30. Scene Size-Up Initial Assessment Trauma Medical Physical Exam Vital Signs & SAMPLE History SAMPLE History Physical Exam & Vital Signs Detailed Physical Exam Ongoing Assessment HOSP O VERALL ASSESSMENT SCHEME
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33. P RECEPTOR P EARL Many EMT-Bs, especially at the beginning of their careers, are reluctant to apply a painful stimulus. Out of shyness or a reluctance to harm the patient, they apply only a mild stimulus that is not sufficient to rouse the patient. The EMT then notifies the ED that the patient is unresponsive to verbal and painful stimuli. But on arrival at the ED, the staff is easily able to elicit a response with a brisk sternal rub or a pinch of the trapezius. Watch for this tendency with new or inexperienced EMT-Bs, and give them the benefit of your experience.
39. P RECEPTOR P EARL New EMT-Bs, in their desire to explain to the patient everything that is going on, may say something like, “I’m going to count your breaths right now, so just relax.” Of course, the patient who knows someone is counting his or her breathing rate will think about it and probably breathe either faster or slower as a result. If you hear new EMT-Bs using this approach, remind them that counting a respiratory rate should be done without bringing the patient’s attention to it.
67. 1. What are the components of a scene size-up? 2. List the steps in the initial assessment of a patient. 3. Give examples of patients who should be handled as a “high priority.” 4. What does the acronym SAMPLE stand for? 5. What is the range of normal vital signs? R EVIEW QUESTIONS