Focused Physical Examination (Medical and Trauma) - NREMT EMT Level

What is the focused assessment for a patient with suspected opioid overdose?

Airway/breathing, respiratory rate/effort, pupils, mental status, vitals. These elements focus on detecting respiratory depression and altered consciousness, which are hallmarks of opioid toxicity requiring immediate reversal.
Which patient condition indicates a focused physical exam rather than a rapid trauma assessment?

Stable patient with a specific chief complaint or isolated injury. Focused exams are appropriate for stable patients where the issue is localized, allowing targeted assessment without the need for a full rapid evaluation.
What does SAMPLE stand for when obtaining focused history during a medical assessment?

Signs/Symptoms, Allergies, Medications, Past history, Last oral intake, Events. SAMPLE is a mnemonic for obtaining pertinent medical history to contextualize the patient's current condition and inform treatment decisions.
Which assessment finding requires immediate reassessment of airway and breathing during a focused exam?

Any change in mental status or increased work of breathing. These signs indicate potential deterioration in airway or breathing status, necessitating prompt reevaluation to prevent life-threatening complications.
What are the 5 components of a distal extremity neurovascular check in trauma?

Pulse, Motor function, Sensation, Capillary refill, Skin color/temperature. These components evaluate neurovascular integrity distal to the injury, ensuring no compromise from swelling, bleeding, or compartment syndrome.
What is the appropriate reassessment interval for an unstable patient after focused exam and interventions?

Every $5$ minutes. Frequent reassessment every $5$ minutes allows early detection of deterioration and evaluation of intervention effectiveness in unstable patients.
Which finding during a focused neuro exam indicates possible spinal cord involvement?

Loss of motor or sensory function below the suspected injury level. This deficit suggests disruption of neural pathways, indicating the need for spinal immobilization and further evaluation to prevent worsening.
What is the correct focused assessment for suspected rib fracture with stable vital signs?

Inspect, palpate chest wall, assess breath sounds, check for crepitus. These steps evaluate for complications like pneumothorax or instability while ensuring the injury is isolated in a stable patient.
Which option best describes how to palpate an injured extremity during a focused trauma exam?

Palpate gently from distal to proximal, comparing bilaterally when possible. This method minimizes patient discomfort and helps identify the extent of injury by starting from the least painful area and using comparison for abnormalities.
Which focused exam finding most strongly suggests internal bleeding in blunt abdominal trauma?

Abdominal tenderness with rigidity or guarding. These signs indicate peritonitis or organ injury, which are critical indicators of potential internal hemorrhage requiring urgent intervention.
What is the correct focused assessment for suspected stroke in the prehospital setting?

FAST (or stroke scale), glucose check, vitals, focused neuro exam. These assessments help confirm stroke suspicion, rule out mimics like hypoglycemia, and monitor for changes in the prehospital environment.
Which focused exam finding is most consistent with a basilar skull fracture?

Battle sign, raccoon eyes, or CSF leakage from nose/ears. These are pathognomonic signs of basilar skull fracture due to blood or fluid tracking along fracture lines, indicating potential severe injury.
What is the focused assessment for suspected head injury in a responsive trauma patient?

Mental status, pupils, scalp/face DCAP-BTLS, C-spine, neuro status, vitals. These assessments detect intracranial pressure changes, external injuries, and neurologic deficits while monitoring for instability in head trauma.
What is the primary purpose of a focused physical examination after the primary assessment?

Identify and manage specific complaints or suspected injuries. Following the primary assessment, the focused exam targets the patient's chief complaint or injury to guide appropriate interventions and management.
Identify the correct focused exam for suspected femur fracture with severe pain but stable vitals.

Inspect/Palpate, PMS check, control bleeding, splint, reassess PMS. This sequence ensures thorough evaluation, stabilization, and monitoring to prevent neurovascular compromise in an isolated but significant injury.
Identify the key focused assessment elements for a patient with chest pain of medical origin.

OPQRST/SAMPLE, lung sounds, skin signs, perfusion, vitals, ECG if available. These elements provide a comprehensive evaluation of cardiac-related chest pain, incorporating history, physical signs, and monitoring for timely intervention.
What does OPQRST stand for when obtaining focused history for pain or discomfort?

Onset, Provocation, Quality, Region/Radiation, Severity, Time. OPQRST is a mnemonic for gathering detailed history on pain to understand its characteristics and guide differential diagnosis in medical assessments.
What does DCAP-BTLS stand for in a focused trauma exam?

Deformities, Contusions, Abrasions, Punctures, Burns, Tenderness, Lacerations, Swelling. DCAP-BTLS is a mnemonic used to systematically identify visible and palpable signs of trauma during focused examinations.
Which action is required if a patient has stroke-like symptoms and low blood glucose?

Treat hypoglycemia per protocol and reassess neurologic status. Hypoglycemia can mimic stroke symptoms, so treatment restores glucose levels, allowing differentiation and potential resolution of neurologic deficits.
What is the minimum body area examined in a focused trauma exam for isolated extremity injury?

The injured extremity and adjacent joints above and below. Examining the injured area and adjacent joints ensures detection of associated injuries or complications that may not be immediately apparent.
Identify the correct exam approach for an unstable trauma patient: focused exam or rapid head-to-toe?

Rapid head-to-toe trauma assessment. Unstable trauma patients require a comprehensive rapid assessment to quickly identify and address life-threatening injuries across the entire body.
What is the standard sequence of techniques for a focused abdominal exam in EMT practice?

Inspect, auscultate, palpate. This sequence allows systematic evaluation of the abdomen, starting with visual inspection, followed by listening for bowel sounds, and then gentle palpation.
What is the key focused assessment for a patient with shortness of breath and wheezing?

Work of breathing, lung sounds, SpO2, accessory muscle use, speech ability. These indicators assess the severity of respiratory distress and guide interventions like bronchodilators for conditions such as asthma.
Identify the focused physical exam priority when an allergic reaction is suspected.

Airway patency and signs of respiratory compromise or shock. Prioritizing airway and circulation is essential as allergic reactions can rapidly progress to anaphylaxis, compromising breathing and perfusion.

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