ABCDE Assessment

Question 0

What does A mean

Answer 0

Airway- airway and oxygenation
Causes maybe:
low Glasgow coma score(GCS), bodily fluids, foreign body, inflammation, infection, trauma etc
Assessment:
Talks freely, unresponsive, sounds gurgling, wheezing, stridor, accessory muscles, see- saw respiration pattern.
Basic interventions:
assess oral cavity, head tilt chin lift, suction,

Question 1

What is the ABCDE

Answer 1

An acute emergency assessment.

Question 2

What does B mean

Answer 2

Breathing- breathing/ventilation
Causes:
low GCS, muscle weakness, exhaustion, asthma, COPD, Sepsis, Cardiac event, pulmonary Odema, pulmonary emboli, ARDS, Pneumothorax, haemothorax,
Assessment:
Look- r.rate and rhythm, symmetry, pattern, effort, SpO2, colour-cyanosis
Listen- talking, sentences, phrases, chest sounds, wheezing, stridor, crackles.
Feel- chest expansion, percussion
Interventions:
AMBU bag if ventilation is <10 resp per min,
Position up right if struggling to breath, beta agonist

Question 3

What does C mean

Answer 3

Circulation throughout the body.
Assessment: (look, feel, measure/obs)
Pulse checked for rate, rhythm and volume, colour, cyanosis, capillary refill and temperature,skin clammy, BP, hypotension (late sign)
sBP< 100mmHg
sBP <20mmHg below pts norm
Low urine output, level of consciousness(LOC)
Interventions:
Raise legs, bloods, fluids, ECG monitoring,
Circulation Shock:
Loss of volume- hypovolaemia
Pump failure- myocardial causes
Vasodilation- sepsis, anaphylaxis, neurogenic

Question 4

What does D mean

Answer 4

Disability: neurological issues.
Causes-
Inadequate perfusion to brain, sedative side effects, low BM/GBM Glomerular Basement Membrane, toxins and poisons, high intracranial  pressure.
Assessment-
AVPU(or GCS)
Pupil size/response
Posture
BM
Pain relief- sedatives, analgesia etc
Interventions-
Optimise airway, breathing, and circulation
Treat underlying cause
Treat low BM
Control seizures

Question 5

What does E mean

Answer 5

Exposure- exposure and examination

Assessment-
Head to toe examination- rashes, swelling, sores, haemorrhage, bruising, catheter, syringe drivers etc
Temperature
Keep warm
Maintain dignity
Intervention-
P.P. history
Notes, charts, Meds prior to admission
Order investigations- ABG, FBC, XR, ECG, 
Mgmt and monitoring plan
Referral
Handover:
Situation
Background
Assessment
Recommendation

Question 6

In an emergency situation what would cause you to believe the patient has a spinal injury. (6)

Answer 6

1. If the head injury is a large blow to the back of the head and unconscious.
2. Complains of severe pain in their neck and back.
3. Won’t move their neck
4. Feels weak, numb or paralysed
5. Has lost control of their limbs, bladder or bowels
6. Has twisted neck or back

Question 7

How would you open a patients airway with a spinal injury and how and when would you use recovery position

Answer 7

Place both hands on either side of face and use fingers to gently lift jaw line. Taking care not to move neck!!!
Recovery position would only be used to avoid further damage i.e choking etc
This would require assistance as it would involve the patient being gently rolled over without neck being moved!!!