Report Date: 15 Mar 2022

081-000-0072
Perform a Medical Patient Assessment
Status: Approved

____________________________

Security Classification: U - Unclassified

Distribution Restriction: Approved for public release; distribution is unlimited.

Destruction Notice: None

Foreign Disclosure: FD1 - This training product has been reviewed by the training developers in coordination with the Joint Base San Antonio, Fort Sam Houston/US Army Medical Center of

Excellence (MEDCoE) foreign disclosure officer. This training product can be used to instruct international military students from all approved countries without restrictions.

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Conditions: In an operational environment, you have a patient requiring a medical assessment. You have a stethoscope, sphygmomanometer,
airway adjuncts, monitoring equipment. You have performed a patient care hand wash. This task should not be trained in MOPP 4.

Standards: Perform a medical patient assessment without causing further injury in accordance with (IAW) Nancy Carolines Emergency Care in the
Streets, 8th edition and Tactical Combat Casualty Care (TCCC) guideline while adhering to all warnings and cautions, without error, using the task
GO/NO-GO checklist.

Special Conditions: None

Safety Risk: Low

MOPP 4: Never

Task Statements

Cue: None

DANGER
None

WARNING
None

CAUTION
None

Remarks: This task should be performed under all environmental conditions. Four or more operational variables of political, military, economic, social,
information, infrastructure, physical environment, time should be present. Some iterations of this task should be performed with degraded mission
command networks, degraded conditions in the electromagnetic spectrum, and/or with degraded, denied, and disrupted space operations environment
(D3SOE).

Notes: 68W, Combat Medic Specialist is the Proponent for this task.

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 Performance Steps
1. Take body substance isolation precautions.

2. Perform scene size-up.

a. Determine if the scene/situation is safe

b. Determine the mechanism of injury/nature of illness.

c. Determine the number of patients.

d. Request additional help if necessary.

e. Consider stabilization of the spine.

3. Perform a Primary Survey.

a. Form a general impression of the patient and the patient's environment.

b. Assess the patient's mental status using the Alert, Verbal, Pain, Unresponsive (AVPU) scale.

(1) A - Alert and oriented.

(2) V - Responsive to verbal stimuli.

(3) P - Responsive to painful stimuli.

(4) U - Unresponsive.

c. Determine the chief complaint/apparent life-threatening condition.

d. Assess the airway.

(1) Perform an appropriate maneuver to open and maintain the airway, if necessary.

(2) Insert an appropriate airway adjunct, if necessary.

e. Assess breathing.

(1) Determine the rate, depth, and ease of breathing, by observing the chest for rise and fall and assess for signs of difficulty breathing, such as
increased rate and use of accessory muscles.

(2) Administer oxygen, if necessary using the appropriate delivery device.

f. Assess circulation.

(1) Check for major bleeding. Control major bleeding, if necessary.

(2) Check skin color, temperature, and moisture.

(3) Assess the pulse for rhythm and force.

(a) Check the radial pulse in adults.

(b) Check the radial pulse and capillary refill in children under 6 years old.

(c) Check the brachial pulse and capillary refill in infants.

(4) Treat for shock, if necessary.

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 g. Identify priority patients and make a transport decision.
Note: High priority conditions that require immediate transport include poor general impression, unresponsive, responsive but not following
commands, difficulty breathing, shock, complicated childbirth, chest pain with systolic blood pressure less than 100, uncontrolled bleeding, and severe
pain.

4. Conduct a Secondary Assessment.

a. Obtain History of Present illness Using OPQRST

(1) Onset

(2) Provocation

(3) Quality

(4) Radiation

(5) Severity

(6) Time

b. Obtain Past Medical History

(1) Signs and Symptoms

(2) Allergies

(3) Medications

(4) Past Pertinent History

(5) Last Oral Intake

(6) Events Leading to Present Illness

c. Perform a Focused physical exam (Assess affected body part/system or, if indicated, completes rapid assessment)

d. Assess vital signs

e. Provide medication, interventions, and treatment as needed.

f. Reevaluate the transport decision.

5. Perform ongoing assessment.

a. Repeat the initial assessment.

b. Repeat vital signs.

c. Repeat the focused assessment regarding the patient's complaint or injuries.

d. Check effectiveness of interventions.

e. Confirm priority.

(Asterisks indicates a leader performance step.)

Evaluation Guidance: Score each Soldier according to the performance measures in the evaluation guide. Training instructor determines if the
entire task will be trained and evaluated or parts, based on a Soldier's military occupational specialty (MOS) or assigned position and available
equipment.

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Evaluation Preparation: You must evaluate the Soldier on their performance of this task in an operational condition related to the actual task.

PERFORMANCE MEASURES GO NO-GO N/A

1. Took body substance isolation precautions.
2. Performed scene size-up.
3. Performed a Primary Survey.
4. Conducted a Secondary Assessment.
5. Performed ongoing assessment.

