A-E assessment

Question 1

What is the A-E assessment used for?

Answer 1

rapid patient assessment, allowing recognition of life-threatening conditions early

Question 2

What approach should be taken alongside the A-E assessment?

Answer 2

a look, listen & feel approach (not just relying on equipment)

Question 3

Who is it suitable for?

Answer 3

all age groups

Question 4

What is the ‘A’? Explain what this is in this context.

Answer 4

AIRWAY- allow normal passage of air to flow from atmosphere to lower respiratory tract, airway in this context is movement of air through upper airway structures

Question 5

How is a normally-functioning airway described?

Answer 5

Patent- meaning air is able to flow through the upper airway free from obstruction

Question 6

How is the airway assessed?

Answer 6

• sounds: is the person’s breathing quiet & calm? Are there any abnormal noises?
• speech: can the patient speak? is their voice clear?
• chest movement: is it equal on both sides?
• effort: is any extra effort needed to breathe?

Question 7

What is the ‘B’? Explain the mechanism behind this.

Answer 7

BREATHING-
1) inspiration- diaphragm flattens, external intercostal muscles contract to elevate ribs & sternum = more space in thoracic cavity
2) because of Boyle’s Law (pressure & volume are inversely proportional), the pressure in the lungs decreases, so atmospheric pressure is now greater
3) air is drawn in to equalise the pressure
4) expiration- diaphragm relaxes to resting position & external intercostal muscles relax to depress ribs & sternum
5) volume decreases, increasing pressure, so air leaves the lungs to equalise pressure

Question 8

How is breathing assessed?

Answer 8

• effort: how much effort is required to breathe? Is breathing rate normal? Are there any unusual sounds? Is the breathing pattern steady & even?
• efficacy: how effective is the breathing in keeping the patient oxygenated? Is their chest moving equally on both sides?
• effect: is the breathing having a detrimental effect on other body systems? Is the patient’s skin a normal colour around mouth & nose? Are they alert & behaving normally?

Question 9

What is the normal respiratory rate?

Answer 9

12-20 breaths per minute

Question 10

What is the ‘C’? What 2 things are considered in this?

Answer 10

CIRCULATION- heart (function of the heart in terms of the effort it’s making to maintain healthy circulation), vessels (blood flow through arteries, veins & capillaries)

Question 11

How is circulation assessed?

Answer 11

• appearance: observe for blueness & darkness, look out for any skin discolouration, are the patient’s hands & feet warm? Do they have good sensation?
• heart rate: how many times does the patient’s heart beat in one minute?
• blood pressure: systolic & diastolic
• capillary refill time: press area for 5s, release & watch blood return (should return in less than 2s)
• output: is the patient drinking water & passing urine normally?

Question 12

What is the normal heart rate?

Answer 12

60-100 beats per minute

Question 13

What is the ‘D’? What does this assess?

Answer 13

DISABILITY- the brain, conscious level, interaction with surroundings, blood glucose

Question 14

How is disability assessed?

Answer 14

• AcVPU assessment: scale to quickly assess conscious level, Alert, Confusion, Voice, Pain, Unresponsive (confusion relates to NEW episodes)
• blood glucose may be checked due to significant impact it has on conscious level & cognitive function

Question 15

What is the ‘E’? What does this assess?

Answer 15

EXPOSURE- considering the skin for scars, bruising, or rashes (consider safeguarding), taking temperature

Question 16

How is exposure assessed?

Answer 16

• temperature: significantly lower or higher than normal can indicate illness etc.
• skin: tells us about possible systemic illnesses, it also allows us to assess for possible injury, or past medical history