Transcript 451_Chap

CHAPTER 11
Focused History
and Physical
Examination for
Medical Patients
In the seriously ill patient,
treatment may begin
before the entire
assessment is completed.
Responsive
Medical Patients
The Patient’s History
Listen carefully to what
patients tell you...
open-ended
questions if you are
…ask
unsure of their responses.
Signs and symptoms
A llergies
Medications
Pertinent past medical history
Last oral intake (solid or liquid)
Events leading to injury or illness
Onset
Provocation
Quality
Radiation
Severity
Time
Rapid
Assessment
A rapid assessment
is a HEAD-TOTOE
examination guided by
the chief complaint.
Inspect and palpate the head.
Assess the neck.
Expose the chest, look for symmetry
and auscultate lung sounds.
P4-10A(2)
Palpate the
abdomen by
quadrants.
If the patient complains
of extremity or back
pain, these areas need to
be evaluated.
Vital Signs
Vital Signs

Breathing

Pulse

Skin

Pupil size and reactivity

Blood pressure
Emergency
Care
Provide emergency
medical care based on the
information gained from
the rapid assessment and
SAMPLE history.
Unresponsive
Medical Patients
History from
Bystanders
Unresponsive
medical patients
should receive a
rapid assessment.
Unresponsive Medical Patients

Maintain patent airway


Adjuncts
Position

Constantly monitor airway

If assisted ventilations not needed, provide
high-flow oxygen

If history unknown, immobilize for transport

Keep warm
SUMMARY

Responsive Medical Patients

Unresponsive Medical Patients