(精编)【医学精品英文课件】Patient with A Medical Complaint教学课件.ppt

Rough Estimate of Blood Pressure By Palpation A rough guideline; accuracy is debatable If the radial pulse is palpated, the B/P is said to be roughly 80 mmHg If the femoral pulse is palpated, the B/P is said to be roughly 70 mmHg If only the carotid (central) pulse is felt, the B/P is said to be roughly 60 mmHg A “Neuro” Assessment Level of consciousness A – alert (means awake but not necessarily oriented; spontaneous eye opening; responds to voice but can be confused; and has motor function ) V – responds to verbal command no matter how slight and type of response P – responds to pain or tactile stimuli only U – unresponsive with no eye, voice, or motor response at all to voice or pain Ask 2 questions to determine level of consciousness “What month is this?” “How old are you?” Obtain the Glasgow Coma Scale (GCS) on all EMS patients Best eye opening (4 points) Best verbal response (5 points) Best motor response (6 points) Evaluate pupillary response Performing a Pupillary Check Ask patient to focus on an object (ie: tip of your nose) Bring the light in from the side and out the same way Without shining in the eyes move the penlight into position for the opposite side and repeat Vital signs Signs of increasing intracranial pressure include increasing B/P and dropping heart rate Check muscle tone and strength Evaluate facial symmetry (smile) Evaluate clarity of speech The above 3 are the Cincinnati Stroke Scale Arm drift, facial symmetry, speech Additionally: Coordination or gait and sensory Movement and sensation Repeat Assessment If you want to see where the patient is going, you’ve got to know where they’re coming from GET A BASELINE EVALUATION You can anticipate something happening if you are watching the trends PERFORM REPEAT ASSESSMENTS AS OFTEN AS INDICATED Prevents surprises Need to constantly monitor the situation Watch for trends Anticipate surprises Pain Management SOP Routine trauma or medical care Continuous patient monitoring Respiratory status SaO2 B