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5 parts of the run

patient assessment

QuestionAnswer
PART I BSI; scene safety; location, TOD, weather, and clues; general impression; age, sex, and weight; ABC's; disability and exposure; chief complaint; status
PART I (ABC's) ALWAYS done first, no matter what else is going on.
PART I (airway) Open or closed? Patent or not patent?
PART I (breathing) General rate; tidal volume; audible lung sounds; work of breathing; more importantly: effective of ineffective?
PART I (circulation) PULSE CHECK: radial vs. carotid, general rate, rhythm, quality. CAPILLARY REFILL: immediate or delayed. SKINS: temperature, color, moisture. MAJOR BLEEDING: arterial, venous.
PART I (intact) What is intact? What is not? What can/do we do?
PART I (DE) DISABILITY: eyes, verbal, motor. EXPOSURE: what do you see? what do we need to see?
PART I (c/c) CHIEF COMPLAINT: cannot move on without it; sometimes obvious, other times not.
PART I (status) DETERMINE PT STATUS: mild, moderate, acute? What is going to help determine this, and why is it important?
PART I (assessment/interventions) ASSESS, INTERVENE, and REASSESS! Give intervention time to work, and then reassess.
PART II OPQRST; BRIM; BRIMCAC; GCS
PART II (onset) Sudden or gradual?
PART II (provocation) What were they doing when it started? What were they doing when symptoms/signs began?
PART II (quality) Have THEM describe it; examples only as a last resort.
PART II (region, radiation, reoccurrence, relief) REGION: locate pain/symptoms. RADIATION: ask THEM where it travels. REOCCURRENCE: Hx of pain/symptom? What was done for it last time? Seen by MD? Dx? RELIEF: taken anything for relief? Has it relieved itself? What was done in the past for relief?
PART II (severity) 0-10 pain scale; How we can relate it? Considerations for Pt not being able to give a #
PART II (time) When did it begin? Put a time of day to it vs how long ago it happened.
PART II (BRIM) Breathing; Response; I Eyes; Movement/muscle tone/motor; Chest
PART II (BRIMCARB) Breathing; Response; I Eyes; Movement/muscle tone/motor; Chest; Abdomen; Refill; BP
PART II (GCS) EYES: spontaneous, verbal, pain, none. VERBAL: oriented, confused, inappropriate, incomprehensible, none. MOTOR: obeys commands, localizes pain, withdraws (pain), flexion/decorticate (pain), extension/decerebrate (pain), none.
PART III Vital signs; PROBELLS
PART III (vital signs, PROBELLS) Pulse, Respirations, O2 Saturation, BP, Eyes, Lungs, LOC, Skins. SPECIALIZED VITALS: orthostatic vitals (rough change of 20 points in BP or HR indicates volume problem), 12 lead EKG, temperature, blood sugar. EKG, temp and BS not always required.
PART IV History, Medications, Allergies, SPECIAL QUESTIONS, Pertinent Negatives
PART V TREATMENT: what will they need? TRANSPORT: where do they need to go and how are they getting there? REASSESS: what needs to be reevaluated; pick top 3.
Created by: leper