Approach to a critically ill patient

Question 1

What do we need to check for in an airway

Answer 1

1. Is it open
2. Is it clear or obstructed
3. Can the patient maintain their own airway

Question 2

What are ABCDE of caring for a critically ill patient

Answer 2

A: Airway
B: Breathing
C: Circulation
D: Disability
E: Exposure

Question 3

What do we need to look at in breathing

Answer 3

1. Rate
2. Auscultation
3. Colour centrally
4. Effort (Increased effort or accessory muscle use)
5. SpO2

Question 4

What are the things that we need to look at in circulation

Answer 4

1. Rate
2. AVPU (Awake/Verbal/Pain/Unresponsive)
3. Colour peripherally
4. End organ perfusion
5. Systolic blood pressure

Question 5

What are the factors that should be looked at in disability

Answer 5

1. GCS
2. Haemo/glucose test
3. Temp
4. Pupillary response
5. Gross motor and sensory function

Question 6

When do you supplement vs ventilate

Answer 6

Patients the are breathing too slow, fast or shallow then ventilate

If a patient has an adequate breathing rate but is not saturating well then give supplemental O2

Question 7

What is the fluid volume boluses that should be given to a hypotensive patient and how do you make sure that you are not giving too much fluid

Answer 7

10-20 ml/kg, patient should be auscultated to make sure that they are not being overloaded

Question 8

What is the History that should be take in a patient that is critically ill

Answer 8

SAMPLE
S: Signs and symptoms
A: Allergies
M: Medications both chronic and acute
P: Past medical history
L: Last meal
E: Events that lead up to the incident