Approach to critically ill patient

Question 1

You are called to the scene of a car accident. Upon arrival, you find an unconscious person inside the vehicle. Explain your approach to assessing this critically injured patient.

Answer 1

In this situation, I would follow a structured approach to assess the critically injured patient. First, I would ensure my safety by checking for any hazards around the scene, including the risk of fire or other dangers. Then, I would approach the patient and try to assess their responsiveness using the AVPU scale (Alert, Voice, Pain, Unresponsive). If they are unresponsive, I would call for help and initiate CPR if there are no signs of life, starting with chest compressions. While assessing their airway, I would also consider the possibility of a cervical spine injury and use appropriate techniques like a jaw thrust. If there are any signs of life, I would proceed with a primary assessment, checking the airway, breathing, and circulation, and addressing any issues as needed.

Question 2

You are in a hospital setting, and a patient is brought in with a severe allergic reaction (anaphylaxis). Describe how you would apply the critically ill assessment algorithm to this patient.

Answer 2

When dealing with a patient experiencing anaphylaxis, I would apply the critically ill assessment algorithm as follows:

Hazards: Ensure my safety and don personal protective equipment if necessary.
Hello: Assess the patient’s responsiveness using the AVPU scale.
Help: Activate medical staff for assistance.
If the patient is unresponsive with no signs of life:

Call for help and locate the resuscitation trolley.
Check for a pulse and start chest compressions (30 compressions).
Open the airway and provide 2 breaths.
If a defibrillator arrives, check and act accordingly.
If the patient has signs of life:

Proceed with the primary assessment.
Assess and manage the airway, breathing, and circulation.
Administer adrenaline if there is airway swelling.