chapter 12 ongoing assessment. 2 overall assessment scheme scene size-up initial assessment...

CHAPTER 12

Ongoing Assessment

2

Overall Assessment SchemeScene Size-UpScene Size-Up

Initial AssessmentInitial Assessment

TraumaTrauma MedicalMedical

Physical ExamPhysical Exam

Vital Signs &Vital Signs &SAMPLE HistorySAMPLE History

SAMPLE HistorySAMPLE History

Physical ExamPhysical Exam& Vital Signs& Vital Signs

DetailedDetailedPhysical ExamPhysical Exam

OngoingOngoingAssessmentAssessment

HOSPHOSP

3

Steps of theSteps of theOngoingOngoing

AssessmenAssessmentt

(This step should never be (This step should never be skipped unless the treatment skipped unless the treatment

of life-threatening of life-threatening injuries/illnesses prevent injuries/illnesses prevent

doing it)doing it)

4

Reassessment

Stable?

Reassess at least every 15 minutes.

Unstable?

Reassess at least every 5 minutes.

5

Steps of the OngoingAssessment

Repeat initial assessment.

Reassess and record vital signs.

Repeat focused assessment regarding

patient complaints and injuries.

Check on interventions/treatment in

progress.

6

Repeat Initial Assessment

Reassess mental status.

Maintain open airway.

Monitor breathing (rate and quality).

7

Reassess pulse (rate and quality).

Monitor skin (color, temperature,

condition).

Reassess capillary refill in pediatric

patients.

Reevaluate patient’s priority.

Repeat Initial Assessment

8

Reassess and record vital signs.Reassess and record vital signs.

9

Repeat focused assessment.Repeat focused assessment.

10

Check interventions.Check interventions.

11

Check Interventions

Is oxygen delivery adequate?

Look at skin color.

Are artificial ventilations adequate?

Make sure chest rises and falls.

Changes in pulse oximetry reading?

Make sure local protocols allow its use.

12

Are there any signs of bleeding?

Look for new blood.

Any other conditions or changes?

Check splinted extremities for distal pulse, sensation, and movement.

Check Interventions

13

Observing Trends

Trends are changes over time.

Changes noted over time are significant

(e.g. changes in BP or pulse).

EMT may need to adjust or establish new

treatments.