HM PQS Section 104 Military Medical Exam
Fundamentals (Updated 2022)with complete solution
How to do Primary Assessment
1. Scene Size Up: BSMNAC
• BSI
• Scene Safety
• Determine MOI/NOI
• Number of patients
• Additional Assistance if necessary
• C-Spine precautions
2. Primary Survey
• General impression
• LOC (AVPU)
• Determine chief complaint
4. ABC/CAB Shock
• ABC/CAB
- Treat life threatening inj as found
• Treat for shock
• Determine patient priority
8. Obtain SAMPLE
• Symptoms
• Allergies
• Meds
• Pertinent Med Hx
• Last oral intake
• Event(s) leading to inj/ill
Scene Size Up (BSMNAC)
B: BSI
S: Scene Safety
M: Determine MOI/NOI
N: Number of patients
A: Additional Assistance if necessary
C: C-Spine precautions
SAMPLE Acronym Stands For
S: Symptoms
A: Allergies
M: Meds
P: Pertinent Med Hx
L: Last oral intake
E: Events leading to inj/ill
How to do Secondary Assessment
1. DCAP-BTLS head to toe
• Deformities
• Contusions
, • Abrasions
• Penetrating Woounds
• Burns
• Tenderness
• Lacerations
• Swelling
2. Treat non life threatening inj
3. Obtain vitals
4. Manage injuries
5. Reassess & verbal report
P-MARCH-P Acronym Stands For
P: Patient/Provider Safety
M: Massive Hemorrhage
A: Airway
R: Respirations
C: Circulation
H: Head Trauma/Hypothermia
P: Pain Management
DCAP-BTLS Acronym Stands For
D: Deformities
C: Contusions
A: Abrasions
P: Penetrating Wounds
B: Burns
T: Tenderness
L: Lacerations
S: Swelling
Normal Baseline Vitals
Resp Rate: 12 - 20 RR
Pulse: 60 - 100 BPM
Blood Press: 90/60 mm Hg - 120-80 mm Hg
Temp: 97.8 °F - 99.9 °F
• Fever: 101.9 °F
Pulse Ox: 95%
Pain: 0/10
Factors that infuence vitals
• Age
• Meds
• Environment
• Last oral intake
• Gender
• Lifestyle
• Ethnicity
• Stress / anxiety
How to Take Orthostatic Blood Pressure
1. Patient lie down for 5 min
Fundamentals (Updated 2022)with complete solution
How to do Primary Assessment
1. Scene Size Up: BSMNAC
• BSI
• Scene Safety
• Determine MOI/NOI
• Number of patients
• Additional Assistance if necessary
• C-Spine precautions
2. Primary Survey
• General impression
• LOC (AVPU)
• Determine chief complaint
4. ABC/CAB Shock
• ABC/CAB
- Treat life threatening inj as found
• Treat for shock
• Determine patient priority
8. Obtain SAMPLE
• Symptoms
• Allergies
• Meds
• Pertinent Med Hx
• Last oral intake
• Event(s) leading to inj/ill
Scene Size Up (BSMNAC)
B: BSI
S: Scene Safety
M: Determine MOI/NOI
N: Number of patients
A: Additional Assistance if necessary
C: C-Spine precautions
SAMPLE Acronym Stands For
S: Symptoms
A: Allergies
M: Meds
P: Pertinent Med Hx
L: Last oral intake
E: Events leading to inj/ill
How to do Secondary Assessment
1. DCAP-BTLS head to toe
• Deformities
• Contusions
, • Abrasions
• Penetrating Woounds
• Burns
• Tenderness
• Lacerations
• Swelling
2. Treat non life threatening inj
3. Obtain vitals
4. Manage injuries
5. Reassess & verbal report
P-MARCH-P Acronym Stands For
P: Patient/Provider Safety
M: Massive Hemorrhage
A: Airway
R: Respirations
C: Circulation
H: Head Trauma/Hypothermia
P: Pain Management
DCAP-BTLS Acronym Stands For
D: Deformities
C: Contusions
A: Abrasions
P: Penetrating Wounds
B: Burns
T: Tenderness
L: Lacerations
S: Swelling
Normal Baseline Vitals
Resp Rate: 12 - 20 RR
Pulse: 60 - 100 BPM
Blood Press: 90/60 mm Hg - 120-80 mm Hg
Temp: 97.8 °F - 99.9 °F
• Fever: 101.9 °F
Pulse Ox: 95%
Pain: 0/10
Factors that infuence vitals
• Age
• Meds
• Environment
• Last oral intake
• Gender
• Lifestyle
• Ethnicity
• Stress / anxiety
How to Take Orthostatic Blood Pressure
1. Patient lie down for 5 min
