37. recognition of an ill patient (Cardiac Arrest prevention)

Question 1

what are the ABCDE

Answer 1

Airway
Breathing
Circulation
Disability
Exposure

Question 2

what should you look for in airway assessment

Answer 2

talking
distressed
choking
Noisy breathing
difficulty breathing
seesaw respiratory pattern
accessory muscles
SOB

Question 3

what do you mean by noisy breathing? give me examples

Answer 3

stridor, wheeze, gurgling

Question 4

what are the airway maneuvers

Answer 4

• head tilt, chin lift, jaw thrust, suction
  Simple adjuncts
  Advanced techniques (LMA, ETT)
  Oxygen!
  REASSESS check to see what you have done has worked

Question 5

what do you look for breathing

Answer 5

Resp rate
Resp effort
accessory muscle use, abdominal movement
sweating
central cyanosis
fatigue

Question 6

what do you listen for in breathing

Answer 6

equal air entry?
added sounds. stridor, wheeze, crackles

Question 7

what do you feel for in breathing

Answer 7

> Trachea
> Expansion
> Percussion
> Surgical emphysema

Question 8

so what do you do for the breathing section

Answer 8

→ Early sats monitoring
→ Supplemental O2
→ Ventilatory support
→ Drugs e.g. bronchodilators
→ Acute interventions
→REASSESS

Question 9

what do you look for and feel for in circulation

Answer 9

colour, temperature to touch
capillary refill time
Heart rate
character of peripheral pulse
NIBP (non-Invasive)
Heart sounds
clinical signs of failure, haemorrhage

Question 10

what do you do to fix circulation

Answer 10

→ Cardiac monitor
→ Large bore (14G/16G) intravenous cannulae
→ Blood
→ IV Fluid challenge
→ ECG
→ REASSESS

Question 11

what are you looking for in Disability

Answer 11

Hypoxia, Hypercapnia, cerebral hypoperfusion, hypoglycemia, drugs
ACVPU +/- GCS
Pupils
Blood glucose
Temperature

Question 12

what would you do to fix disability

Answer 12

→ Maintain normoglycaemia
→ Reversal of agents (BZD, opioids)
→ Seizure control
→ Patient positioning
→ REASSESS

Question 13

what do you do in exposure

Answer 13

→ Remove clothes to enable thorough examination
○ e.g. injuries, bleeding, rashes, drains
→ Avoid heat loss
Maintain dignity

Differentials
Ensure normothermia
REASSESS

Question 14

what score can help you identify an ill patient

Answer 14

NEWS-2

Question 15

what do NEWS-2

Answer 15

• Predict clinical deterioration
  • Guide escalation of patient care
  • Urgency of escalation