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NREMT Advanced-EMT Updated 2024/2025 Verified 100%
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Secondary Assessment: SAMPLE - - Signs and Symptoms (history of present issues); - Allergies; - Medications; - Past Medical History, Pertinent Negatives; - Last Oral Intake; - Events (leading to present: trauma or medical) Secondary Assessment: OPQRST-I - especially for Respiratory and Cardia...

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  • September 15, 2024
  • 49
  • 2024/2025
  • Exam (elaborations)
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NREMT Advanced-EMT
Secondary Assessment: SAMPLE - - Signs and Symptoms (history of present issues);

- Allergies;

- Medications;

- Past Medical History, Pertinent Negatives;

- Last Oral Intake;

- Events (leading to present: trauma or medical)



Secondary Assessment: OPQRST-I - especially for Respiratory and Cardiac patients:

- Onset;

- Provocation/Palliation;

- Quality;

- Radiation;

- Scale/Severity;

- Time;

- Interventions



Initial Assessment: G-CAAT - - General Impression;

- Chief Complaints, Life Threats (hemorrhage);

- AVPU;

- ABC's (airway, breathing, circulation);

- Transport Decision (Load and Go or Stay and Play)



Components of General Impression - ASSS-FLOP-VD:

- Apparent state of health;

- Skin color, obvious lesions;

- Signs of distress;

,- Sexual development;

- Facial expressions;

- Level of consciousness;

- Odors;

- Posture, Motor, Gait;

- Vital statistics;

- Dress, Grooming, Hygiene



Components of AVPU - - Alert;

- responds to Verbal stimuli;

- responds to Painful stimuli;

- Unresponsive




What is OPQRST? - a mnemonic for remembering the questions to ask when assessing the
patient's chief complaint or major symptoms



Onset - - When and how did the symptom begin?

- Ask the patient if the onset was sudden or gradual.

- Also determine if the onset was associated with a particular activity.



Initial Assessment: B-SMNAC - - BSI (body substance isolation);

- Scene Safety;

- Mechanism of Injury (MOI)/Nature of Illness (NOI);

- Number of Patients;

- Assistance (additional units, Fire, Police, etc.);

- C-spine (and/or C-collar)



Provocation/palliation: - - What makes the symptom worse?

,- What makes the symptom better?



Quality - How would you describe the pain?



Radiation - - Where do you feel the pain?;

- Where does the pain go?



Scale/Severity - - On a scale from 0 to 10, with 10 being the worst.

- How bad is the symptom?



Time - - Determine if the symptom has been present for minutes, hours, days, weeks, months, or
years;

- The length of time the symptoms are present is important to document



Secondary Assessment: V-FITD - - Vital Signs, baseline (VS);

- Focused Physical Exam (performed);

- Interventions (RX's per medical direction, etc.);

- Transport (re-evaluate decision);

- Detailed Physical Exam (verbalized);



Order of Initial Assessment - - B-SMNAC;

- G-CAAT;



Order of Secondary Assessment - - OPQRST-I;

- SAMPLE;

- V-FITD



S1 - "Lub"

Caused by the closing of the Mitral (Bicuspid) and Tricuspid atrioventricular valves.

, S2 - "Dub"

Caused by blood closing the semilunar valves (aortic and pulmonic).



S3 - "Ta"

Oft referred to as the galloping heart, caused by blood sloshing around in a compliant left ventricle.



S4 - A rare noise in the middle of "lub," caused by a failing left ventricle and best heard in the
cardiac apex.

Ta-LUB-dub, ta-LUB-dub



Septum - 2 Sub Types - Separates the two halves of the heart.

Interatrial and Interventricular



NSAID - Nonsteroidal Anti-inflammatory Drug



Antipyretic Agent - Inhibits Prostaglandins

Acts on hypothalamus, heat regulation center.

Vasodilation & Sweating



Platelet Inhibitor - Prevents formation of thromboxane A2



Decreased Afterload Effects - Decreased Arteriole Pressure = Decreased Aortic Pressure = Left
Ventricle Works Better



Decreased Preload Effects - 1. Venous Dilation = Decreased Preload = Decreased Heart Size

2. Decreased Heart Size = Increased Blood Flow to Coronary and Collateral Vessels = Myocardial
Perfusion is Improved

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