![]() ![]() Many providers make the faulty assumption that a patient’s problem today is the same issue that was affecting them before. What is wrong today isn’t necessarily what’s been wrong before. If the paramedic had not detected the stroke during his complete assessment, the patient would have been transported to his preferred hospital 20 miles away, rather than to the primary stroke center just four miles away.ģ. The patient's arm drift and unequal pupils clearly demonstrated that he was having an acute stroke. However, because this patient was so adamant that something was wrong, the paramedic did a complete assessment, including a full neurological evaluation. As a result, the first responder's initial assessment was incomplete and consisted of vital signs and a 3-lead ECG. The first responders on the scene conveyed to the paramedic their private opinion that the patient was just trying to get out of work, because he appeared to be fine. In between questions, however, the patient would close his eyes and drift off, as if he were asleep. The patient was alert, oriented and able to answer all questions appropriately. The patient only knows that something is wrong.įocus on assessing and treating the patient's basic life threats before interrogating bystanders or investigating the sceneįor example, a paramedic crew responded to a call at a business for a middle-aged male patient whose only complaint was that he could not stay awake. This occurs because the AMS has made it difficult to communicate, or because the patient's signs and symptoms are odd, vague or difficult to describe. Even when the patient is somewhat conscious, they often find it difficult to describe what is wrong. The patient can’t always tell you what is wrong.ĪMS patients are usually not alert and thus unable to give the EMS practitioner much reliable information. Is the root cause hypoglycemia, an acute MI, sepsis, a head injury, stroke or hypoxia? The only way for the EMS practitioner to get to the root cause quickly and accurately is by performing a complete patient assessment.Ģ. In practice, however, this can be a challenge because AMS can result from almost anything. One of the core duties of EMS practitioners is to determine the root cause of AMS in a patient. Anything can cause altered mental status. Here are six reasons, from actual patient cases, that demonstrate why it is critical to perform a complete patient assessment with every AMS patient.ġ. AMS is relatively easy to determine in the field, but getting to the root cause of AMS requires a complete patient assessment. Altered mental status is a simple yet definitive indicator that something is wrong with the patient.
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