology in emergencies. It describes epidemiology as the study of disease distribution and causes. Descriptive epidemiology determines disease distribution, analytical epidemiology examines risk factors, and evaluation epidemiology assesses program effectiveness. Surveillance systems collect health data to monitor trends and detect outbreaks. Rapid needs assessments identify priority health issues to guide emergency response.
Medical Documentation Improvement InitiativeOmer Khan
The document proposes an initiative to improve medical resident documentation at SBAHC. It outlines a 4-step plan: 1) demonstrate the purpose of good documentation; 2) conduct a needs assessment; 3) engage physicians in a clinical documentation improvement program; 4) develop documentation tools. The initiative aims to address deficiencies in documentation, which impacts patient care and outcomes. Good documentation is important for quality care, legal protection, and demonstrating the care provided. The proposal also includes policies and procedures for house physician patient care responsibilities, including conducting assessments and documenting findings.
This document provides an overview of clinical trials, including their purpose, classifications, terminology, design, phases, ethics, and impact. It discusses how clinical trials test interventions to collect data and further understanding, outlines the main types of research studies, and describes key components of clinical trial protocols including recruitment, informed consent, and oversight. The summary emphasizes that clinical trials aim to better understand health while protecting participants, through review boards and ethical standards.
The document outlines the nursing process which includes assessment, diagnosis, planning, implementation, and evaluation. Assessment involves collecting subjective and objective data on the patient's physical, psychological, social, and medical history. Nursing diagnoses are developed based on the assessment findings and describe the patient's actual or potential health problems. Goals are then set and a care plan is developed which outlines nursing interventions. Implementation involves performing the interventions and reassessing the patient. Evaluation assesses if goals were met and determines if changes need to be made to the care plan. The nursing process is circular and ongoing to meet the changing needs of the patient.
Similar to Lecture presentation phtls_lesson08 (20)
This document discusses toxicology, hazardous materials, and weapons of mass destruction. It begins by outlining the objectives of reviewing toxidromes, hazardous environments, and managing toxicologic emergencies using the AMLS Assessment Pathway. It then defines key terms like toxicology, toxidrome, and major toxidromes. The autonomic nervous system and its sympathetic and parasympathetic divisions are described. Initial approaches for hazardous scenes and weapons of mass destruction exposures are reviewed. Two case studies of potential toxic exposures are then presented and managed using the AMLS Assessment Pathway.
This chapter discusses environmental-related emergencies including thermoregulation issues like hypothermia and heat-related illnesses, atmospheric pressure changes, and submersions like drowning. It provides two case studies - one involving an elderly male found confused and hypothermic, who is ultimately diagnosed with hypothermia, dehydration, and alcohol intoxication. The second case involves a drowning victim pulled from the water who is treated for drowning and mild hypothermia. The document stresses using the AMLS assessment pathway to identify life threats and refine diagnoses to guide treatment.
This document provides an overview of infectious diseases and discusses two case studies using the AMLS Assessment Pathway. For the first case, the summary is:
A male college student collapsed with abdominal pain and was found to have splenic rupture from acute infectious mononucleosis. For the second case, the summary is:
A female returned from Latin America with fever, eye swelling, and difficulty breathing and was diagnosed with Chagas disease caused by a parasite transmitted by kissing bugs.
This patient was found barely breathing in a public restroom. Initial observations found her unresponsive with a slow respiratory rate. Her history is unknown but track marks indicate possible drug use. Differentials include drug overdose, hypoglycemia, or sepsis. Treatment will focus on supporting her ABCs while gathering diagnostics to identify the cause.
This document provides information on assessing and managing patients with abdominal disorders. It presents two case studies:
1) A 40-year-old pregnant woman with acute cholecystitis presenting with abdominal pain.
2) A 68-year-old woman with a ruptured abdominal aortic aneurysm presenting with abdominal and back pain as well as dizziness. Both cases are assessed using the AMLS assessment pathway and treated accordingly. The document stresses the importance of identifying life threats and obtaining a thorough history and exam to guide diagnosis and treatment.
