1. A force that impacts or is applied to the body but is not sharp enough to penetrate it
2. Bringing the patient’s head into a neutral position in which the nose is lined up with the navel and holding it there manually
3. AVPU mnemonic for assessment of mental status
1. Blunt trauma
2. In-line stabilization
3. A: Alert
V: Responds to Verbal stimulus
P: Responds to Painful stimulus
U: Unresponsive
1. AVPU mnemonic for assessment of mental status
2. Back arched, arms flexed inward toward the chest
3. Back arched, arms extended straight out parallel to the body
4. Closed or blocked; not patent
5. Open, not blocked
6. A respiratory rate that is too fast
7. Absence of breathing; respiratory arrest
8. Shortness of breath or perceived difficulty in breathing
9. Four things to include when checking circulation
1. A: Alert
V: Responds to Verbal stimulus
P: Responds to Painful stimulus
U: Unresponsive
2. Flexion posturing or decorticate posturing
3. Decerebrate posturing or extension posturing
4. Occluded (as in occluded airway)
5. Patent (as in patent airway)
6. Tachypnea
7. Apnea
8. Dyspnea
9. Pulse; Possible major bleeding; Skin color, temperature, and condition; Capillary refill
1. Treatment for:
obvious blood, vomitus, secretions, or other obstructions in the airway
2. Treatment for:
obvious open wound to the anterior, lateral, or posterior chest
3. Treatment for:
paradoxical movement of the chest
4. Treatment for:
major bleeding that is spurting or flowing steadily
5. Treatment for:
mechanism of injury that might produce spinal injury
1. Immediately suction or clear the obstruction.
2. Immediately cover the open wound with a nonporous or occlusive dressing.
3. Stabilize the segment with your hand or provide bag-valve-mask ventilation if necessary.
4. Apply direct pressure to the site of bleeding.
5. Establish and hold manual in-line stabilization of the head and neck.
1. Treatment for:
altered mental status to include a patient who is confused, who responds only to verbal or painful stimuli, or who does not respond
2. Treatment for:
airway occluded from the tongue (sonorous sounds)
3. Treatment for:
inadequate respiratory rate (too slow or too fast, with other signs of inadequate breathing)
4. Treatment for:
inadequate tidal volume (shallow breathing or poor chest rise)
5. Treatment for:
rapid and weak pulses
1. Closely assess airway and breathing status and administer high-concentration oxygen.
2. Immediately perform a head-tilt, chin-lift, or jaw-thrust maneuver if a spine injury is suspected.
3. Immediately begin positive-pressure ventilation (PPV) with supplemental oxygen connected to the ventilation device.
4. Immediately begin PPV with supplemental oxygen connected to the ventilation device.
5. Apply a nonrebreather mask at 15 L/min and assess for shock.
1. Treatment for:
carotid pulse present, but absent peripheral pulses
2. Treatment for:
pale, cool, clammy skin
3. Treatment for:
capillary refill greater than 2 seconds with other signs of poor perfusion
4. Treatment for:
absent carotid pulse in the adult or child; absent brachial pulse in the infant
5. A clear fluid that surrounds and cushions the brain and spinal cord
1. Apply a nonrebreather mask at 15 L/min and treat for shock (hypoperfusion).
2. Apply a nonrebreather mask at 15 L/min and treat for shock.
3. Apply a nonrebreather mask at 15 L/min and treat for shock.
4. Immediately begin cardiopulmonary resuscitation (CPR) and apply AED.
5. Cerebrospinal fluid (CSF).
1. How do you check for facial symmetry?
2. A section of the chest that moves in the opposite direction to the rest of the chest during the phases of respiration.
3. A protrusion, or pushing, of a portion of the brain through the cranial wall.
4. Breathing a foreign substance into the lungs.
5. Treatment for jugular venous distention (JVD) with a patient at a 45-degree angle or excessively engorged jugular veins.
