The purpose of an initial assessment is to guide the initial
path of treatment. You should be able to quickly assess a patient,
generally within a minute, by evaluating a few key clinical indicators.
At that point you can make a SICK or NOT SICK classification.
A SICK patient is one who can die quickly unless
you initiate aggressive BLS and ALS treatment and
rapid transport. This patient appears physiologically
unstable as indicated by key clinical signs.
A NOT SICK patient is one who can be ill or injured,
but not severely enough to be life threatening. This
patient appears physiologically stable and does not
need immediate ALS measures at this time. BLS treatment
can still be required!
The SICK/NOT SICK choice is a very important medical
decision. In some cases, it is a life-saving choice.
You should be able to decide within the first minute
of contact whether or not the patient is critically
ill. You do this by forming a clinical picture. Once
the decision is made, responder actions should proceed
in a manner appropriate to the patient's condition.
The key clinical indicators
you need to make an initial assessment include:
respirations (rate and character)
pulse (rate and character)
mental status
skin signs and color
body position
Your determination of SICK or NOT SICK will guide which initial
treatment options you employ. For example, the SICK patient with
moderate dyspnea would receive high flow oxygen and appropriate positioning. In addition, you would update the incoming ALS unit.
Make an initial assessment
and start appropriate treatment.