This document provides information on neurologic disorders and conducting a neurologic exam. It describes the anatomy and physiology of the brain and nervous system. It then presents two case studies of patients presenting with neurologic complaints. The first case involves a 66-year-old woman experiencing difficulty speaking, which upon assessment is determined to likely be an acute ischemic stroke. The second case involves a 68-year-old man who fell while walking and is complaining of a mild headache, with the differential diagnosis including intracranial hemorrhage or elevated intracranial pressure. The document stresses using the AMLS assessment pathway to evaluate patients with potential neurologic issues.
The document discusses shock, including the types (hypovolemic, distributive, cardiogenic, obstructive), stages, pathophysiology, and case study of a 72-year-old male found lethargic in bed who is assessed using the AMLS pathway and diagnosed with sepsis from an untreated foot infection.
This document provides information on cardiovascular disorders and two case studies involving patients presenting with chest discomfort.
The first case involves an elderly male patient at a nursing home with chest pain and difficulty breathing. After assessment, the patient is diagnosed with a spontaneous pneumothorax.
The second case involves a young male camper with chest pain that has worsened over 36 hours. Additional information reveals recent recreational drug use. Assessment findings include subcutaneous emphysema and early repolarization on ECG. He is diagnosed with pneumomediastinum from increased intrathoracic pressure from holding in marijuana smoke.
Both cases demonstrate use of the AMLS assessment pathway to evaluate patients with chest discomfort and identify differential diagnoses
This document provides an overview of respiratory disorders and management of shortness of breath. It discusses respiratory anatomy and physiology, normal ventilation and how it is affected by obesity and aging. It also covers respiratory assessment, distinguishing respiratory distress from failure, and two case studies where emergency medical responders use the AMLS Assessment Pathway to evaluate and treat patients presenting with shortness of breath.
This document discusses special considerations in EMS, including pediatrics, geriatrics, burns, multiple patients, and trauma resuscitation. It notes that pediatric and geriatric patients have unique anatomical differences that require modified care. Burns are serious injuries that involve multiple organ systems, and smoke inhalation can be life-threatening. Multiple patient situations may require triage to prioritize those most in need of immediate treatment. Trauma resuscitation policies allow withholding efforts in non-survivable injuries but require special consideration for hypothermia, immersion, and lightning strike victims.
Thank you for the summary. I don't have any additional questions. The summary effectively captured the key points about spinal cord injuries, assessment, and management.
Congestive heart failure occurs when the heart cannot adequately pump blood to meet the body's needs. It can be caused by conditions like coronary artery disease, heart attacks, or viruses. Common symptoms include shortness of breath, fatigue, swelling, and coughing. Medications help decrease cardiac workload and fluid retention. Community paramedics help with medication compliance by identifying reasons for non-compliance and providing education. They monitor for signs of acute heart failure like sudden fluid buildup or rapid heartbeat. Proper medical care of CHF can improve symptoms, though lifestyle changes and lifelong treatment are usually needed.
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2024 HIPAA Compliance Training Guide to the Compliance OfficersConference Panel
Join us for a comprehensive 90-minute lesson designed specifically for Compliance Officers and Practice/Business Managers. This 2024 HIPAA Training session will guide you through the critical steps needed to ensure your practice is fully prepared for upcoming audits. Key updates and significant changes under the Omnibus Rule will be covered, along with the latest applicable updates for 2024.
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Texting and Email Communication: Understand the compliance requirements for electronic communication.
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The South Beach Coffee Java Diet is a variation of the popular South Beach Diet, which was developed by cardiologist Dr. Arthur Agatston. The original South Beach Diet focuses on consuming lean proteins, healthy fats, and low-glycemic index carbohydrates. The South Beach Coffee Java Diet adds the element of coffee, specifically caffeine, to enhance weight loss and improve energy levels.
Unlocking the Secrets to Safe Patient Handling.pdfLift Ability
Furthermore, the time constraints and workload in healthcare settings can make it challenging for caregivers to prioritise safe patient handling Australia practices, leading to shortcuts and increased risks.
