This unit describes the knowledge and skills required to continue the assessment and treatment of the patient. Estimated teaching time 2 hours. Over 95 slides in length. Meets or exceeds USDOT NHTSA 2009 EMT/EMR training requirements. Recommended classroom time 2 hours and 2 hours lab time.

1. PREVIEW OF
EMT/EMR SECONDARY
ASSESSMENT
POWERPOINT TRAINING
PRESENTATION

2. CHIEF COMPLAINT
Major sign or symptom reported by patient
Symptom
What patient tells you is wrong
Sign
What you can see, hear, feel, smell or
measure about patient

3. MINOR LOCALIZED INJURY
A cut finger would not require a Secondary
Exam

4. PERFORM A PHYSICAL EXAMINATION
TO GATHER ADDITIONAL
INFORMATION
Compare one side of the body
to the other

5. BRIEFLY ASSESS THE BODY FROM
HEAD TO TOE
Systematically inspect and palpate, look
and/or feel for the following examples
of injuries or signs of injury
Deformities Contusions
Abrasions Punctures/penetrations
Burns Tenderness
Lacerations Swelling
Crepitus

6. IMMEDIATELY TREAT
LIFE-THREATENING PROBLEMS
FOUND IN SECONDARY SURVEY

7. BASELINE VITAL SIGNS
May consist of
Breathing
Pulse
Skin perfusion
Pupils
Blood pressure
Level of consciousness

8. BREATHING
Assessed by observing the
patient's chest rise and fall
Rate is determined by counting
the number of breaths in a
30-second period and
multiplying by 2
Care should be taken not to
inform the patient, to avoid
influencing the rate

9. NORMAL RATES
Adult 12-20 Respirations/min
11-14 years 12-20 Respirations/min
6-10 years 15-30 Respirations/min
3-5 years 20-30 Respirations/min
1-3 years 20-30 Respirations/min
6-12 months 20-30 Respirations/min
0-5 months 25-40 Respirations/min
Newborn 30-50 Respirations/min

10. BREATHING
Quality of breathing can be determined
while assessing the rate
Quality can be placed in 1 of 4
categories:
Normal
Shallow or deep
Labored
Noisy

11. PULSE
Initially a radial pulse should be assessed
in all patients one year or older
In patients less than one year of age a
brachial pulse should be assessed

12. PULSE
POINTS Carotid
Radial
Brachial
Femoral
Popliteal

13. PULSE
If the pulse is present, assess rate and
quality
Rate is the number of beats felt in
30 seconds multiplied by 2
(or 15 seconds multiplied by 4)

14. PULSE
If peripheral pulse is not
palpable, assess carotid pulse
Use caution, avoid excess
pressure on geriatrics
Never attempt to assess carotid
pulse on both sides at one
time

15. SKIN
The patient's color should be
assessed in the nail beds,
oral mucosa, and
conjunctiva
In infants and children, palms
of hands and soles of feet
should be assessed
Normal-pink

16. CAPILLARY REFILL
Normal capillary refill in infants and
children is < 2 seconds
Abnormal capillary refill in infants and
children is > 2 seconds

17. BLOOD PRESSURE
Should be taken on patients
over three years old
The pressure exerted by
circulating blood upon the
walls of the blood vessels

18. Cuff with bladder
Gauge
Squeeze bulb

19. Ear piece
Bell
Tubing

20. SYSTOLIC BLOOD PRESSURE
Force exerted against the arteries when the
heart is contracting
This is the first distinct sound of blood flowing
through the artery as the pressure in the
blood pressure cuff is released
This is a measurement of the force exerted
against the walls of the arteries during
contraction of the heart
Normal adult systolic blood pressure-120

21. APPEARANCE & BEHAVIOR
Unresponsive
Coma
State of profound unconsciousness
Absence of spontaneous eye
movements
No response to verbal or painful stimuli
Patient cannot be aroused by any
stimuli

22. APPEARANCE & BEHAVIOR
Observe posture and motor behavior
Facial expression
Anxiety
Depression
Anger
Fear
Sadness
Pain

23. PELVIS

24. PELVIC REGION
Check for
Symmetry
Tenderness

25. LOWER EXTREMITIES
Overview
Symmetry
Surface findings
General physical findings
Range of motion
Sensory
Motor function
Circulatory function

26. BRAVE TRAINING SOLUTIONS
PREVIEW OF
EMT SECONDARY ASSESSMENT
POWERPOINT TRAINING PRESENTATION
www.bravetraining.com

27. LOWER EXTREMITIES
Peripheral vascular system
Tenderness
Temperature of lower legs
Distal pulses

28. UPPER EXTREMITIES
Overview
Symmetry Strength
Surface findings
General physical findings
Range of motion Sensory
Motor function Circulatory function
Arm drift

29. Scalp
Skull
Face
Symmetry of expression
Appropriate facial expression
HEAD

30. HEAD
Drainage or bleeding
Nose
Ears
Objects or swelling in mouth
Vomit, blood
Teeth

31. EARS
Drainage
Blood
Cerebral Spinal Fluid

32. EYES
Blood in anterior chamber
Pupil size, shape, and response
Normal – equal and reactive to light
Abnormal
Constricted
Dilated
Unequal
Conjunctiva color and hydration

33. EYES
Reactivity is whether or not the pupils
change in response to the light
Reactive - change when exposed to light
Non-reactive - do not change when
exposed to light
Equally or unequally reactive

34. NOSE
Drainage (Blood, Cerebral Spinal Fluid)
Symmetry

35. MOUTH
Burns
Odors
Swollen or lacerated tongue
Condition of teeth or dentures
Hydration

36. CHEST
Breath Sounds
Present
Absent
Equal

37. BACK
Roll with spinal precautions and assess
posterior aspect of body, inspect and
palpate for injuries or signs of injury

38. ABDOMEN
Overview
Position patient for examination
Shape and size
Palpation method
Four quadrants
Palpate affected area last

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