A-E Assessment Flashcards
Q: What is the purpose of the A–E (ABCDE) assessment?
A:
A systematic approach to assess and manage critically ill or deteriorating patients.
Prioritizes life-threatening problems with the principle: “Treat first that kills first.”
Involves assessment, investigation, and intervention at each stage, with continuous reassessment.
Q: What does each component of the A–E assessment represent?
A:
A – Airway: Ensure a patent airway.
B – Breathing: Assess and support respiratory function.
C – Circulation: Evaluate hemodynamics and manage shock/bleeding.
D – Disability: Assess neurological status.
E – Exposure: Perform a full-body check while maintaining dignity and warmth.
Q: How do you assess and manage the Airway (A)?
A:
Check for verbal response (a clear response indicates a patent airway).
Listen for abnormal sounds: snoring, gurgling, stridor.
Use head-tilt/chin-lift or jaw thrust if obstructed.
Use airway adjuncts (nasal/oral airways) if needed.
Q: What steps are involved in assessing Breathing (B)?
A:
Count respiratory rate and assess depth.
Observe for use of accessory muscles.
Check oxygen saturation (SpO₂).
Administer oxygen (15 L/min) via a non-rebreather mask if hypoxic.
Auscultate lungs for abnormal sounds.
Q: How do you assess Circulation (C)?
A:
Check skin color and temperature.
Assess pulse (rate, rhythm, strength).
Measure blood pressure and monitor trends.
Perform capillary refill time (CRT); >2 seconds suggests poor perfusion.
Treat hypotension with a 500 mL fluid bolus (250 mL if cardiac risk).
Q: What does the Disability (D) assessment include?
A:
Use the ACVPU scale: Alert, Confusion, response to Voice, Pain, or Unresponsive.
Check pupil size and reactivity.
Measure blood glucose for hypo/hyperglycemia.
Perform limb strength tests.
Q: What is involved in the Exposure (E) step?
A:
Perform a top-to-toe assessment for injuries, rashes, bleeding, or signs of infection.
Check temperature (hypo/hyperthermia).
Inspect drains, wounds, and devices for complications.
Maintain the patient’s dignity, privacy, and warmth.
Q: What is the role of the Chain of Prevention in patient care?
A:
Includes Education, Monitoring, Recognition, Calling for help, and Response.
Designed to reduce preventable cardiac arrests and hospital deaths.
Q: How does the NEWS2 score support the A–E assessment?
A:
Helps detect early signs of deterioration.
Aids in decision-making for escalation of care.
Must be used alongside clinical judgment.
Q: What is the SBAR communication tool, and why is it important?
A:
S: Situation – Identify yourself and the issue.
B: Background – Patient history and context.
A: Assessment – Current findings.
R: Recommendation – Suggested actions.
Ensures clear, structured communication for patient safety.
Q: How should team roles be managed during the A–E assessment?
A:
Recognize personal clinical limitations.
Call for expert help early.
Ensure team members are competent in assigned tasks.
Maintain clear communication between team members.
Q: What initial safety checks must be performed before the assessment?
A:
Ensure personal safety and use PPE.
Assess the patient’s general appearance for signs of distress or confusion.
Introduce yourself and obtain consent.
Q: How is hypotension managed during the circulation assessment?
A:
Administer a 500 mL bolus of isotonic fluid in <15 minutes.
Monitor for signs of fluid overload (e.g., crackles in lungs).
Reassess blood pressure every 5 minutes.
Q: How do you assess for shock during the circulation assessment?
A:
Check for weak pulse, prolonged capillary refill, and cold extremities.
Identify and treat possible causes: fluid loss, bleeding, sepsis, or cardiac failure.
Q: Why is continuous reassessment important in the A–E approach?
A:
Patient conditions can change rapidly.
Reassess after each intervention.
Helps detect deterioration and adjust care accordingly.
Q: What is the role of a 12-lead ECG in the A–E assessment?
A:
Performed if acute coronary syndrome (ACS) is suspected.
Detects arrhythmias, ischemia, or infarction.
Q: How should patients with suspected sepsis be managed during A–E?
A:
Follow the Sepsis Six: Blood cultures, antibiotics, fluids, lactate check, urine monitoring, oxygen.
Send blood, urine, and other samples for cultures.
Escalate care if sepsis is confirmed.
Q: What are key points for performing the Exposure step safely?
A:
Maintain dignity and privacy.
Use warming blankets if hypothermia is detected.
Minimize patient exposure to reduce heat loss.
Q: How is a severe airway obstruction managed during the A–E assessment?
A:
Use suctioning to clear secretions or vomit.
Insert airway adjuncts (e.g., oropharyngeal or nasopharyngeal airways).
Escalate to advanced airway management (e.g., intubation) if required.
Call for anesthesia/critical care support if the airway is compromised.
Q: What is the role of a chest X-ray in the breathing assessment?
A:
Identifies causes of respiratory distress, such as pneumonia, pneumothorax, or pulmonary edema.
Assists in confirming the correct placement of endotracheal tubes or NG tubes.
Helps detect pleural effusion or rib fractures.
Q: How should active bleeding be managed during the circulation assessment?
A:
Apply direct pressure to the bleeding site.
Use pressure bandages or tourniquets for severe limb bleeding.
Elevate the bleeding area if appropriate.
Consider tranexamic acid (TXA) in trauma cases.
Q: How is the Glasgow Coma Scale (GCS) used in the disability assessment?
A:
Provides a more detailed neurological assessment than ACVPU.
Scores Eye Opening (E), Verbal Response (V), and Motor Response (M) (Total score: 3–15).
Used to monitor changes in consciousness and detect neurological deterioration.
Q: Why is pain assessment important in the disability check?
A:
Pain can cause physiological stress, impacting vital signs.
Use pain scales like Numeric Rating Scale (NRS) or FLACC for non-verbal patients.
Manage pain promptly with analgesia to improve patient comfort.
Q: How should temperature abnormalities be managed during the exposure step?
A:
Use active warming methods for hypothermia (e.g., warming blankets, fluids).
Apply cooling measures for hyperthermia (e.g., fans, antipyretics).
Monitor core temperature regularly to guide interventions.
