Patient Assessment - Week 3

Patient Assessment – Week 3

Knowing how to perform a patient assessment is one of the most vital tools of the Paramedic.  It helps you to answer vital questions like who, what, when, and how about the patient and the surrounding scene. No matter the call, no matter the patient, the EMS provider needs to be able to rapidly zero in on a complaint, make a working diagnosis, and provide adequate treatment for the patient’s condition.  If you don’t know what is going on with the patient, how are you going to provide them with adequate treatment?

Below are some tricks that you can use to ensure you are performing a great assessment:

1. Just Do It! – Remember, you can’t over-assess your patient. The more information you get the better. Every patient gets a full assessment, every time. Even if you can’t act on the information you gather, the information could prove invaluable to healthcare providers further down the road. They need good information on the acute phase of the patient’s illness. Remember, the Paramedic is “the eyes and ears of the physician in the field.”

2. Standardize! – Develop your own version of the standard assessment and do it every time.  Think up a set of questions you want to know the answers to about your patient, and answer them every time. Not only will practicing the assessment get it down to a science, you’ll also get very quick at it.  Me personally, I take a temperature and blood glucose on every patient I come into contact with.  Other information such as last tetanus shot, last flu shot, last menstrual period and pts primary doctor will make your own and the receiving facilities report writing much easier. 

                                                    

3. Start your assessment the second you arrive on scene – Start gathering information about the patient immediately.  The assessment should be performed constantly and not just at any one specific point in your contact with the patient.  It should be performed multiple times based on the changing condition of your patient. 

4. Check THESE THREE THINGS when you first encounter the patient – Always introduce yourself to the patient using your name and while you’re doing this, feel their radial pulse with your fingers. This tells you three immediately important things that will drive the rest of your care: The status of their Airway, Breathing, and Circulation. You’ll feel the rate and quality of their pulse; feel their skin temperature, moisture, and condition; and be able to assess their work of breathing when they answer you back from your introduction. If any of these things are compromised then the patient is probably sick and in need of intervention.

5. Try to determine the patient’s ultimate diagnosis – As you progress through the Paramedic class, your knowledge of the body and the various systems within it will increase dramatically.  All of this instruction is so that you can make your own field diagnosis, so that you can start treatment and interventions that could potentially save the patients life.  EMS is an extension of the doctor’s treatment, and most of the time we are the first step in a much longer process.

  

6.     Don’t afraid to touch the patient – You’re a medical person. Medical people touch other people. Sometimes they see them naked. Sometimes it’s uncomfortable and sometimes you have to touch them in a way that wouldn’t otherwise be socially acceptable. Of course, don’t do anything wrong, illegal, or immoral… but when you’re checking for a broken leg you have to touch the leg. Actually look at, listen to, and feel your patients, but always maintain your professionalism. 

Practical Exercise

Start writing your own patient assessment form, and share with me some questions you would want to ask your patient during your assessment.  Provide some insight, whether it is book knowledge or practical field knowledge, which causes you to want to ask those questions.