Patient Reassessment and Ongoing Care
Help Questions
NREMT: EMT Level › Patient Reassessment and Ongoing Care
During reassessment of a diabetic patient who received oral glucose, which finding best indicates treatment effectiveness?
Vital signs have returned to completely normal baseline ranges
Blood glucose reading shows a slight increase from initial measurement
Patient's skin has become less diaphoretic and feels warmer
Patient reports feeling less confused and more alert than before
Explanation
Improved mental status (less confusion, more alert) is the best indicator that oral glucose is effectively treating hypoglycemia. While blood glucose increase is good, mental status is the key clinical indicator. Less diaphoresis and warmer skin are positive but less specific. Vital signs may not immediately return to normal even with effective treatment.
During transport, an EMT should reassess a stable patient at what minimum interval?
Every 5 minutes throughout the transport period
Every 10 minutes throughout the transport period
Every 15 minutes throughout the transport period
Only when the patient's condition appears to change
Explanation
Stable patients should be reassessed every 15 minutes during transport to monitor for changes in condition. This allows for early detection of deterioration while not being excessive for stable patients. Every 5 minutes is the interval for unstable patients. Every 10 minutes is not a standard interval. Waiting only for apparent changes is inadequate as subtle deterioration may be missed.
During reassessment of a patient receiving oxygen via non-rebreather mask, which finding indicates the need to adjust oxygen delivery?
Patient is breathing at a rate of 20 respirations per minute
The reservoir bag completely deflates during each inspiration taken
Patient reports the mask feels tight against their face
SpO2 reading has improved from 89% to 96% since application
Explanation
If the reservoir bag completely deflates during inspiration, the oxygen flow rate is too low and needs to be increased to maintain adequate oxygen concentration. The bag should deflate only slightly with each breath. A tight-fitting mask is appropriate for proper seal. Improved SpO2 indicates effective treatment. A respiratory rate of 20 is within normal range.
During reassessment, which change would be most concerning and require immediate intervention?
Patient becomes more alert and begins asking questions about location
Patient reports a headache and requests something for the pain
Blood pressure increases slightly from baseline due to patient anxiety
Patient's level of consciousness decreases and she becomes less responsive
Explanation
Decreasing level of consciousness in a post-ictal patient may indicate status epilepticus, head injury, or other serious complications requiring immediate intervention and possible ALS intercept. Increasing alertness is expected during recovery. Slight BP increase from anxiety is not immediately concerning. Headache is common post-ictally and doesn't require immediate intervention.
What is the primary purpose of ongoing reassessment during patient transport?
To identify changes in patient condition and treatment effectiveness
To gather additional history information that was missed initially
To provide reassurance to the patient during the transport period
To practice assessment skills for continuing education requirements
Explanation
The primary purpose of reassessment is to identify changes in patient condition and evaluate whether treatments are working effectively, allowing for timely interventions. While additional history may be gathered, this is secondary. Reassessment is not for skills practice. Patient reassurance is a benefit but not the primary purpose.
During reassessment of a patient with suspected stroke, which new finding would be most significant?
Facial droop has progressed to include complete paralysis of one side
Blood pressure has decreased from 180/100 to 160/90 during transport
Patient's speech has improved and is now clear and understandable
Patient reports the headache has decreased in intensity since transport began
Explanation
Progression of neurological deficits (worsening facial droop to complete paralysis) indicates evolving stroke and may require immediate notification to receiving hospital and possible diversion to stroke center. Decreased headache could indicate improvement. Slight BP decrease is not immediately concerning. Improved speech would be a positive finding.
When reassessing a patient's pain level during transport, what is the most appropriate method?
Ask detailed questions about the exact location and character changes
Ask if the pain is better, worse, or the same as before
Use a 1-10 numeric pain scale and compare to baseline
Observe facial expressions and body language for pain indicators only
Explanation
A numeric pain scale (1-10) provides objective, measurable data that can be compared to baseline measurements for trending. This is the standard approach in EMS. Yes/no questions are less specific. Observation alone without patient input is inadequate. Detailed character questions are more appropriate for initial assessment, not ongoing reassessment.
When reassessing a patient who received oral medication assistance, which timeframe is most appropriate for evaluating medication effectiveness?
Continuously monitor without specific time intervals for changes
Wait until arrival at hospital for complete evaluation
Within 2-3 minutes of medication administration for immediate effects
After 5-10 minutes to allow for absorption and onset
Explanation
Oral medications typically require 5-10 minutes for absorption and onset of effects, making this the appropriate timeframe for reassessment of effectiveness. 2-3 minutes is too soon for oral medications (appropriate for IV medications). Waiting until hospital arrival delays important assessment. Continuous monitoring without specific intervals lacks systematic approach and documentation standards.
During transport, an EMT should document reassessment findings in what manner?
Document reassessment only if the patient's condition deteriorates during transport
Only document significant changes from the initial assessment findings
Note the time of reassessment but detailed findings are optional
Record complete vital signs and assessment findings at each interval
Explanation
Complete vital signs and assessment findings should be documented at each reassessment interval to provide a complete picture of patient trending and care provided. This creates a legal record and helps receiving facilities understand the patient's course. Documenting only changes misses important trending information. Documentation only for deterioration misses improvement or stability. Time alone without findings is inadequate documentation.
When reassessing a trauma patient's bandages during transport, an EMT notices blood has soaked through the original dressing. What is the appropriate action?
Apply additional dressing material over the existing blood-soaked bandage
Document the finding and increase pressure on the existing dressing
Apply a tourniquet proximal to the bleeding site immediately
Remove the blood-soaked dressing and apply a fresh clean bandage
Explanation
Additional dressing material should be applied over existing bandages to maintain clot formation and avoid disrupting any clots that may have formed. Removing the original dressing can disrupt clot formation and worsen bleeding. A tourniquet should only be used for severe extremity bleeding when direct pressure fails. Simply documenting without action doesn't address continued bleeding.