ABCDE

Question 1

What do you do at the airway section?

Answer 1

If patient talking, airway is patent (can maybe check mouth?)

If patient is not talking, check to see if their airway is obstructed and perform airway manoeuvres and/or use airway adjunct

Question 2

What do you assess at B?

Answer 2

Resp rate
Oxygen saturation
General inspection of breathing
Tracheal deviation
Chest expansion
Percussion
Auscultation

Question 3

What interventions can you make at B?

Answer 3

Oxygen (15L non-rebreather)
Nebuliser if COPD or asthma
Call senior to prescribe steroids
Large bore cannula in 2nd intercostal space mid-clavicular line if pneumothorax
?ABG for low sats

Question 4

What do you assess at C?

Answer 4

Heart rate
Blood pressure
Fluid balance assessment e.g. ask if fluid balance chart kept, check catheter bag
Check hand temperature
Cap refill (peripheral and central if prolonged)
Radial and brachial pulse
JVP
Heart sounds
Leg and sacral oedema (possibly in E?)

Question 5

What investigations should you carry out at C?

Answer 5

Wide bore cannulas in antecubital fossae
Blood tests (FBC, U&E, LFT, VBG, ?glucose for everyone, add in others as per condition)
3 or 12 lead ECG depending on presentation
Instruct to keep strict fluid balance recording

Question 6

What blood tests would you add in suspected sepsis?

Answer 6

CRP, lactate, blood cultures

Question 7

What blood tests would you add in suspected haemorrhage/surgical emergency?

Answer 7

Coagulation and cross-match

Question 8

What blood tests would you add in suspected acute coronary syndrome?

Answer 8

Troponin

Question 9

What blood tests would you add in suspected anaphylaxis?

Answer 9

Mast cell tryptase

Question 10

What blood tests would you add in suspected arrhythmia (according to geeky medics)?

Answer 10

Calcium , magnesium, phosphate, TFTs, coagulation

Question 11

What blood tests would you add in suspected overdose?

Answer 11

Toxicology screen

Question 12

What interventions can you make at C?

Answer 12

Fluid resuscitation if hypovolaemic (Administer a 500ml bolus Hartmann’s solution or 0.9% sodium chlorideover less than 15 mins)
If ACS: pain relief (e.g. morphine), nitrates, aspirin, clopidogrel and oxygen
IV Abx if sepsis suspected (and say you’re initiating sepsis 6)
Request blood products if haemorrhage/initiate major haemorrhage protocol

Question 13

What volume of bolus should you give patients at risk of fluid overload e.g. heart failure?

Answer 13

250mls

Question 14

What do you assess for in D?

Answer 14

AVPU/GCS
Pupils
?drug chart
Glucose and ketones

Question 15

What % IV glucose do you give in hypoglycaemia if unconscious?

Answer 15

10% (ask for protocol)

Question 16

What do you give in an unconscious hypoglycaemic patient if IV glucose not available?

Answer 16

IM glucagon

Question 17

What do you give in DKA?

Answer 17

IV fluids and IV insulin (ask for protocol)

Question 18

What do you give in suspected opioid toxicity?

Answer 18

Naloxone

Question 19

What do you assess at E?

Answer 19

Expose patient
Temperature
Abdominal exam

Question 20

When should you call for senior help?

Answer 20

When your interventions are not helping
When an intervention needs done that you can’t do