This head-to-toe exam should take no more than 2 or 3 minutes. Before you touch the patient, explain what you will be doing and what you are looking for: pain, bleeding, and deformity. This will put the patient at ease and make the exam easier on you both. Your patient may be scared or embarrassed so always utilize dignity and respect.
This is also the time to establish rapport with your patient and encourage sharing of medical history with you by asking the following:
• Have you had any recent surgeries or procedures?
• What medications are you taking? For what condition?
• Your date of birth?
• Do you have any allergies? Food? Medicine? Environmental?
• History - What events brought on this episode?
• What makes it worse? Better? Has this happened before?
The patient assessment also the time to accumulate baseline vital signs. The information you need can be remembered by this pneumonic:
PPR-BELS
P PULSE OXIMETRY - What is the patient’s blood saturation of oxygen?
P PULSE - What is the patient’s pulse in beats per minute?
R RESPIRATIONS - How many breaths does the patient take in one minute?
B BLOOD PRESSURE - Obtain, either with a digital cuff or by auscultating, the patient’s blood pressure.
E EYES - Are the pupils equal in size? Reactive to light?
L LEVEL OF CONSCIOUSNESS - Is your patient alert to person, place, time and recent history? Is the patient’s level of consciousness altered or unconscious?
S SKIN - What is the patient’s skin like? Warm, dry and color appropriate? Cool and clammy? Damp and gray?
When you contact Aircare Access operators, they will want to know the outcome of these vital signs as well as the time they were taken. They may ask you to repeat some or all of the vital signs to get updates.
Using a medical report form will assist you in making sure you have covered all the body systems
and accumulated all the needed information. This form is available from Aircare Access and is a wonderful guide to help you maneuver through the patient exam.
ASSESSING CHILDREN
Children represent special challenges when ill or injured. As a rescuer, it is important to understand that children are not just small adults. They have unique characteristics, both physically and emotionally. Children’s cognitive skills are also less than that of an adult. They don’t understand why they are hurt and that you are trying to help. Children can be fearful, emotional, combative, loud or unwilling to communicate as their means of self-defense.
Children lack the negotiation skills or strength to get themselves out of scary situations. Their only method of fighting back is noise. Regardless of the child’s age, your main goal is not to make the situation worse by frightening or angering the child. When parents or caregivers are involved, they may need as much reassurance as the child. If one becomes frightened, the other will too, making your job more difficult.
The most important aspect of assessing children is evaluating their overall appearance. Assess their responsiveness and pay particular attention to their breathing. An anxious child who is working hard to breathe is not well. If a child stops breathing at any point during your exam, you may need to relieve an airway obstruction, provide rescue breathing or perform CPR.
PATIENT EVALUATION
The ever-popular smart phone is even aiding in patient care. In addition to that, secure video conferencing is now available on some diagnostic devices so doctors can see the patient they are assisting. As with most parts of our lives, technology is advancing and helping make tasks easier. The same is true in aviation.
There are tools available to help with your patient assessment and information conveyance. Having the correct diagnostic tools is a very important part of taking accurate vital signs on your patient. An Aircare Access Medical Kit provides three essential tools for your patient assessment; digital wrist BP cuff, pulse oximeter and thermometer. These tools will assist you in providing the advanced pieces of information needed by the Aircare Access physician to determine the patient care plan.
Patient Assessment 95
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