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    Emergent Assessment

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    awangkuafiq
    The document provides an assessment of an emergent patient, noting various physical findings. Key findings include: - The patient was lethargic and unconscious, with a BMI over 30. Referred pain was noted in the head, neck, eyes, chest, left arm, and flank/genital region. - On inspection, asymmetry and massive bleeding over 12 inches was seen, with pale conjunctiva and nonreactive pupils over 4m. - Palpation found lockjaw, crepitations in the neck, and no carotid pulse. No peripheral pulses were detected. - Ausculation revealed a blood pressure varying from 120-180/40-110 systolic depending on weight.

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    Emergent Assessment

    Uploaded by

    awangkuafiq
    53 views51 pages
    The document provides an assessment of an emergent patient, noting various physical findings. Key findings include: - The patient was lethargic and unconscious, with a BMI over 30. Referred pain was noted in the head, neck, eyes, chest, left arm, and flank/genital region. - On inspection, asymmetry and massive bleeding over 12 inches was seen, with pale conjunctiva and nonreactive pupils over 4m. - Palpation found lockjaw, crepitations in the neck, and no carotid pulse. No peripheral pulses were detected. - Ausculation revealed a blood pressure varying from 120-180/40-110 systolic depending on weight.

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    The document provides an assessment of an emergent patient, noting various physical findings. Key findings include: - The patient was lethargic and unconscious, with a BMI over 30. Referred pain was noted in the head, neck, eyes, chest, left arm, and flank/genital region. - On inspection, asymmetry and massive bleeding over 12 inches was seen, with pale conjunctiva and nonreactive pupils over 4m. - Palpation found lockjaw, crepitations in the neck, and no carotid pulse. No peripheral pulses were detected. - Ausculation revealed a blood pressure varying from 120-180/40-110 systolic depending on weight.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as ppt, pdf, or txt
    53 views51 pages

    Emergent Assessment

    Uploaded by

    awangkuafiq
    The document provides an assessment of an emergent patient, noting various physical findings. Key findings include: - The patient was lethargic and unconscious, with a BMI over 30. Referred pain was noted in the head, neck, eyes, chest, left arm, and flank/genital region. - On inspection, asymmetry and massive bleeding over 12 inches was seen, with pale conjunctiva and nonreactive pupils over 4m. - Palpation found lockjaw, crepitations in the neck, and no carotid pulse. No peripheral pulses were detected. - Ausculation revealed a blood pressure varying from 120-180/40-110 systolic depending on weight.

    Copyright:

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    of 51

    Emergent

    Results of Physical Assessment

    Demographic Profile

    BMI = 30 15 environment

    Chief Complaint

    Level of Consciousness

    lethargic to unconscious conscious but not alert

    Chief Complaint

    time of arrival
    more than 10 minutes

    Chief Complaint

    referred pain

    head+neck+eyes chest + left arm flank and genital

    General Appearance

    Asymmetry with massive bleeding


    size 12 inches 4 pads / 10 gauze

    General Appearance

    external manipulation

    impalement injury massive bleeding

    Emergent assessment for interview

    Two of the following selections

    Inspection region one

    color

    retinal color gray detachment = red massive bleeding conjunctiva = pale

    Inspection region one

    pupils

    4m nonREACTIV ANISOCORIC headache = O.P.

    Inspection region one

    obstruction

    absence of gag reflex = aspiration precaution central hearing loss

    Inspection region one

    tumor

    lymph nodes neck region orbital region

    Inspection region one

    temperature
    39 - blushing cheeks - sunken eyes
    centigrade

    Inspection region two

    color of skin = blue or black edematous

    grade 4

    Inspection region two

    chest costal

    barrel chest pigeon breast flail retracting

    Inspection region two

    nipple line

    deviating to lateral pustular secretion swelling or tumor

    Inspection region two

    rib count - 12 Cspine fracture genital = urine output per hour

    Inspection region two

    site of injection

    GLUTEUS rectus abdominis pectoralis

    Inspection region two

    range of motion

    FRACTURE spinal cord injury brain injury

    Inspection region two

    respiration

    rate = 30 = 30kgs rate = 50 = 15kgs rhythm = kaussmal dynamic = abdomen

    Inspection region two

    chest wall
    no diaphragm relaxation upon expiration

    Inspection region two

    precordium = dynamic pain score 7

    Inspection region three

    color = blue nails =CRT 4s fissures = cut or indentations

    Inspection region three

    turgor

    edematous retracting atrophy

    Inspection region three

    sensation

    absence tingling numbness

    Inspection region three

    site of injection

    deltoid muscle vastus lateralis rectus femoris

    Inspection region three

    range of motion

    spinal cord injury brain injury internal fracture

    Inspection region three

    temperature

    febrile to touch 0 38 centigrade

    Inspection region three

    pain score = 7

    hyper algesia hypo algesia

    Inspection region three

    capillary refill= 4 capillary blood glucose

    60 mg/dl or 100

    Inspection region three

    deep tendon reflex


    patellar brachial posterior tibial

    Emergent assessment inspection


    1.
    2. 3.

    10 of the selections No nasal breathing episodes GCS = 3 + no verbal output

    Percussion

    pectorals
    pain score 8-9 dull resonating

    posterior chest

    Percussion

    abdominal
    umbilical + traubes space
    both tympanitic

    Emergent assessment percussion

    3 of the criterias every sound are tympanitic in effect no breath sounds

    Palpation region one

    joints = lock jaw + crepitations on the neck region no carotid pulse

    Palpation region two

    crepitations

    anterior chest posterior chest

    emphysema

    Palpation region three

    lymph nodes engorged no peripheral pulse

    Emergent assessment palpation

    3 criterias present no peripheral pulse

    Auscultation

    blood pressure

    15 kgs = 120 sbp 110/40 to 180/110 palpatory systolic

    Auscultation

    blood pressure

    30 kgs 150/90 to 200/110 palpatory systolic

    Auscultation

    normal pulse pressure

    40 65

    Auscultation

    heart sound

    closure of S4 is very loud heaves + thrills

    Auscultation

    bronchial sound

    wheezing rales / ronchi stridor

    Auscultation

    bowel sound

    less than 19 per minute more than 50

    Emergent assessment auscultate

    all of the above 3 of the above

    Circulation

    FiO2 = 80% resp acidosis conduction system

    Pulseless

    ventricular tachycardia

    Asystole
    Ventricular

    fibrillation PVC or PAC Supraventricular tachycardia

    Serum Osmolarity
    2 x Na + K + BUN/2.8 + DXT/18
    Compute for the serum osmolarity = 270 mmOsm 290 mmOsm

    Total score

    10 + 3 + 3 + 3 + FiO2 + ABG + ECG + serum Total = 22 25 criterias present

    Prevention is better than cure

    Terima Kasih

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