Assessment and Diagnostics
Core concepts
Assessment in flight medicine is a structured, repeated process: primary survey (airway, breathing, circulation, disability, exposure), resuscitation, secondary survey, and ongoing reassessment. Understand how transport alters diagnostics: noise limits auscultation, vibration and motion degrade ECG and blood pressure readings, pulse oximetry may lag behind rapid desaturation, and ultrasound is operator- and environment-dependent. Candidates should know when to use capnography, point-of-care glucose, lactate, ECG, and focused ultrasound, and how to trend findings rather than react to a single value.
Traps
A common question trap is the “normal” vital sign in compensated shock or early deterioration. Another is anchoring on an initial diagnosis and ignoring a changing exam. Monitor artifacts, poor perfusion, hypothermia, and vasopressors can all distort readings. Do not treat a number without confirming the patient and the signal quality. In transport, a deteriorating patient may need a destination or mode change, not more diagnostics.
Rule of thumb
Treat the patient, not the monitor; if the monitor and the patient disagree, reassess the patient and the equipment. Trend vital signs and mental status over time.
Worked example
A patient has a narrow pulse pressure, cool skin, and delayed capillary refill but a “normal” systolic pressure. This suggests compensated shock. The correct response is to recognize occult hypoperfusion, obtain repeat vitals and lactate if available, and begin appropriate resuscitation and transport planning rather than waiting for hypotension.