6. Treatment for tracheal deviation.
7. Shortness of breath while lying flat.
8. Crowing and stridor are both commonly associated with ____________.
9. In assessing the circulation of an infant less than 1 year of age, which pulse do you check?
10. The appropriate sequence for checking circulation during the primary assessment.
11. Pale skin typically indicates _____________.
1. Have the patient grin
2. Paradoxical movement
3. Brain herniation
4. Aspiration
5. Rapid transport, consider ALS intercept, establish airway, begin PPV if inadequate respiratory rate is present
6. Rapid transport, consider ALS intercept, establish airway, begin PPV if inadequate respiratory rate
7. Orthopnea
8. Swelling or muscle spasms of the airway
9. Brachial pulse
10. a. Palpate for a pulse.
b. Check for major bleeding.
c. Assess skin signs.
d. Determine capillary refill time.
11. Shock
An emergency medical technician (EMT) can estimate a systolic blood pressure by palpating specific pulses. Identify the pulse locations and the systolic values.
Blood Pressure Estimation
• Radial pulse: 80 systolic
• Femoral pulse: 70 systolic
• Carotid pulse: 60 systolic
1. Cool and clammy (moist) skin is often related to ________________.
2. What is a quick method to check peripheral perfusion related to shock?
3. At what locations do you check for capillary refill?
4. A trauma patient presents with pale, cool, clammy skin, and an altered level of consciousness. You should assume ___________.
5. What should you consider doing whenever a patient’s airway is compromised?
6. What do you do when caring for a patient with blunt injury to the head whose mental status is deteriorating as you continue the exam?
7. What does clear fluid leaking from the ears indicate?
8. A large puncture wound to the neck is immediately sealed with occlusive dressing to prevent ______________.
9. When caring for a critical patient with distal extremity fractures, when should splinting be performed?
1. Blood loss or decreased perfusion
2. Capillary refill
3. Nail beds, fleshy part of the palm, forehead, or cheeks
4. Shock
5. Calling for advanced life support
6. Hyperventilate the patient at a rate of 20 ventilations per minute
7. A possible skull fracture
8. An air embolus
9. While transporting patient to the hospital
What does the “S” in the mnemonic “SAMPLE” stand for?
Signs, Symptoms
• Signs
• Objective findings
• What you perceive
• Symptoms
• Subjective
• What patient experiences
What does the “A” in the mnemonic “SAMPLE” stand for?
Allergies
• ANY allergies?
• Don’t focus only on allergies to medication.
• All allergies could be significant.
• What are they?
• Are you being treated for this condition?
What does the “M” in the mnemonic “SAMPLE” stand for?
Medications
• Do you take any medications?
• What are they?
• Are you taking them as prescribed? (Is the patient compliant?)
• Are you taking any over-the-counter medications?
• May we see the medications?
What does the “P” in the mnemonic “SAMPLE” stand for?
Past, Pertinent Medical History
• Have you had any recent illnesses?
• Have you been receiving medical care for any conditions?
What does the “L” in the mnemonic “SAMPLE” stand for?
Last Oral Intake
• Last food or drink
What does the “E” in the mnemonic “SAMPLE” stand for?
Events Leading up to Incident
What are the 5 baseline vitals?
1. Pulse—rate, rhythm, and quality
2. Respirations—rate, rhythm, and quality
3. Skin—color, temperature, turgor, and moisture
4. Pupillary response and size
5. Blood pressure
Name 5 types of body substance isolation (BSI) equipment.
1. Latex or vinyl gloves
2. Eye protection
3. Mask
4. Gown
5. Turnout gear
List some scene hazards that may be encountered during your scene size-up.
• Oncoming traffic
• Unstable surfaces (eg, wet or icy patches, loose gravel, slopes)
• Leaking fluids or fumes (eg, gasoline, diesel fuel, battery acid, transmission fluids)
• Broken utility poles and/or downed electrical lines
• Aggravated or hostile bystanders/potential for violence
• Smoke or fire
• Possible hazardous or toxic materials (eg, propane, hydrogen chloride)
• Other dangers at crash or rescue scenes (unsecured vehicles, hazmat placards)
• Crime scenes
While performing the ABCs for an unconscious, unresponsive adult, check for the presence of a pulse at the ________ artery.
Carotid