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GEMMA Wean is a high end larval co-feeding and weaning diet aimed at Artemia optimisation and is fortified with a high level of proteins and phospholipids. GEMMA Wean provides the early weaned juveniles with dedicated fish nutrition and is an ideal follow on from GEMMA Micro or Artemia.
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GEMMA Wean is available in 0.1mm, 0.2mm and 0.3mm. There is also a 0.5mm micro-pellet, GEMMA Wean Diamond, which covers the early nursery stage from post-weaning to pre-growing.
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TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
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LGBTQ+ Adults: Unique Opportunities and Inclusive Approaches to CareVITASAuthor
This webinar helps clinicians understand the unique healthcare needs of the LGBTQ+ community, primarily in relation to end-of-life care. Topics include social and cultural background and challenges, healthcare disparities, advanced care planning, and strategies for reaching the community and improving quality of care.
This particular slides consist of- what is Pneumothorax,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is a summary of Pneumothorax:
Pneumothorax, also known as a collapsed lung, is a condition that occurs when air leaks into the space between the lung and chest wall. This air buildup puts pressure on the lung, preventing it from expanding fully when you breathe. A pneumothorax can cause a complete or partial collapse of the lung.
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2. Secondary Assessment (1 of 3)
• Completes the full patient assessment
• Goals:
– Identification and treatment of previously
unrecognized life-threatening injuries
– Identification and treatment of
non-life-threatening injuries
3. Secondary Assessment (2 of 3)
• Secondary assessment is completed only
when time and situation permits
– Critical patients
• Focus remains on primary assessment until all life-
threatening conditions are identified and managed
• May need to postpone secondary assessment and
return to primary assessment based on changes in
the patient’s condition
7. Vital Signs (2 of 6)
• First set of vital sign measurements are
used as a baseline for that patient
• Repeat (at least) every time the patient’s
condition changes
• Repeat vital signs should be compared to
previous set(s)
– Trending
11. Vital Signs (6 of 6)
• Skin parameters
– Color
– Temperature
– Moisture
– Capillary refill
• May or may not provide accurate information
• Age of patient
• Underlying medical conditions
– The environment may affect findings
13. Physical Examination
• Physical examination directed by scene
assessment, primary assessment, history,
MOI/kinematics, and patient complaints
• Detailed versus focused examination
– Detailed involves all areas of the body
• Head-to-toe
– Focused involves limited areas of the body
• Systematic approach
14. Monitors
• Utilized as indicated by patient condition
– Pulse oximetry
– Cardiac monitor
– End tidal CO2
(ETCO2)/capnography
– Continuous blood pressure
Courtesy Masimo
15. Treatment Options (1 of 4)
• Immobilization
– Selective spinal immobilization
– Extremities
• Open wounds
– Control of external hemorrhage
– Prevent infection/contamination
16. Treatment Options (2 of 4)
• Re-evaluate need for:
– Supplemental oxygen
– IV access and fluid administration
– Prevention of body heat loss
17. Treatment Options (3 of 4)
• Comfort Measures:
– Pain control
– Positioning
– Padding
19. Decision-Making Time
• Considerations:
– Situation
– Assessment
– History
– MOI/kinematics
– Patient severity
– Treatment available
– Additional resources required
• Transport decision
20. Transportation (1 of 2)
• The receiving facility decision
– Level of care needed
– Notification
• The decision to transport as soon as
possible is based on:
– Situation
– Severity of injuries
21. Transportation (2 of 2)
• Other considerations:
– Prioritizing multiple patients
– Distance to receiving facility
– Weather conditions
– Traffic conditions
22. Communication (1 of 2)
• Receiving facility
– Timely notification
• Allows receiving facility to prepare
– Brief description of scene
– Number of patients arriving
– Current patient status
– Treatment provided
– ETA
24. Summary (1 of 3)
• If the patient is critical, secondary
assessment might not be completed
• Continue to monitor and reassess the
components of the primary assessment
• Repeat vital signs are compared to
previous sets for changes (trending)
25. Summary (2 of 3)
• The extent of the secondary assessment
is based on the patient’s complaints and
condition as time permits
• Transport decisions are based on the
patient’s assessment and needs
26. Summary (3 of 3)
• Communicate findings with receiving
facility
– Prior to arrival
– Upon arrival
• Verbal
• Written
Instructor Notes
Lesson 8 will provide participants with an overview on how to perform a secondary assessment on a trauma patient.
