Appraoach To Acutely Unwell Flashcards
What does ABCDE stand for?
Airway, breathing, circulation, disability & exposure
What are 3 signs of airway issues?
See-saw breathing (abdominal breathing)
Using accessory muscles
Central cyanosis
What are signs of Breathing problems? (6)
- sweating
- redness
- chest expansion shortens
- cyanosis
- accessory muscle use
- record spO2/auscultation/percussion/tracheal positioning
What signs are for circulatory concern?
- Colour of skin (redness)
- temperature
- swelling?
- veins?
- pulse, cap. Refill, auscultation, BP
- look for blood loss
What signs suggest disability problems?
- skewed ABG
- check for drug toxicity
- BGM
- AVPU/GCS
What signs suggest exposure issue?
Rashes
External wound
Abdo exam?
Treatment for airway problem?
- Simple airway manoeuvres
- Airway suction
- Insert adjunct (oropharyngeal/nasopharyngeal)
- Tracheal intubation
- Oxygen/ tracheostomy
Treatment for breathing problems?
Oxygen if below 94%
Oxygen for COPD aim for 88-92%
What mask would you use for normal patient to get sats above 94%?
Usually 15L non-rebreathe
What mask would you use for COPD patient to get sats between 88-92%?
Venturi mask 28% for 4L or Venture 24% 4L.
What treatment would you do for cardiovascular problems? (6/7 steps)
Insert 1 or more cannula (usually 20g pink or 14/16 orange/grey for more or bigger bolus)
- take blood from cannula
FLUID 500ml Hartmanns OR 0.9% sodium chloride over 15 mins, 250 for those with pre-existing heart problems
Reasses HR and BP every 5 mins.
Repeat fluid challenge if not improved.
ECG recorded
(Aspirin 300mg asap for suspected ACS)
What tx would you give for low glucose?
50ml of 10% glucose/dextrose if below 4mmol
what would you give for drug toxicity?
Naloxone
What is the goal CRT?
<2secs
What can a bounding pulse indicate?
Sepsis