ABCDE protocol and handovers Flashcards
Airways - what do you check for?
airway obstruction - paradoxical chest movements during respiration, central cyanosis, lack of breath sounds
how do you clear the airway
remove anything in the mouth, head tilt and chin up, jaw thrust, opening manouvres
what do you check for in breathing
RR, chest expansion, raised JVP, SpO2, palpate, percuss, auscultate, deal with life-threatening conditions
what do you check for in circulation?
- primary cause of shock = normally hypovalaemia
- count HR
- measure BP, palpate peripheral and central pulses
- auscultate heart
- external and concealed haemorrhage
how do you treat a CV collapse
fluid replacement, haemorrhage control, and restoration of tissue perfusion
large cannulae - high flow rate
bolus of 500ml of warmed crystalloid solution (hartmann’s solution, 0.9% NaCl) over <15 min if patient is hypotensive
re-assess HR and BP every 5
repeat fluid and seek expert help
what do you do if signs of cardiac failure occur after shock
decrease fluid infusion rate or stop altogether
inotropes or vasopressors
what do you do when assessing disability
exclude or treat hypoxia and hypotension
AVPU or GCS score
pupil size and reactivity
blood glucose or ABG if peri-arrested
IN LATERAL POSITION IF AIRWAY IS NOT PROTECTED
what are the local protocols for management of hypoglycaemia
start 10% glc IV at 200ml/hour if conscious
if unconscious - 200ml/15 min
what does E mean
exposure
respect dignity and minimise heat loss however to examine patient properly, full exposure of body may be necessary
what is the acronym for handovers
SBAR
Situation - your name, ward, patient DOB, reason, main concern
background - normal meds, pMH, etc
assessment - examination findings, treatment, doses and timings
recommendation - differentials, investigations, treatments, explain what you need !!
