ABCDE assessment/treatment

Question 1

What does ABCDE stand for?

Answer 1

Airway/c-spine
Breathing
Circulation
Disability
Exposure

Question 2

Outline airway/c-spine

Answer 2

1. Assess for signs of airway obstruction
   - reduced/absent air entry
   - noisy/absent breath sounds
   - paradoxical chest/abdominal movements
   - recruitment of accessory muscles

1A. Treat airway obstruction
- airway opening manoeuvres
  > Head tilt/chin lift
  > Jaw thrust (in cases of suspected/confirmed c-spine injury)
- patient positioning (recovery) and suctioning
- adjuncts
  > NPA/OPA
  > LMA
  > ETT

2. Assess for signs of c-spine injury
   - obvious deformity/injury
   - complaints of c-spine pain
   - trauma presentation

2A. Address c-spine injury
- activate c-spine precautions

Question 3

Outline breathing

Answer 3

1. Assess breathing
   - RR
   - Auscultate
   - Trachea position/tug
   - Effort of breathing
   - SpO2
2. Treat
   - If RR < 12: apply BVM
   - If Spo2 <95%:
   > Apply O2 as needed to target:
   • Spo2 88-92% for patients with COPD/type 2 respiratory failure
   • Spo2 >/= 95% for all other patients

Question 4

Outline circulation

Answer 4

1. Assess circulation
   - HR + pulse (do these match?)
   - BP
   - Perfusion (central/peripheral perfusion + CCRT)
   - Other signs of decreased CO: U/O + LOC
2. Treat
   - PIVCs (14/16G x 2)
   - Bloods
   - Attach monitoring
   - 12-lead ECG

• IV fluids if hypotensive
• Immediate treatment for ACS if suspected:
  > Aspirin 300mg PO
  > GTN spray
  > Morphine/fentanyl IV
• Organise appropriate imaging:
  > XR / CT / USS / Echo / Angio

Question 5

Outline disability

Answer 5

1. Assess disability
   - AVPU
   - Pupils
   - BSL
   - Drug chart + allergies
2. Treat
   - If BSL < 4.0: 25-50mL dextrose 50% IV push
   - If drug overdose: administer antagonist

Question 6

Outline exposure

Answer 6

1. Assess head to toe considering dignity and heat loss. Measure temperature
2. Treat
   - Wound care
   - If temperature <35.5: bair-hugger
   - If temperature >40: paracetamol 1g IV/PO, targeted cooling