EMT CHAPTER 11

Describe special challenges to history taking and methods of how you would overcome each challenge

(1) silent patients: watch for body language and try to determine the cause and rectify it whenever possible; (2) overly talkative patients: show patience, allow some free rein but interrupt as needed to gather information; (3) patients with multiple symptoms or complaints: try to clarify and filter information so you can determine the actual chief complaint; (4) anxious patients: be reassuring and allow the patients to express their feelings; (5) angry or hostile patients: remain calm, confident, and professional and refrain from becoming frustrated, defensive, or angry yourself;

Explain how to assess a patients respiratory rate and quality of breathing. State the normal ranges of respiration's per minute for the adult, child and infant

Breathing is assessed by observing the patient chest rise and fall. Breathing rate is determined by counting the number of breaths and 30 second. And multiply it by two. The normal respiratory rate range for an adult patient at rest is 8/24-minutes, for children 15/30-minutes, 25/50-minute for infants and 30/60-minute for newborn

Describe what you would observe when a patient is breathing normally and when a patient is breathing abnormally

Normal breathing evolves average chest was motions where the chest expense of at least 1 inch accessory muscles of the abdomen or not used to breed the rate is within normal limits and inhalation and exhalation are about the same length and shallow breathing there is only slight chest or abdominal wall motion indicating an adequate title volumes in labored breathing there might be grunting and straighter nasal flaring and gasping.

List the information collected by using the OPQRST mnemonic

O = onset (when and how did the symptoms begin?), P = provocation/palliation/ position (what makes it worse/better?), Q = quality (how would you describe the pain?), R = radiation (where do you feel the pain?), S = severity (how bad is it?), and T = time (how long has it been going on?).

Explain the indicates for tand limitations of pulse oximetry. explain how to take an SpO2 reading

Pulse oximetry is a method of detecting hypoxia by measuring oxygen saturation levels in the blood. The procedure is indicated in any situation where the patient's oxygen status is a concern or when hypoxia may be even remotely suspected. It can, however, provide unreliable or false readings due to poor perfusion status, hypothermia, excessive patient movement, anemia, and even if the patient has a history of smoking. The device is used by clipping a small sensor onto the patient's finger, toe, earlobe, or across the bridge of the nose. Turn on the device and match the pulse reading on the device to the patient's actual heart rate. Infrared light shines through the tissue and detects hemoglobin saturation to provide an estimate of oxygenation.

Name the categories of information you need to obtain through a SAMPLE history

S = signs and symptoms, A = allergies, M = medications, P = pertinent past history, L = last oral intake, and E = events leading to the injury or illness.

List the places on the body to check for skin color. Identify normal and abnormal skin colors

Skin color changes include any discoloration of the skin in a patchy or uniform pattern. Skin color changes can include red, yellow, purple, blue, brown (bronze or tan), white, green, and black coloring or tint to the skin. Skin can also become lighter or darker than normal.

Explain how to assess a patient's pupils and describe normal and abnormal findings

To assess the pupils, briefly shine a light into the patient's eyes and look for pupil size, equality, and reactivity. Normally, both pupils are the same size and constrict equally in response to light. Abnormal pupils may be dilated (too large) or constricted (too small), or unequal in size, and neither or only one pupil may react to light.

Identify normal resting pulse rates in an adult, adolescent, school age child, preschool child, and infant. Define the terms that you would use to describe the terms that you would use to describe pulse quality

To take a pulse, position the patient in a sitting or lying position and use the tips of two or three fingers—not the thumb—to palpate the artery, and count the number of beats in a 30-second period and then multiply by two. The average resting range is 60-80 beats/minute for an adult, 60-105 beats/minute for an adolescent, 60-120 beats/minute for a school-age child, 80-150 beats/minute for a preschooler, and 120-150 beats/minute for an infant.

State the general circumstances under what you would choose to take a radial pulse, a brachial pulse or carotid pulse

in a conscious adult the radial artery is a preferred pulse point, in an unconscious and unresponsive adult the preferred post point is a carotid artery. With children and infants you may use the brachialpulse

Identify the components of vital signs and state how often they should be taken

standard vital sign assessment include checking breathing, pluse, skin signs, pupils, and blood pressure. In a stable patient vital sings should be taken every 15 minutes and as often as necessary to ensure a proper care. In an unstable patient vital signs should be taken every 5 minutes.

Explain how to take a blood pressure by palpation and by auscultation. Also identify the normal ranges of systolic and diastolic blood pressure for an adult male and an adult female.

taking blood pressure by palpation you apply the cuff and inflate rapidly to 30 mmHg above the level where you can no longer feel the radial pulse then slowly deflate the cuff. Note the pressure at which the radial pulse returns. You will not be able to measure the diastolic pressure by palpation. Taking blood pressure by auscultation, you apply the cuff then palpate the brachial artery. Close the valve and pump until the radial pulse is no longer felt. note the number and deflate the cuff. Position the stethoscope over the brachial artery and inflate the cuff to 30 mmHg above the level where you stopped feeling the pulse. deflate the cuff at about 2mmHg per sec.