Supporting Reference(s):

Step Reference ID Reference Name Required Primary Source Information

Number
ISBN 13 978-1284137170 Nancy Caroline's Emergency Care In the Yes Yes
Streets, Volume 2 - 8th edition
TCCC TCCC Guidelines for Medical Personnel Yes No

TADSS : None

Equipment Items (LIN): None

Materiel Items (NSN) :

Step ID NSN LIN Title Qty

6515-01-528-9274 Cuff, Sphygmomanometer 1
6515-00-374-2220 Stethoscope 1
UM-H550820-PR Gloves Exam Med (Purple), 1 Ea. 1

Environment: Environmental protection is not just the law but the right thing to do. It is a continual process and starts with deliberate planning.
Always be alert to ways to protect our environment during training and missions. In doing so, you will contribute to the sustainment of our training
resources while protecting people and the environment from harmful effects. Refer to the current Environmental Considerations manual and the current
GTA Environmental-related Risk Assessment card.

Safety: In a training environment, leaders must perform a risk assessment in accordance with current Risk Management Doctrine. Leaders will
complete the current Deliberate Risk Assessment Worksheet in accordance with the TRADOC Safety Officer during the planning and completion of each
task and sub-task by assessing mission, enemy, terrain and weather, troops and support available-time available and civil considerations, (METT-TC).
Note: During MOPP training, leaders must ensure personnel are monitored for potential heat injury. Local policies and procedures must be followed
during times of increased heat category in order to avoid heat related injury. Consider the MOPP work/rest cycles and water replacement guidelines IAW
current CBRN doctrine.

Prerequisite Individual Tasks : None

Supporting Individual Tasks : None

Supported Individual Tasks : None

Supported Collective Tasks : None

Knowledges :
Knowledge ID Knowledge Name
081-NP-68C-0037 Identify patients' rights.
081-CL-MED-0010 PATIENT SAFETY
081-PAD-68G- Know how to obtain patient information found in appropriate inpatient computer databases.
KN062
081-VC-68T-KN0236 Use a patient monitor.
081-PAD-68G- How to obtain patient identification
KN053

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081-PAD-68G- How to identify forms used for documenting patient care
KN029
K23375 Knowledge of the anatomy and physiology of a pediatric patient
K23324 Knowledge of the treatment and transport of a patient with an infectious or communicable disease
081-C2-68W-0136 Knowledge of patient priorities for evacuation.
081-UE-FMC-5748 IDENTIFY MEDICAL EMERGENCIES IN A PEDIATRIC PATIENT
K22774 Knowledge of aircraft safety versus patient safety
K23319 Knowledge of optimal interventions for a patient with hypothermia
081-SR-68P-R254 Knowledge to perform patient care handwash
K23318 Knowledge of optimal interventions for a patient with heat exhaustion
K22676 Knowledge of conventional patient positioning
081-NP-WM6-0007 Conduct a patient interview.
K27794 Factors that influence Patient Movement
081-C2-68W-0144 Knowledge of classifications of patients.
K23295 Knowledge of assessing a burn patient
K23602 Knowledge of cardiac conditions associated with geriatric patients
081-SR-68P-H110 Knowledge of body mechanics and patient handling
K23479 Knowledge of the management of a patient with a drug overdose
081-C2-68W-0806 Knowledge of how to take a patient's temperature.
081-C2-68W-0869 Knowledge of proper patient lifting and carrying techniques.
K1052 Principles of a Medical Patient Assessment
081-IBAM-0009 Recognize a Seizing Patient
K22695 Knowledge of assessment and management of cardiac conditions of pediatric patients
K23382 Knowledge of cardiac considerations associated with pediatric patients
K22697 Knowledge of assessment and management of trauma conditions of pediatric patients
K22698 Knowledge of assessment and management of meningococcal infections in pediatric patients
K22703 Knowledge of steps to prepare a patient for a FAST exam
K23378 Knowledge of assessment methods for a pediatric patient
081-SR-68P-B019 Knowledge of patient relations
K23467 Knowledge of considerations for transporting a comatose patient

Skills :
Skill ID Skill Name
S2769 Provide care to a military working dog (MWD) in shock
081-C2-68W-0200 Patient assessment and care for musculoskeletal injury.
081-VC-68T-SK0046 Ability to recognize symptoms of Shock
081-C2-68W-0272 Demonstrate the care of the patient exhibiting signs and symptoms of internal bleeding.
081-C2-68W-0213 Demonstrate ventilating a patient using a variety of ventilator techniques.
081-C2-68W-0035 Demonstrate positioning of the patient for the procedure.
081-C2-68W-0106 Properly position the patient for the procedure.
081-VC-68T-SK0233 Perform first aid for shock.
081-VC-68T-SK0114 Evaluate the mental status of the patient.
081-C2-68W-0101 Perform manual airway maneuvers for pediatric patients.
081-VC-68T-SK0070 Assess the patient’s pulse.
S2780 Monitor a patient during a blood transfusion
081-C2-68W-0189 Ability to screen patients.
081-C2-68W-0187 Ability to interview patients.
081-VC-68T-SK0113 Evaluate the breathing of the patient.

ICTL Data : None

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