Jugular venous distension Tracheal position Spinal tenderness Retractions Breath sounds wall deformity Abdomen/Back Flank/abdominal tenderness or bruising Abdominal distension Extremities Edema Pulses Deformity Neurologic Mental status/orientation Motor/sensory Obtain Baseline Vital Signs (An initial full set of vital signs is required: pulse, blood pressure, respiratory rate, neurologic status assessment) Neurologic status assessment [see ] involves establishing a baseline and then trending any change in patient neurologic status Glasgow Coma Score (GCS) is frequently used, but there are often errors in applying and calculating this score. With this in consideration, a simpler field approach may be as valid as GCS. Either AVPU (Alert, Verbal, Painful, Unresponsive) or only the motor component of the GCS may more effectively serve in this capacity Patients with cardiac or respiratory complaints Pulse oximetry 12-lead EKG should be obtained early in patients with cardiac or suspected cardiac complaints Continuous cardiac monitoring, if available Consider waveform capnography (essential for patients who require invasive airway management) or digital capnometry Patient with altered mental status Check blood glucose Consider waveform capnography (essential for patients who require invasive airway management) or digital capnometry Stable patients should have at least two sets of pertinent vital signs. Ideally, one set should be taken shortly before arrival at receiving facility Critical patients should have pertinent vital signs frequently monitored Obtain OPQRST history: Onset of symptoms Provocation location; any exacerbating or alleviating factors – Quality of pain Radiation of pain Severity of symptoms pain scale – Time of and circumstances around onset Obtain SAMPLE history:
Jugular venous distension Tracheal position Spinal tenderness Retractions Breath sounds wall deformity Abdomen/Back Flank/abdominal tenderness or bruising Abdominal distension Extremities Edema Pulses Deformity Neurologic Mental status/orientation Motor/sensory Obtain Baseline Vital Signs (An initial full set of vital signs is required: pulse, blood pressure, respiratory rate, neurologic status assessment) Neurologic status assessment [see ] involves establishing a baseline and then trending any change in patient neurologic status Glasgow Coma Score (GCS) is frequently used, but there are often errors in applying and calculating this score. With this in consideration, a simpler field approach may be as valid as GCS. Either AVPU (Alert, Verbal, Painful, Unresponsive) or only the motor component of the GCS may more effectively serve in this capacity Patients with cardiac or respiratory complaints Pulse oximetry 12-lead EKG should be obtained early in patients with cardiac or suspected cardiac complaints Continuous cardiac monitoring, if available Consider waveform capnography (essential for patients who require invasive airway management) or digital capnometry Patient with altered mental status Check blood glucose Consider waveform capnography (essential for patients who require invasive airway management) or digital capnometry Stable patients should have at least two sets of pertinent vital signs. Ideally, one set should be taken shortly before arrival at receiving facility Critical patients should have pertinent vital signs frequently monitored Obtain OPQRST history: Onset of symptoms Provocation – location; any exacerbating or alleviating factors Quality of pain Radiation of pain Severity of symptoms – pain scale Time of and circumstances around onset Obtain SAMPLE history:
Iowa-EMS-Clinical-Treatment-and-Interventions-Guidelines-10.9.18.docx