Safety First: General Impression


Study Notes:

  1. 1.We seek and report 5 points (in order) to get a general impression of our patient:
        • Location
        • Age
        • Gender
        • Position Found
        • Level of Distress

  2. 2.Use appropriate medical words to describe the position you find them in.
        • Supine
        • Prone
        • High or Low Fowlers
        • Sitting (note any tripoding)
        • Standing

  3. 3.Determine an accurate level of distress
        • Mild = patient seems fine
        • Severe = they’re dying
        • Moderate = between mild and severe

“G is for General impression”


“Safety First” ... Table of Contents

Safety    Use your BSI - Biological Safety

              F is for Fire - Scene Safety

I                 I is for Incident: MOI/NOI          

R                Determine the numbeR of patients

S                Send for help

T                Trauma to the C-spine?

G                General impression of the patient

E                Estimate LOAs

T                Threats to you or your patient?

1°A             1° Airway

1°B             1° Breathing

1°C             1° Circulation

1°D             1° Decision

2°A             2° Airway

2°B             2° Breathing

2°C             2° Circulation

2°D             2° Decision

“So ... whaddya think”?

At this point we're getting the first good look at our patient and trying to get a general impression who they are and how they are doing.  So 'G' stands for General impression.

However, even though we call it a 'general impression' we are quite specific about what we observe and report.

What we, as paramedics, have learned through experience, is that if you want to paint as clear a picture of an incident in another persons imagination then you need to include 5 very specific pieces of information (in this order).  They are:

  1. BulletThe location you are at.

  2. BulletWhether the patient is male or female.

  3. BulletRoughly how old the patient is.

  4. BulletThe position you found the patient in.

  5. BulletThe level of distress the patient seems to be in.

You have to memorize these points, to learn to look specifically for these pieces of information when you approach a patient, and then report these points, in order, whenever you are presenting your general impression to another medical professional.  For example, imagine that there is another more advanced paramedic crew responding to back you up and they are asking for the general impression of your patient.

Imagine that I tell you that you are on scene with a person in a car accident.  Can you form a picture of that in your head?

Now, instead of reporting that we have a 'person in a car accident', take a look at how much easier it is to imagine the following (properly reported) situations:

  1. In a ditch 2 feet below grade at the oncoming traffic side of the road beside an overturned car with a 35 year old male collapsed in the car in severe distress.

  2. In a public mall with an 82 year old female, sitting upright on the ground in mild distress.

  3. In a private residence with a 76 year old male, high fowlers in bed in moderate distress.

I just mentioned ‘high fowlers’ position.  If you aren’t familiar with the medical names for patients positions, you might want to take a quick look at this review page.

You might wonder how you can determine someone’s level of distress just by looking at them.  At this point, it's very, very general. 

You kind of guess. 

If the patient seems to be fine; if they're walking around calmly, or sitting in a relaxed way and they don't look panicked you can guess (just for now) that they are in mild distress. 

On the other hand, if they are collapsed on the ground, or if they clearly are not responding to their environment, or you can tell that they look like they're in shock or have been really smashed up, then we guess that they are in severe distress.

Unless they fall into either extreme we label them as being in 'moderate' distress until we find out more.

So G stands for General Impression.