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Riverbend EMS

Patient Assessment (Mnemonic Tables)

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This page consist of online training for EMS personnel.  The subject of training is "Patient Assessment".  To see more training topics,  Click Here!



Size-up represents the very beginning of patient assessment.   It requires the EMS crew to evaluate several aspects concerning the situation in a very short period of time.   It is the essence in assuring the safety of the crew and the patient.   This information may be obtained as part of dispatch, but should always be reassessed upon arrival at the scene.   For some situations, size-up is an on-going process.   As additional information is obtained, modification is performed to the size-up of the patient and the situation overall.

Perform initial assessment on all patients after assuring scene and personal safety.   If the scene is safe and the environment permits,  perform the assessment prior to moving the patient.   The initial assessment is a rapid means of assessing patient condition and priorities of care "tirage".

The focused history and physical exam are performed following the initial assessment and correction of immediate threats to life.   The focused history and physical exam differs for medical and trauma patients.   During this process,  obtain additional information regarding the patient's condition.   This assessment may be performed at the same location as the initial assessment,  unless the scene or patient's condition requires otherwise.   This assessment is the second hands-on approach to gain information and to continue providing patient care.

The detailed physical exam is performed following the focused history and physical exam.   It will be performed after all critical interventions have been completed.   It is situation and time dependent.   Depending upon the severity of the patient's injury or illness,  this assessment "may not" be completed.   During this process,  additional information regarding the patient's condition is obtained.   Typically,  this assessment will be performed while en route to the receiving facility.

The on-going assessment should be performed on all patients after assuring completion of critical interventions.   Ideally,  it is completed following the detailed physical exam.   However,  the patient condition may preclude performance of the detailed physical exam.   In these cases,  the on-going assessment is extremely valuable.   The on-going assessment is a means of determining changes in the patient's condition.

Below are tables that contain information of importance to the EMS Professional. Mnemonics as we know them with the definition of meanings. Feel free to print this page or save it on your hard drive. We hope this page gives some understanding of the mnemonics we use in our profession, feel free to E-mail us at any time with any questions or comments about any information on this page.

THE AVPU "SYSTEM" OR "SCALE"

AAlert and awake. Eyes open spontaneously. Oriented to person, place, and time.
VResponds to voice stimulus. Responds to voice but may not be oriented to person, place, or time.
PResponds to painful stimulus only. Does not respond when spoken to but withdrawls from a painful stimulus.
UUnresponsive or unconscious. Does not react to a painful stimulus.

THE DERM METHOD

DDepth of consciousness: Awake or unresponsive?
EEye signs: Are pupils Equal and Reactive to Light?(PEARL)
RRespiratory status: Are respirations normal, abnormal, (labored or shallow), or are they absent?
MMotor status: Does the patient respond to command or painful stimulus? Does the patient move all extremities and have sensation in each?

S-A-M-P-L-E HISTORY

SSigns and symptoms of present illness or injury
AAllergies
MMedications
PPertinent Past Medical History (PMHx)
LLast oral intake: (solid or liquid)?
EEvents leading to the injury or illness

DCAP-BTLS

DDeformities
CContusions
AAbrasions
PPunctures/Penetrations
BBurns
TTenderness
LLacerations
SSwelling

AEIOU - TIPS

AAcidosis or Alcohol
EEpilepsy
IInfection
OOverdose
UUremia
TTrauma
IInsulin
PPsychosis
SStroke or (CVA)

THE OPQRST METHOD

OONSETWhen did the pain start?
PPROVOKING OR PALLIATIVEWhat brought the pain on? How did the pain start? Does anything make it better or worse?
QQUALITYHow does the pain feel? Describe the pain
RREGION OR RADIATIONWhere is the pain? Do you have pain in any other place?
SSEVERITYHow bad is your pain? Can you compare the pain to any other pain you have ever had?
TTIMINGHow ling have you had the pain? Does it occur constantly or come and go?

Comments:

One of the most important skills an EMS professional has is the patient assessment skills.  All attempts possbile should be made to maintain and increase this skill level.  This is one of your best methods of decision making procedures in the field.  Please feel free to E-mail us with questions,  we also welcome your input in this area.



This Site Designed and Maintained by:Lee Sampson/Flight Paramedic
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