Chief Complaint lthe major sign and/or symptom reported by the patient lsymptoms Problems or a patient reports

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1 Chapter 8 Baseline Vital Signs and SAMPLE History Baseline Vital Signs and SAMPLE History lassessment is the most skill learn. lduring assessment you will: Gather key information. Evaluate the patient. Learn the. Learn about the patient s overall health. Gathering Key Patient Information lobtain the patient s name. lnote the age,, and race. llook for identification if the patient is unconscious. EMT-Bs Chief Complaint lthe major sign and/or symptom reported by the patient lsymptoms Problems or a patient reports lsigns Conditions that can be, heard, felt, smelled, or measured by the EMT Baseline Vital Signs (1 of 3) lkey signs used to evaluate a patient s condition lfirst set is known as vitals. lrepeated vital signs compared to the baseline Baseline Vital Signs (2 of 3) lvital signs always include: Respirations Blood pressure Baseline Vital Signs (3 of 3) lother key indicators may include: -Skin temperature and condition in adults 1

2 lother key indicators may include: -Skin temperature and condition in adults -Capillary time -Pupils -Level of consciousness Respirations lrate Number of in 30 seconds x 2 lquality Character of breathing lrhythm Regular or leffort Normal or labored lnoisy respiration Normal, stridor,, snoring, gurgling ldepth Shallow or deep Normal Respiratory Rates ladults: breaths/min lchildren: 15 to 30 breaths/min linfants: breaths/min Pulse (1 of 3) Pulse (2 of 3) Pulse (3 of 3) lrate Number of beats in seconds x 2 lstrength Bounding, strong, or weak (thready) lregularity Regular or irregular Normal Ranges for Pulse Rate Adults: beats/min Children: 70 to 150 beats/min Infants: beats/min 2

3 Children: Infants: 70 to 150 beats/min beats/min l The Skin lcolor Pink, pale, blue, red, or yellow ltemperature Warm, hot, or cool l Dry, moist, or wet Capillary Refill levaluates the ability of the system to restore blood to the capillary system (perfusion). ltested by depressing the patient s fingertip and looking for return of blood. lshould be less than seconds Blood Pressure lblood pressure is a vital sign. la drop in blood pressure may indicate: Loss of blood Loss of vascular tone Cardiac g problem lblood pressure should be measured in all patients older than years. Measuring Blood Pressure ldiastolic Pressure during phase of the heart s cycle lsystolic Pressure during lmeasured as millimeters of mercury (mm Hg) lrecorded as systolic/diastolic Blood Pressure Equipment Auscultation of Blood Pressure (1 of 2) Place cuff on patient's arm. 3

4 Auscultation of Blood Pressure (1 of 2) lplace cuff on patient's arm. lpalpate artery and place stethoscope. linflate cuff until you no longer hear pulse sounds. lcontinue pumping to increase pressure by an additional mm Hg. l Auscultation of Blood Pressure (2 of 2) lbegin slow deflation (5mmHg/second) lthe pulse beat heard is the lcontinue slow deflation lthe pulse beat heard is the las soon as pulse sounds stop, open the valve and release the air quickly. Palpation of Blood Pressure lsecure cuff. llocate pulse. linflate to 200 mm Hg. lrelease air slowly until pulse is felt. lmethod only obtains pressure. Normal Ranges of Blood Pressure ladults: /60-90 lchild: mmhg systolic linfant: mmhg systolic Blood Pressure/Pulse Correlation As a general rule on adults: lif l pulse is present, BP should be at least 80mmHg systolic lif pulse is present, BP should be at least 70mmHg systolic lif pulse is present, BP should be at least 60mmHg systolic Level of Consciousness AVPU 4

5 Level of Consciousness AVPU A and Alert V - Responsive to Verbal stimulus P - Responsive to U - Unresponsive Abnormal Pupil Reactions lfixed with no reaction to light ldilate with light and constrict without light lreact lunequal in size lunequal with light or when light is removed Constricted Pupils Dilated Pupils Unequal Pupils Pupil Assessment lp - Pupils le - la - And lr - Round lr - in size ll - React to Light Reassessment of Vital Signs lreassess stable patients every minutes. lreassess unstable patients every minutes. Obtaining a SAMPLE History (1 of 2) ls Signs and Symptoms What signs and symptoms occurred at onset? la Is the patient allergic to medications, foods, or other? lm Medications What medications is the patient taking? Obtaining a SAMPLE History (2 of 2) P past history 5

6 33 lp past history Does the patient have any medical history? ll Last oral intake When did the patient last eat or drink? le Events leading to injury or illness What events led to this incident? Other Signs to Consider lmovement on command lreaction to pain lmedical ID tags lstrength/weakness 6