ABCDE assessment

Question 1

Airway

Answer 1

ASSESS
Can the patient talk?
Yes - airway patent
No - added sounds (choking, snoring, gurgling, stridor), visible obstruction

TREAT
Airway manoeuvres, adjuncts

Question 2

Breathing

Answer 2

ASSESS
1. Inspection
2. RR
3. SpO2
4. Tracheal position
5. Chest expansion
6. Percussion
7. Auscultation

TREAT
O2, ABG, CXR

Question 3

Circulation

Answer 3

ASSESS
1. Pulse (rate, strength, regularity)
2. BP
3. Limb temperature
4. CRT
5. JVP
6. Cardiac auscultation
7. Fluid balance

TREAT
IV access, bloods, fluid bolus, ECG, catheterisation

Question 4

Disability

Answer 4

ASSESS
1. Consciousness (ACVPU or GCS)
2. Pupils
3. Blood glucose
4. Pain assessment
5. Review drug chart

Question 5

Exposure

Answer 5

ASSESS
1. Temperature
2. Inspect skin, wounds
3. Examine abdomen, calves
4. ? Peripheral oedema
5. Devices: IV lines, catheter/drain output

Question 6

Primary A-E assessments

Answer 6

this should be performed in a quick efficient way
treat problems as you find them
if ACVPU level has deteriorated since the start of the assessment, repeat ABCD again before moving onto E

Question 7

Secondary A-E assessments

Answer 7

these build on the findings of the primary assessment where patient-specific investigations and treatments are instigated (e.g. peak flow if asthma suspected; catheterisation if required; X-rays/ultrasound/CT scans)
these can be delegated in the primary assessment but should not delay the efficiency of the assessment

Question 8

What are 5 signs of a critically ill patient?

Answer 8

needs O2 to keep SpO2 ≥92% (88% in COPD)
systolic BP ≤90 mmHg (or drop of >40 from normal)
lactate ≥2 mmol/L
depressed consciousness
rapid deterioration of unknown cause