Acute Care & Anaesthetics

Question 1

Briefly describe the contents of the DRS ABCDE assessment.

Answer 1

• Danger: assess the scene using a tool such as SCENE or METHANE
• Response: does the person respond to voice?
• Shout: get help
• C: catastrophic haemorrhage - pressure on the upstream artery, tourniquet and apply pressure
• Airway: assess if the airway is patent; perform airway manoeuvres and/or suction/clear the airway
• Breathing; RIPPAS (RR, inspection, palpation, percussion, auscultation, saturations); oxygen non-rebreather mask 15L
• Circulation: HR and radial pulse, BP, temperature, and CRT. IV access for bloods +/- fluids
• Disability: pupils (PERRL) + GCS, DEFG, and on the floor and four more
• Exposure: skin (rash?), calf (DVT?)

Question 2

Describe the SCENE framework.

Answer 2

• safety: assess for dangers now and use appropriate PPE
• cause: what happened?
• environment: are there any environmental factors that need to be managed by you or others? Consider weather, nightfall, access/egress
• number of patients
• extra resources: mobilise extra resources (eg more ambulances, helicopter, trauma team) ASAP

Question 3

Describe the METHANE framework.

Answer 3

• major incident: has a major incident been declared?
• exact location (eg What3Words)
• type of incident (eg RTC, fire, chemical spill)
• hazards: likelihood of hazards and their impact
• access (and egress), including rendezvous point(s)
• number of casualties
• emergency services: how many already on scene, and how many more required?

Question 4

Name signs of airway obstruction.

Answer 4

• inspiratory stridor, expiratory wheeze
• gurgling, snoring, crowing
• see-saw breathing: paradoxical movements of the chest and abdominal breathing
• no sound from the mouth/upper airway
• use of accessory muscles