ABCDE Flashcards
ABCDE assessment, managing obstructed airways
What are signs of an airway obstruction?
LOOK
-Paradoxical chest and abdomen movements (see-saw)
-Use of accessory muscles
-Posturing (sitting up, tripod)
- Holding throat
- WOB + tracheal tug
- Cyanosis
LISTEN
- Noisy breath sounds [partial]
- Silent [full]
How can an airway obstruction be managed?
CALL FOR HELP
MANOUVERS
- Head tilt, Chin lift, Jaw thrust
ADJUNCTS
- OPA
- NPA
-Supraglottic airway/LMA
-ETT
OTHER
-Suction
-Obstruction removal
-Suction tracheostomy
-Oxygenation
Describe RATES?
Rate
Auscultation
Trachea
Effort
SPO2
(alternative: Look, Listen, Feel)
Describe a circulatory assessment.
LOOK
- Colour
- Haemorrhage (“Blood on floor and 4 more”)
-Access?
- ECG/Rhythm
LISTEN
- Auscultate heart sounds/bp
FEEL
- Temperature
- Diaphoresis
- CRT
- Vein Quality
- Pulse quality
VITAL SIGNS
- HR
- BP
- CRT
- URINE OUTPUT 0.5ml-1ml/kg/hour
What is pulse pressure and how does it differentiate between shock types?
The difference between systolic and diastolic blood pressure. 35-45mmHg.
Narrow - arterial vasocon, cardiogenic and hypovolaemic shock
Wide - arterial vdilation, anaphylaxis and sepsis
Describe the assessment of disability.
AVPU
GCS
PERL
BSL
Drugs [chart]
What is treatment of hypoglycaemia?
UNCONCIOUS
- 50ml 10% IV Dextrose minutely until either
–consciousness achieved
–max 250ml
-IM glucagon 1mg
- Buccal glucose
CONCIOUS
- Oral glucose
- IV glucose
Causes of airway obstruction?
TRAUMA
- Maxofacial
- Neck Trauma
- Mucosal burns
PHYSIOLOGICAL
- Laryngospasm
- Bronchospasm
ANATOMICAL
- OSA
- Floppy epiglottis (children)
- Blocked Trachaeostomy
CONDITIONS
- Anaphylaxis
- Oedema
- Tonsilitis/Quinsy
- Croup (???)
FOREIGN BODY
- Blood/vomitus
- Teeth
- Object
- Secretions
List causes of respiratory distress.
TRAUMA
- Tension Pneumo
- Flail chest/rib fracture
- Maxofacial/Neck
ACUTE CONDITIONS
- Anaphylaxis
- Pulmonary Odema
- PE
- ARDS
- Acute on chronic COPD
- Asthma
- Pneumonia
- APO
- MI
- Sepsis
SUPRESSION
- Overdose [opioid, benzo]
- Opioids
- Brain Injury
- Decompensation
- Anaesthetics [low tolerance or too much]
Describe the algorithm for managing choking?
EFFECTIVE COUGH
- Encourage coughing
INEFFECTIVE COUGH AND CONSCIOUS
- Call for help
- Encourage coughing
- 5 back blows, check patient, 5 chest thrusts
- Continue until resolved or unconscious
UNRESPONSIVE
-send for help, start CP
Airway: Assessment, treatment
ASSESSMENT
- Patency [open, compromised, obstructed]
TREATMENT
- Airway Manoeuvres
- Suction
- Adjuncts [opa, npa, sga, ett]
- O2
When might JVP be seen?
Tension pneumothorax
Severe Asthma
What might the following audible airway noises indicate: rattling, stridor, wheeze, snore.
RATTLING
- Secretions in upper airway
STRIDOR
- Partial airway obstruction
WHEEZE
- Collapsing alveoli in lungs, inadequate ventilation due to this
ABSENT
- Severe asthma, life threat
SNORE
- OSA
- Partial obstruction
What does percussed hyperresonance mean?
Pneumothorax
What might the following auscultated sounds indicate: dullness, absent, reduced, wheeze?
DULLNESS
- consolidation, infection, mass
ABSENT
- pneumothorax, one lung
REDUCED
- infection, poor ventilation
WHEEZE
-collapsed alveoli asthma
What does deviated tracheal position indicate?
Pneumothorax
Tension Pneumothorax
Pleural fluid
Lung fibrosis
What might felt emphysema on examination indicate?
Pneumothorax, treat as such until proven otherwise.
Fluid between pleura and skin (i.e. blood, plasma)
Gas caught between pleura and skin.
What might the following palpated pulses indicate: poor, bounding, different between sides?
Poor - v cardiac output
Bounding - sepsis
Differing - aortic dissection
What are signs and symptoms of poor cardiac output?
Oliguria - poor urine output
Poor radial pulse
Decreased level of consciousness
What are signs and symptoms of cardiac failure?
Dyspnoea
^ HR
^ JVP
Third heart sound
Pulmonary crackles
Oedema legs
