Building a picture of patients' health status one assessment at a time

Patient assessment is fundamental to everything we do in paramedic practice. It is reasonable to state that we cannot make a safe decision about patient care without an appropriate assessment of the patient. Patient assessment is a skillset that we apply in one form or another to every patient encounter. However, it is arguably the most complex activity we undertake. Each assessment helps us to build a picture of the health status of the patient and to make an appropriate decision about care options.

No single assessment is of much use on its own and we need to combine the findings to make sense of the patient's condition. However, if we use blood pressure as an example of the complexity involved in patient assessment, consider the level of knowledge and understanding that is required to make sense of blood pressure figures:

• Normal physiology of blood pressure
• The patient's current condition
• The patient's pre-existing conditions
• The compensatory mechanisms that may be affecting the blood pressure
• Environmental factors
• Medications being taken by the patient
• The correct procedure for measuring the patient's blood pressure
• Limitations of the equipment used to take the blood pressure
• The usefulness of the blood pressure reading.

You may be able to think of other considerations, but it is safe to say that patient assessment requires a significant level of knowledge, understanding and skill. It also requires a commitment to carry out the assessment correctly as incorrect information can be detrimental to patient care and outcomes.

Throughout 2025, the Journal of Paramedic Practice will be offering a new series that aims to identify and highlight best practice when undertaking certain patient assessment skills. This series aims to identify some of the best-practice considerations you should make when undertaking an assessment (for example, is it okay to put a blood pressure cuff on over clothing?), and some of the limitations of the assessment. Wherever possible, it will identify the evidence to support the contentions and help to build the knowledge base that will allow you to better justify your actions.

The areas we propose to explore form the fundamentals of patient assessment that most paramedics use on a frequent basis in practice.

These include:

• Capillary refill time
• Blood pressure
• The electrocardiogram (ECG)
• Respiration
• Chest auscultation
• Pulse oximetry
• Peak flow
• Glasgow coma score
• Blood glucose monitoring.

We are also open to exploring questions you may like answered so please contact the JPP (jpp@markallengroup.com) if you would like us to explore a specific area of patient assessment.