Conducting an illness assessment

In past weeks we have focused on providing emergency care for specific illnesses or injuries. We’ve learned that we always begin caring for a patient by performing a ‘primary assessment’ and by monitoring the ‘ABCD’S’ of the patient’s ‘lifeline’.

When conducting an illness assessment we dont try to diagnose the patients condition, but simply collect information about the patient to help us determine what first aid may be needed.

This week we are going to take a closer look at some secondary care skills. Suppose a friend, family member or co-worker complains that they just ‘don’t feel well.’ They may indicate specific symptoms such as dizziness, shortness of breath, nausea or pain, or you may notice certain signs like pale skin or a change in their normal behaviour.

In a situation like this we can provide care by performing an ‘illness assessment’.

When conducting an illness assessment we don’t try to diagnose the patient’s condition, but simply collect information about the patient to help us determine what first aid may be needed or, if EMS has been activated, to provide important information to medical personnel.

We begin as always with a primary assessment, however, if the patient is conscious and responsive and shows no signs of serious bleeding, shock or spinal injury, we can move on to our illness assessment.

To guide us through the steps of an illness assessment we can use the mnemonic SAMPLE.

S=Signs and Symptoms. A ‘symptom’ is something the patient complains of and a ‘sign’ is something you observe.

Ask how the patient is feeling and what occurred immediately before they began to feel ill. Use paper and a pen/pencil to record the patient’s pulse and respirations. Check temperature and moisture by feeling the skin on the patient’s forehead with the back of your hand.

Look for apparent skin colour changes and record your findings. If the patient has dark skin check for colour changes on the nail beds, lips, gums, tongue, palms, whites of the eyes and ear lobes.

A=Allergies. Ask the patient if they are allergic to anything – food, drugs, airborne matter, etc. Ask if they have been exposed to anything they are allergic to.

M=Medications. Ask if the patient takes medications for a medical condition. Record the name of the medication and the time the patient last used it. If possible, collect all medications to give to EMS personnel.

P=Pre-existing conditions. Ask if the patient has any pre-existing medical conditions (e.g., heart condition, diabetes, asthma, epilepsy).

L=Last meal. Ask when the patient last had a meal and what they ate. Ask the patient if they have consumed any alcohol or recreational drugs.

E=Events. Ask the patient about events leading up to the illness. Use the information you gather in your illness assessment to determine if the patient should seek medical treatment.

If in doubt, err on the side of caution. The patient may deny his/her symptoms and be hesitant to seek care. They may say things like ‘don’t worry, I’m fine’, or ‘I don’t want to make a fuss.’ Encourage the patient by stressing that their condition is probably minor but they should get checked out ‘just to be on the safe side.’

This weekly column is only an introduction to emergency care skills and is designed to increase interest in First-Aid/CPR training. For information on courses please contact the Red Cross, a medical professional, or a local dive shop.

Check temperature and moisture by feeling the skin on the patient’s forehead with the back of your hand.

Look for apparent skin colour changes and record your findings. If the patient has dark skin check for colour changes on the nail beds, lips, gums, tongue, palms, whites of the eyes and ear lobes.