ABCDE

Question 1

ABCDE

Answer 1

To do in emergency before taking care of anything else
Treat 1st what kills 1st
Talk out loud
Assess, address, advance: treat directly if possible, contact team if needed
A: airway
B: breathing
C: circulation
D: Disability
E: Exposure
Have vitals: pulse, ECG, blood pressure, intraveneous blood test
Look, listen, feel

Question 2

A

Answer 2

Airway (obstruction)
Is the cervical spine stable (in case of trauma)?
• Look: Inspection oral cavity
Make sure airway not blocked, is able to breath.
• Listen: Audible breath sounds (stridor, rales, snoring)?
• Feel: Feel movement of air with ear or hand above patient’s mouth/nose
Tilt head up with hand under chin and on forehead
put ear over mouth and check for breathing coming out of nose and mouth. Check abdomen and chest breathing
Oxygen assistance if needed

Question 3

B

Answer 3

Breathing
• Look: Colour, visible chest abnormalities, respiratory movements
• Listen: Auscultation and percussion lungs
• Feel: Respiratory movements (L=R?), emphysema, rib fractures
Can have ABG (arterial blood gaz test)
Oxygen saturation 93-100%
RR : 12-16 / min and regularity, rythm, depth
Accessory muscle
Abdominal Breathing
Symmetry -> pneumothorax
Position trachea to jugular notch
Oxygen assistance if needed

Question 4

C

Answer 4

Circulation
• Look: Colour of skin, external blood loss, neck veins
• Listen: Auscultation heart
• Feel: Temperature hands/feet, wrist/groin/neck
Examination abdomen (in case of shock) or pelvis (in case of trauma)
Blood pressure 120/80 mmHg
Heart rate and regularity
listen to heart, any murmur ? correspond to pulse ?
Pulse radial and if not femoral
Central venous pressure (blood pressure vena cava)
urine production
Feel skin warmth, hands and feet.
Capillary refill
Look if any hemmorage, oedema

Question 5

D

Answer 5

Disability
Check drugs chart
Check pupils with light, constriction and if any lateralizatoin
Get glucose level with finger pick test
Assess Consciousness:
Glasgow Coma Scale EMV score (Eye, Motor, Verbal)
AVPU scale (alert, verbal, pain, unresponsive)

Question 6

EMV score

Answer 6

part of D part: Glasgow coma scale
EMV score (Eye, Motor, Verbal)
3 to 15
Shout, shake if needed

E Opening the eyes
Investigate whether the patient:

spontaneously opens their eyes when you enter the room
= 4 points
opens their eyes upon your request
= 3 points
opens their eyes in response to a pain stimulus,  e.g. pressure on the supra-orbital nerve or fingernails [Figures 99, 100]
= 2 points
does not even open their eyes in response to pain
= 1 point

M The motor response
Investigate whether the patient:

can carry out a task
= 6 points
can locate an administered (pain) stimulus (‘tell me where’ or ‘point to where you feel this’). For example, you could exert pressure on a fingernail or toenail 
= 5 points
retracts the arm or leg to which you are administering the pain stimulus
= 4 points
abnormally flexes the arm or leg to which you are administering the pain stimulus
= 3 points
extends the arm or leg to which you are administering the pain stimulus
= 2 points
displays no motor response
= 1 point

If there is a difference between left and right, the best score should be used.

V Verbal reactions
Investigate whether the patient:

What’s your name ?
Can you tell me where you are ?
Can you tell me what day/month it is ?

is alert, i.e. knows what time it is, what day it is, where they are
= 5 points
is confused, i.e. disorientated to place and time
= 4 points
only uses isolated words out of context
= 3 points
only responds to questions and tasks with moans 
= 2 points 
does not respond to questions and tasks at all 
= 1 point

Do not note only the total number of points, but the scores for the individual components as well (i.e., EMV: 8 (3,3,2)).

Question 7

AVPU scale

Answer 7

Part of D
AVPU scale (alert, verbal, pain, unresponsive)
Ask: 
What's your name ?
Can you tell me where you are ?
Can you tell me what day/month it is ?
-> alert if answers correct
-> verbal if responding but incorrect answers
If neither -> test pain
pressure on the supra-orbital nerve or fingernails
-> pain if pulls away
if nothing -> unresponsive

Question 8

E

Answer 8

exposure
can expose body (respect dignity and don’t provoke too much heat loss), look at patient skin, check temperature and do abdomen exam.
Reasses: repeat ABCDE