Instructor Notes
Expand on the following points:
The secondary assessment is a head-to-toe evaluation of a patient.
The secondary assessment is performed only after:
The primary assessment is completed
All life-threatening injuries have been identified and treated
Resuscitation has been initiated
The secondary assessment completes the full assessment of the patient.
The goals of the secondary assessment are:
Identify and treat previously unrecognized life-threatening injuries
Identify and treat non-life-threatening injuries
Instructor Notes
Expand on the following points:
The secondary assessment is completed only when time and the situation permits.
With critical patients, the focus remains on the primary assessment until all life-threatening conditions are identified and managed.
The prehospital care provider may need to postpone the secondary assessment and return to primary assessment based on changes in the patient’s condition.
Instructor Notes
Expand on the following points:
Never delay in transporting a critical patient in order to complete a secondary assessment.
Instructor Notes
Expand on the following points:
The component of the secondary assessment are:
Taking the patient’s vital signs.
Obtaining the patient’s medical history.
Performing a head-to-toe physical examination.
Initiating appropriate treatment based on the results of the full patient assessment.
The information obtained from the secondary assessment will be used during the decision-making process.
Determining how to transport the patient.
Determining which receiving facility to transport the patient.
Initiating communication with the receiving facility.
Instructor Notes
Expand on the following points:
The first part of the secondary assessment is the reassessment of vital functions.
A set of complete vital signs includes the multiple components of blood pressure, pulse rate and quality, ventilatory rate (including breath sounds), and skin color and temperature.
All components in combination give an overall picture of the patient’s condition.
Instructor Notes
Expand on the following points:
Emphasize to the participants the importance of repeat vital sign determinations as a measure of the patient’s improvement or deterioration.
The first set of vital sign measurements are used as a baseline for the patient.
For the critical trauma patient, a complete set of vital signs are evaluated and recorded every 3 to 5 minutes, as often as possible, or at the time of any change in condition or a medical problem.
Repeat vital signs should be compared to previous set(s) of vital signs.
By comparing the sets of vital signs, trends in the patient’s condition will become apparent.
Instructor Notes
Expand on the following points:
The following factors should be considered when evaluating the patient’s pulse:
The location of the pulse.
The strength of the patient’s pulse.
The rate of the patient’s pulse.
The rhythm of the patient’s pulse.
Instructor Notes
Expand on the following points:
The following factors should be considered when evaluating the patient’s respirations:
The patient’s ventilatory rate
The depth and expansion of the patient’s chest
The effort it takes the patient to breathe
Is the patient using accessory muscles to help breathe?
Is the patient breathing through the mouth or through the nose?
The patient’s breath sounds and their location
Instructor Notes
Expand on the following points:
Even if an automated, noninvasive blood pressure device is available, the initial blood pressure should be taken manually.
Automated blood pressure devices may be inaccurate in patients in shock.
Auscultation of a blood pressure while in a moving ambulance may be difficult.
Palpated blood pressures may be used to follow trends in the patient’s blood pressure.
Instructor Notes
Expand on the following points:
The patient’s skin parameters include:
Color
Temperature
Moisture
Capillary refill
May or may not provide accurate information depending on the age of patient and underlying medical conditions.
Capillary refill is helpful in children but less reliable in adults.
The environment may affect findings on the condition of the patient’s skin.
Instructor Notes
Expand on the following points:
A quick history is obtained on the patient.
This information should be documented on the patient care report and passed on to the medical personnel at the receiving facility.
Depending on the patient’s condition, a verbal history can be taken from the patient, family members, or bystanders.
Additional information can be gathered from on-scene observation.
