This document discusses the rapid physical exam (RPE) performed by EMS providers. The RPE is a quick head-to-toe assessment of unresponsive patients or those unable to communicate. It examines the head/neck, chest/abdomen/pelvis, back/buttocks, and extremities for injuries like deformities, contusions, abrasions, and tenderness. The RPE follows the same sequence as the rapid trauma exam and uses DCAP-BTLS to recall assessment points. After the RPE, providers obtain vital signs, medical history, and explain next steps to families. Regular practice is needed to conduct the RPE efficiently in emergency situations.

1. Principles of Patient Assessment
in EMS

2. Chapter 10 – Rapid Physical
Exam
© 2011 Bedford-Parkinson-Tolouei EMT Education Unit

3. Objectives
 Describe when the EMS provider would
perform the rapid physical exam (RPE).
 List factors to consider when removing
patient clothing as part of the RPE.
 Describe the sequence for evaluation of
body parts or regions as part of the RPE.
© 2011 Bedford-Parkinson-Tolouei EMT Education Unit

4. Objectives (continued)
 List pertinent information the EMS
provider should gather from family or
caretakers when a patient is unable to
provide it.
 Describe how the EMS provider can best
gain proficiency in conducting the RPE
quickly and accurately.
© 2011 Bedford-Parkinson-Tolouei EMT Education Unit

5. Introduction
 A rapid PE is completed on the
unresponsive medical patient, conscious
stroke, intoxicated, or postictal patient.
 The RPE is a rapid systematic exam of the
following body areas:
 Head/neck
 Chest/abdomen/pelvis
 Back/buttocks
 Extremities
© 2011 Bedford-Parkinson-Tolouei EMT Education Unit

6. Introduction (continued)
 The RPE is similar to the rapid trauma
exam (RTE)
 The acronym DCAP-BTLS is used to recall
assessment points.
 Deformities
 Contusions
 Abrasions
 Punctures/penetrations
 Burns
 Tenderness
 Swelling
© 2011 Bedford-Parkinson-Tolouei EMT Education Unit

7. Steps in the RPE
 Utilize appropriate BSI precautions
 Remove any clothing needed to actually
look at the skin
 Consider environmental conditions
 Be considerate for privacy and modesty
 Reconsider the nature of illness (NOI)
 Be alert for any possible MOIs
© 2011 Bedford-Parkinson-Tolouei EMT Education Unit

8. Steps in the RPE (continued)
 Systematically evaluate each of the
following body areas from head-to-toe:
 Head & Neck
 Assess for DCAP-BTLS, crepitation and JVD
 Do not poke fingertips into fractures or soft spots
 Chest
 Assess for DCAP-BTLS, paradoxical motion,
crepitation and breath sounds
 Note any obvious scars from past medical history
(e.g.: CABG)
© 2011 Bedford-Parkinson-Tolouei EMT Education Unit

9. Steps in the RPE (continued)
 Abdomen
 Assess for DCAP-BTLS, firmness, softness, and
distension
 Note any tenderness, masses, or bulges
 Note any scars as a clue to past medical history
 Pelvis
 Assess for DCAP-BTLS, pain, tenderness, unstable
motion
 The pelvis is made up of 3 bones (ilium, ischium,
pubis) and the lower spine
 The potential for blood loss is great and may mask
1,500 ml
© 2011 Bedford-Parkinson-Tolouei EMT Education Unit

10. Steps in the RPE (continued)
 Extremities
 Assess for DCAP-BTLS, distal pulse, motor
function & sensation (PMS)
 Assess reflexes, strength and range of
motion (ROM)
 Posterior
 Assess for DCAP-BTLS
 This area is often overlooked
 Do not roll patient onto a fractured hip or
arm!
© 2011 Bedford-Parkinson-Tolouei EMT Education Unit

11. Following the RPE
 Obtain baseline VS
 Obtain the SAMPLE history
 Consider info from the: family,
bystanders, caretakers and first
responders
 Look for clues on medical history
 Consider calling physician if known
 Ask about advanced directives
 Explain to the family/caretaker
what is happening and what to
expect next
© 2011 Bedford-Parkinson-Tolouei EMT Education Unit

12. Conclusion
 Upon completion of IA, if you determine
the patient has a medical emergency and
is not responsive, the RPE should be done.
 The RPE is a systematic exam of the head,
neck, chest, abdomen, pelvis, posterior,
and extremities.
 Time is often a factor
 Achieving proficiency takes practice!
© 2011 Bedford-Parkinson-Tolouei EMT Education Unit