ABCDE assessment

Question 1

Premise to ABCDE assessment

Answer 1

Ideally I would like to gather help from my team and/or call for senior support at the earliest time possible to ensure patient safety; as the patient may deteriorate quickly

Question 2

Airway assessment

Answer 2

o Check for air movement (ear to mouth or fogging on instrument)
o Listen for added noises (Stridor, snoring/gargling)
o Clear C-Spine (Trauma) or collar if not possible to clear until CT (NEXUS criteria)

Question 3

Airway: When can C-spine not be cleared

Answer 3

CS pain, intoxicated, distracting injury, ,low GCS = can not clear

Question 4

Airway: actions to take if obstructed airway / low GCS

Answer 4

• Chin lift (if clear C-S) / Jaw thrust
• NPA (!BSF C/I) / OPA / think does the pt need ETT
• If ?anaphylaxis, ADRENALINE 0.5mL 1:1000 NOW
• If foreign body in airway, one single clean gloved finger sweep
• If secretions ++ , suction

Question 5

Breathing assessment

Answer 5

o Obs: SpO2%, RR
o Ex: Look, listen, feel approach
o Consider: ABG or portable CXR if respiratory issue
o Put patient on O2 if low %Spo2

Question 6

Circulation assessment

Answer 6

o Control any haemorrage if possible, major haemor call >1500mL
o Obs: HR, BP, temp, CRT
o Exam: hydration status and urine output if possible, pulse, HS1+2
o Inv: ECG + keep on continuous cardiac monitor (if cardio)
o 2x large bore cannulae (or 1x) while obtaining a set of bloods

Question 7

Circulation actions to take

Answer 7

If low BP
o Consider haemodynamic support with IV fluid bolus (20ml/kg)
o Consider calling anaesthetics if likely to need ionotropic support

If arrhythmia - ACLS guidelines, assess for adverse features and manage as indicated

If ?sepsis - sepsis six (Fluids, Abx, O2, Cultures, Urine monitoring, Lactate)

Question 8

Diasbility assessment

Answer 8

o I would formally assess the AVPU
o If P/U, then I would thoroughly assess the GCS (V6M5E4)
o Assess pupil size and reactivity, and do spot CBG (Glucose)
o If neuro pathology, brief neurological exam

Question 9

Exposure assessment

Answer 9

o Obtain urine for dipstick, check for tenderness/fractures/rashes/bleeding everywhere (maintaining dignity)
o Assessment of Mental Capacity / AMTS if elderly or Psych Hx
o If appropriate evaluate escalation status (ITU/Ward/DNAR)

REASSESS

Question 10

Post ABCDE

Answer 10

1. Reassess ABCDE
2. SAMPLE ->

Signs + symptoms
Allergies
Medications
PMHx
Last meal in case intubation required
Everything else relevant to issue