#because I just automatically do it and haven't used the terms 'primary and secondary assessment' since EMT class

[luinhealthcare]

Does Hyrule mind teaching how to assess a patient??👉👈

"You... want to learn how to assess patients?" Hyrule asked hesitantly.

Wild shrugged. "What if I want to be an EMT?"

"You also said you wanted to be a chef in the hospital."

"I can do both, you know."

Hyrule laughed. "I suppose so. Well... we'll need a patient for this to work."

Wild immediately snatched Sky, who yelped as his friend snaked a hand around his wrist. "Sky's the patient, heaven knows he needs to be looked over anyway."

"Look who's talking, Mr. I-Have-Seizures-and-Don't-Tell-Anybody," Sky grumbled as he was manhandled to sit between the other two.

"Well, everyone knows now."

Hyrule and Sky gave Wild a scalding look. Adequately apologetic, Wild shrugged sheepishly.

"Anyway," Hyrule sighed, shifting his focus to Sky. "Assessments come in different forms. You've got a primary and a secondary assessment. Primary is kind of a general overview and checking for life threatening stuff, secondary is in-depth on what the issue actually is. Make sense?"

Wild nodded.

"Great!" Hyrule continued with a smile. "Okay. Sky's our patient. Sky, you got shot once, right?"

Sky nodded, and Wild balked. "He what?!"

"It was a long time ago," Sky waved a dismissive hand.

"Okay, so that's our scenario," Hyrule said, standing. "We're dispatched for a 21-year-old male with a GSW--"

"That means gunshot wound, right?"

"Yeah. GSW, conscious patient. That's all we've got. So, you get on scene, and the very first thing you do is check for scene safety. If the scene isn't safe, we're not going in. First thing you're taught in EMS - your own safety comes first, because if you're shot you can't help the patient. It's you, your partner, then the patient."

"How often do you actually listen to that rule?" Sky asked, raising an eyebrow.

"That's not what we're learning today," Hyrule waved off easily. It was pretty common knowledge that while he would never put his partner's life at risk, he'd gotten himself into dicey situations before. But he knew how to get himself out of those situations too. "So, we determine the scene is safe. Next, is our primary assessment. The purpose of this assessment is to check for life threatening things, and an overview of major body systems. Neuro status, bleeding, and your ABCs: Airway, Breathing, Circulation.

"The situation is pretty dynamic, like sometimes you walk up and somebody's got an arterial bleed and spurting blood everywhere, your assessment stops right there and you go fix that bleed. But generally you'll have time to do the entire primary assessment."

"Okay, so neuro and ABCs?"

"Yeah. And the good thing is that most of it happens all at once, you know? You walk up to Sky and he looks at you, then boom, you've got a good neuro - he's awake, he's alert. He may not be oriented, but you can figure that out by just talking to him. And by this point you can tell if there's life threatening bleeding. Then it's ABCs - is his airway patent, or open? Is he breathing, and is he doing so normally? Is his skin warm, dry, and normal tone for him? You can literally do al these things by just walking into the room and looking at him for five seconds. The primary assessment is done really fast and, the more times you do it, basically automatically."

"What would be an example of something being wrong?" Wild askd.

Hyrule glanced at him. "When I got on scene for your crash, you were unconscious and unresponsive--in other words, you were not only unconscious, but nothing would wake you up--and your breathing was gurgling sounding because you had blood in your airway."

Glancing at Sky, Hyrule said, "Sky can give us an example of a not great primary assessment, I'm sure."

Helpfully, Sky immediately flopped off the chair he was sitting on, collapsing to the ground with a crash. Wild laughed, and footsteps rushed from upstairs into the living room.

Twilight immediately froze in the entranceway, eyes wide and fixed on Sky. "Sky, what the--guys what the hell is hap--"

Sky perked up immediately. "Oh, sorry! I'm just helping Hyrule teach Wild!"

Twilight froze a moment and then sighed heavily, pinching the bridge of his nose and grumbling under his breath.

Hyrule smiled, pointing at Twilight. "He just perfectly showed a good primary assessment looks like! He walked in and saw the patient down on the ground, tried to figure out a neuro by calling out to him, and when Sky woke up he immediately could tell he was fine. Neuro intact, not bleeding, had a patent airway because he's talking, breathing normally, and skin looks normal."

"I hate all of you," Twilight groaned, walking out of the room.

"Okay, but by skin looking normal... what does it mean when it doesn't?" Wild asked.

"Your skin can tell a story," Hyrule explained. "If you're diaphoretic, which means sweating, something is likely wrong. Though it depends on context - if your patient's sweaty but they were just exercising, it makes sense. If Sky's sweaty on the ground after being shot, he's in shock. If the skin is cool, the body isn't circulating well - that can sap the color right out of your skin - the lighter your skin tone the more notable it is, but darker skin tones can become paler too. A lot of times with darker skin tones you'll want to look at their palms or their lips, that'll help you determine it. Another color is grey - that usually means cardiac and it's bad. So skin can tell you a lot!"

"How did my skin look?" Wild questioned, curious.

"Pale," Hyrule immediately answered. "Anyway. Sky's your patient. Look him over."

"Okay," Wild blew out a breath, approaching Sky and kneeling beside him. "So he's unconscious, that's my neuro so far."

"Can you arouse him at all?"

Wild poked Sky in the neck. Sky flinched. Wild poked again and Sky giggled. Wild's eyes widened in realization, and a mischievous smile crossed his face.

"Wild, wait--"

Sky started laughing hysterically as his friend tickled him, wiggling and trying to shove him away.

"Get--off of m--Wild you jerk--"

Hyrule chuckled. "Well, we're not taught to tickle our patients, but that works."