EMT Skills: Medical Patient Assessment/Management - EMTprep.com

Summary

In this EMT practical assessment, the responder is tasked with evaluating and managing a 24-year-old female patient experiencing respiratory distress. The responder follows a structured process, assessing airway, breathing, circulation (ABCs), and gathering information on the patient's medical history using OPQRST and SAMPLE methods. The patient is given high-flow oxygen due to wheezing, and her vitals are monitored. The assessment concludes with the EMT suspecting an asthma attack and coordinating care with an ALS ambulance for further treatment.

Takeaways

• 🧑‍⚕️ The assessment is about evaluating the ability to assess, interview, and treat a medical patient.
• 🕒 The candidate has 15 minutes to complete the patient assessment skill.
• 🚑 The patient is a 24-year-old female with respiratory distress (difficulty breathing).
• 🔍 The initial assessment reveals the patient is seated in a tripod position, conscious, and alert.
• 👩‍⚕️ ALS ambulance is immediately requested due to the patient’s condition.
• 💨 The patient's respiratory rate is 24 breaths per minute, and lung sounds reveal wheezing in all fields.
• 💉 The patient is given high-flow oxygen via a non-rebreather mask at 15 liters per minute.
• 💓 Circulation check: pulse is 96 beats per minute, skin is pale but no cyanosis or sweating.
• 🩺 After secondary assessment, the patient's respiratory rate improves to 20, and vitals are stable (BP: 112/70, pulse: 90).
• 🫁 Field impression suggests the patient is experiencing an asthma attack, and her albuterol inhaler may be used for treatment.

Q & A

What is the primary purpose of the EMT practical assessment described in the script?

The primary purpose is to evaluate the EMT's ability to assess a patient, conduct an interview, and verbalize the treatment of the patient's conditions based on the evaluation.

What is the patient’s chief complaint, and how does it influence the EMT’s approach?

The patient's chief complaint is difficulty breathing. This leads the EMT to focus on assessing the patient's airway, breathing, and circulation, with particular attention to respiratory function.

Why did the EMT request an ALS ambulance early in the assessment?

The EMT requested an ALS ambulance due to the nature of the patient's illness (respiratory distress), which may require advanced life support interventions.

What is the patient's level of consciousness, and how is this determined?

The patient is alert and conscious, as determined by the EMT when he approaches her and notices that she is seated in the tripod position and responsive to his questions.

How does the EMT assess the patient's airway and breathing in the initial examination?

The EMT assesses the airway by listening to whether air is moving through and whether any abnormal sounds like stridor are present. The EMT then checks the breathing rate (24 breaths per minute) and listens to lung sounds, which reveal wheezes.

What immediate treatment does the EMT provide for the patient's breathing difficulty?

The EMT provides the patient with High Flow oxygen via a non-rebreather mask at 15 liters per minute.

What findings does the EMT note regarding the patient's circulation during the assessment?

The EMT notes that the patient has a pulse rate of 96 beats per minute, no major bleeding, and pale but not cyanotic skin. The patient's skin is also at a normal temperature and not sweaty.

What is the significance of the 'OPQRST' assessment in the scenario?

The OPQRST assessment helps the EMT gather more detailed information about the patient's symptoms, including the onset, provoking factors, quality, severity, and duration of the condition (tightness in the chest rated 8 out of 10 and lasting about an hour).

What additional information is gathered during the 'SAMPLE' assessment?

During the SAMPLE assessment, the EMT learns that the patient is allergic to penicillin, takes albuterol for asthma, has no other relevant medical history, ate breakfast as her last meal, and was watching TV when the breathing difficulty began.

What does the EMT conclude is the likely cause of the patient’s breathing difficulties?

The EMT concludes that the patient is likely experiencing an asthma attack based on the patient's history of asthma, the wheezing lung sounds, and her difficulty breathing.

What steps does the EMT take after concluding that the patient is having an asthma attack?

The EMT would assist the patient with her albuterol inhaler if she has it available and continue to reassess her vital signs, including respiratory rate, blood pressure, and pulse, while waiting for the ALS ambulance to arrive.