ABCDE + ALS Flashcards
what does ABCDE stand for
Airway
Breathing
Circulation
Disability
Exposure
How to assess an airway
check patency - can patient speak in full sentences?
Noises - gurgling/gasping/snoring/stridor/wheeze – partial obstruction?
Look in mouth if apporopriate- foreign body
methods to open + maintain an airway
Head tilt + chin lift
Jaw thrust
Airway adjuncts
Suction i.e. vomit in mouth
types of airway adjunct
oropharyngeal airway (guedel)
nasopharyngeal
supraglottic (Igel)
laryngeal mask airway
how to assess breathing
Rate, rythmn, depth, acessory muscle use
Inspection - Neck + chest
Palpation - trachea + chest expansion
Percussion
Auscultation
Saturations
signs of increased work of breathing
increased resp rate
accessory muscle use
grunting
subcostal recession
nasal flare
how is oxygen given in an emergency situation
15L via non-rebreather mask
how to assess circulation
Pulse - rate, rythmn, character
BP
Capillary refil time
Listen to heart
Feel patient - cold/clammy
Peripheries - perfusion / oedema
what procedures should be performed when assessing circulation
IV access - grey wide bore gannulas
Emergency bloods e.g. FBC, U+Es, coag screen, LFTs, CRP
Fluid administration
ECG
What fluid should be given if patient is hypotensive?
500mL Hartmanns / 0.9% Sodium chloride over 15 mins
(250ml if any evidence of HF)
how to assess disability
AVPU
Pupils - equal / reactive
Blood sugar
GCS
how to assess exposure
temperature
expose patient - looking for rashes/ trauma / clinical signs
output of drains, stomas, catheters
What should you do if a patient is unresponsive + not breathing normally
call for help / resuscitation team
CPR 30:2
Attach defibrillator
what are the shockable rythmns
Ventricullar fibrillation
Pulseless VT
what rhythms are non-shockable
asystole
Pulseless electrical activity
what drugs should be given in cardiac arrest?
Adrenaline 1mg IV every 3-5 mins
Amiodarone 300mg IV after 3 shocks
What are the reversible causes of cardiac arrest?
Hypoxia
Hypovolaemia
Hypo/hyperkalaemia
Hypothermia
Thrombosis
Tension Pneumothorax
Tamponade - cardiac
Toxins
treatment of hyperkalaemia
10mls 10% calcium gluconate
(+ glucose + insulin)
signs of cardiac tamponade
Becks triad: low BP, increased JVP, muffled heart sounds
pulsus paradoxus (pulse fades on inspiration)
Kussmauls sign: increased JVP on inspiration
how is cardiac tamponade diagnosed?
Echo
treatment of cardiac tamponade
pericardiocentesis under echo guidance
pathophysiology of a tension pneumothorax
trauma to chest wall creates a one way valve that lets air into, but not out of, the plural space – air is drawn into lungs + trapped in plural space during expiration
increasing pressure within thorax with each breath
signs of tension pneumothorax
tracheal deviation away from affected side
reduced air entry on affected side
resonant percussion on affected side
tachycardia
hypotension
management of tension pneumothorax
large bore cannula into 2nd intercostal space midclavicular line to relieve pressure, then chest train as definitive management
what are the componenets of GCS
eye opening
best verbal response
best motor response
what is the GCS scored out of?
15
how is eye opening scored on GCS
4 = spontaneous
3 = to voice
2 = to pain
1 = none
how is best verbal response scored on GCS?
5 = Orientated
4 = Confused
3 = Inappropriate words
2 = Sounds
1 = None
how is best motor response scored on GCS
6 = Obeys commands
5 = Localises to pain
4 = Normal Flexion
3 = Abnormal flexion
2 = Extension
1 = None
what physiological changes might a pregnant person display
resp: increased minute ventilation (increased resp rate + tidal volume), resp alkalsos, increased oxygen consumption
Cardio: increased cardiac output, decreased BP
Renal: decreased urea + creatinine due to increased GFR
Haemoglobin: anaemia