The mnemonic SAMPLE serves as a reminder of the key components of the patient history:
Signs / symptoms
Allergies
Medications
Pertinent past medical history
Last oral intake
Events leading to the injury
Instructor Notes
Expand on the following points:
The physical examination is directed by the results of the scene assessment, primary assessment, patient history, MOI/kinematics, and patient complaints.
Based on these components, the prehospital care provider will determine whether to perform a detailed versus focused physical examination.
The detailed physical examination is a head-to-toe examination that involves all areas of the body.
The focused physical examination involves limited areas of the body.
Both types of physical examination take a systematic approach.
Instructor Notes
Expand on the following points:
Monitors are utilized as indicated by the patient’s condition.
These devices potentially include:
Pulse oximetry
Cardiac monitor
End tidal CO2/capnography
Continuous blood pressure
Discuss the limitations of various monitors with participants and the importance of correlating the results displayed by the monitors with the patient’s actual condition.
Instructor Notes
Expand on the following points:
Included in assessment and management are the skills of packaging, transporting, and communicating.
When indicated, stabilization of the spine should be an integral component of packaging the trauma patient.
The entire length of the spine needs to be immobilized, based upon the patient assessment and mechanism of injury.
If time is available, the following measures are accomplished:
Careful stabilization of extremity fractures using specific splints
If the patient is in critical condition, immobilization of all fractures as the patient is stabilized on a long backboard
Bandaging of major wounds as necessary and appropriate (i.e., wounds with active hemorrhage)
This will also help to prevent infection or contamination from entering the open wound.
Instructor Notes
Expand on the following points:
Reconsider the need for:
Supplemental oxygen
IV access and fluid administration
Prevention of body heat loss
Instructor Notes
Expand on the following points:
Consider providing the following comfort measures:
Administering pain control
The positioning of the patient
Padding to prevent pressure sores
Instructor Notes
Expand on the following points:
Consider providing the following comfort measures:
Giving emotional support (reassurance) to both the patient and the patient’s family members
Instructor Notes
Expand on the following points:
Review all of your findings, including:
The situation
The full patient assessment
The patient’s history
The MOI/kinematics
The severity of the patient’s condition
The treatments available
If any additional resources are required
How should the patient be transported based on these considerations?
Determine if the patient will be transported ground versus air.
Determine if ALS providers should be requested for transport.
Determine if this is an emergency versus non-emergent situation.
Instructor Notes
Expand on the following points:
Determine which receiving facility to transport the patient.
The following questions are weighed:
The closest facility or trauma center?
What level of care will the patient require at the receiving facility?
Notify the receiving facility so the staff may prepare to treat the patient.
The decision to transport as soon as possible is based on:
The situation
The severity of the patient’s injuries
Instructor Notes
Expand on the following points:
Other transport considerations include:
Prioritizing multiple patients
The distance to the receiving facility
The weather conditions
The traffic conditions
Instructor Notes
Expand on the following points:
Provide the receiving facility with:
Timely notification to allow the receiving facility to prepare
A brief description of scene
The number of patients arriving
The patient’s current status
Any treatments provided to the patient
The estimated time of arrival
Instructor Notes
Expand on the following points:
Provide the receiving facility with:
A verbal and written hand-off report
A good patient care report is valuable for the following two reasons:
It gives the receiving facility staff a thorough understanding of:
The events that occurred
The patient’s condition
It helps ensure quality control throughout the prehospital system by making case review possible.
Instructor Notes
Expand on the following points:
If the patient is critical, secondary assessment might not be completed.
Continue to monitor and reassess the components of the primary assessment.
Repeat vital signs are compared to previous sets for changes (trending).
Instructor Notes
Expand on the following points:
The extent of the secondary assessment is based on the patient’s complaints and condition as time permits.
Transport decisions are based on the patient’s assessment and needs.
Instructor Notes
Expand on the following points:
Communicate findings with receiving facility:
Prior to arrival
Upon arrival
Both verbally and written via the patient care report
Instructor Notes
Allow time for a question and answer session to answer any questions about the topics presented in the lesson.