CHAPTER 12 Ongoing Assessment
Jan 20, 2016
CHAPTER 12
Ongoing Assessment
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Overall Assessment SchemeScene Size-UpScene Size-Up
Initial AssessmentInitial Assessment
TraumaTrauma MedicalMedical
Physical ExamPhysical Exam
Vital Signs &Vital Signs &SAMPLE HistorySAMPLE History
SAMPLE HistorySAMPLE History
Physical ExamPhysical Exam& Vital Signs& Vital Signs
DetailedDetailedPhysical ExamPhysical Exam
OngoingOngoingAssessmentAssessment
HOSPHOSP
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Steps of theSteps of theOngoingOngoing
AssessmenAssessmentt
(This step should never be (This step should never be skipped unless the treatment skipped unless the treatment
of life-threatening of life-threatening injuries/illnesses prevent injuries/illnesses prevent
doing it)doing it)
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Reassessment
Stable?
Reassess at least every 15 minutes.
Unstable?
Reassess at least every 5 minutes.
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Steps of the OngoingAssessment
Repeat initial assessment.
Reassess and record vital signs.
Repeat focused assessment regarding
patient complaints and injuries.
Check on interventions/treatment in
progress.
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Repeat Initial Assessment
Reassess mental status.
Maintain open airway.
Monitor breathing (rate and quality).
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Reassess pulse (rate and quality).
Monitor skin (color, temperature,
condition).
Reassess capillary refill in pediatric
patients.
Reevaluate patient’s priority.
Repeat Initial Assessment
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Reassess and record vital signs.Reassess and record vital signs.
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Repeat focused assessment.Repeat focused assessment.
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Check interventions.Check interventions.
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Check Interventions
Is oxygen delivery adequate?
Look at skin color.
Are artificial ventilations adequate?
Make sure chest rises and falls.
Changes in pulse oximetry reading?
Make sure local protocols allow its use.
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Are there any signs of bleeding?
Look for new blood.
Any other conditions or changes?
Check splinted extremities for distal pulse, sensation, and movement.
Check Interventions
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Observing Trends
Trends are changes over time.
Changes noted over time are significant
(e.g. changes in BP or pulse).
EMT may need to adjust or establish new
treatments.