The siren wailed, a familiar, urgent cry cutting through the night. Another call. Another chance to make a difference. As an EMT, my life is a series of rapid assessments, split-second decisions, and the constant pressure to provide the best possible care under often chaotic circumstances. This isn't just a job; it's a responsibility, a privilege, and a relentless test of my skills and composure. Tonight, the call was a possible cardiac arrest. The adrenaline surged.
My partner, Sarah, and I arrived at the scene – a small apartment building, the air thick with tension. A frantic woman met us at the door, her face etched with worry. "He collapsed! He's not breathing!"
Our training kicked in. We moved swiftly, our movements precise and coordinated. The medical assessment began, a systematic process honed over years of experience. This is what it looks like in the field, the scenarios that shape our careers:
The ABCs of Trauma and Medical Emergencies: Airway, Breathing, Circulation
This forms the bedrock of any emergency medical assessment. Before anything else, we needed to determine if the patient had a patent airway. Was he choking? Was there any obstruction? We quickly assessed his airway, ensuring it was clear and open. Next came breathing – was he breathing adequately? Was his breathing shallow, rapid, or labored? We checked his respiratory rate and depth, noting any unusual sounds. Finally, circulation – was his heart beating? Did he have a pulse? We checked for a carotid pulse, the most reliable indicator in an emergency.
What are the Common EMT Medical Assessment Scenarios?
The reality is that there's no single "common" scenario. Every patient is unique, presenting with a different combination of symptoms and requiring tailored treatment. However, we encounter several recurring types of medical emergencies that demand specific assessment approaches:
1. Cardiac Arrest: This is a life-threatening situation requiring immediate CPR and defibrillation. The assessment focuses on establishing whether there's a pulse and breathing, then initiating advanced life support measures as quickly as possible.
2. Stroke: Recognizing the signs of a stroke (FAST – Face drooping, Arm weakness, Speech difficulty, Time to call 911) is crucial. The assessment involves neurological checks to evaluate the patient's level of consciousness, motor function, and speech.
3. Trauma: Trauma assessments are more extensive, involving a systematic evaluation of the entire body for injuries. This includes checking for airway compromise, breathing difficulties, significant bleeding, and spinal injuries.
4. Respiratory Distress: Patients experiencing respiratory distress exhibit shortness of breath, wheezing, or coughing. The EMT’s assessment must focus on identifying the cause (asthma, pneumonia, etc.) and providing appropriate support, like oxygen therapy.
5. Diabetic Emergencies: Diabetic emergencies such as hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar) require a rapid assessment of the patient's blood glucose level and administration of appropriate treatment, often involving glucose administration or insulin.
What are the steps of a medical assessment by an EMT?
The process is dynamic and adapts to each situation, but a general framework exists. It usually involves the following key steps:
- Scene Safety: Ensuring the safety of both the patient and the EMT team is paramount.
- Initial Assessment: This includes checking for responsiveness, airway, breathing, and circulation (ABCs).
- Rapid Trauma Assessment (if applicable): This involves a quick head-to-toe examination for injuries.
- Detailed Medical Assessment: This encompasses a thorough history taking (SAMPLE – Symptoms, Allergies, Medications, Past medical history, Last meal, Events leading to the incident) and a comprehensive physical examination.
- Ongoing Assessment: Continuous monitoring of vital signs and patient condition is essential throughout transport.
How do I perform a medical assessment on a patient?
You don't. Medical assessments are performed by trained professionals like EMTs and paramedics. This is not something to be attempted without extensive training and certification. The information here is for educational purposes only and should not be considered a guide for providing medical care. Improper medical assessment can have serious consequences.
What is the difference between a medical assessment and a physical exam?
A physical exam is a more comprehensive evaluation typically performed in a clinical setting by a physician. A medical assessment, performed by EMTs in emergency situations, is a focused, rapid assessment prioritising immediate life threats.
Back to the apartment. After a seemingly endless few minutes, we managed to restore the patient's breathing. The relief was palpable. It was a near miss, a stark reminder of the life-or-death stakes involved. We transported him to the hospital, our work far from over, continuing our ongoing assessment and providing the best possible care during transit. As the siren faded into the distance, I knew – the next call could be anything. And I would be ready.
