Assessment

Question 1

Why is assessment important?

Answer 1

MH issues at increased risk of range of physical health problems including….

issues relating to poverty and social inequality…

genetic/social/physical -> baby health

Early identification of clinical deterioration is important in preventing subsequent cardiopulmonary arrest and to reduce mortailty

Question 2

Medical Model

Answer 2

We are the sum of parts - anatomical parts, physiological systems and biochemical systems

Comprehensive assessment breaks down these three components thereby gathering extensive infoto guide goal related therapy

Critique - the soul

Question 3

Normal Baseline observations

Answer 3

Respiratory rate, depth and pattern - 12-20 breaths per minute, normal depth, regular

Blood Pressure
- systolic 111-129

Pulse - 51-90
Consciousness - alert

O2 Sat

NEWS charts - standardising assessments, systems based approach

Question 4

Assessment framework, alternative to ABCDE

Answer 4

Inspection - using senses e.g. vision, listening

Palpation - touch and feel with the hands - temperature, texture, moisture, motion e.g. pulse

Percussion - using sound, short sharp strokes, usually by doctor

Auscultation - Listen to breathe, bowel etc.

Question 5

ABCDE

Answer 5

Assess for safety, early call for help, own safety e.g. PPE, inform mentor or line manager with any concerns

Elicit response - pain?

LOOOK LISTEN AND FEEEEEL

Airway -
chest and abdo movements, foreign bodies in mouth or airways, swelling, vomit, cyanosis (blue-purple or grey), sputum green or yellow, listen for breathing, feel airflow

speaking ? = normal or ‘patent’

Breathing -
respiratory rate, depth, pattern, use of accessory muscles, colour, cyanosis, evidence of hypoxia, ability to hold convo, tracheal position
Ability to cough, amount, colour and consistency of sputum, chest movements?

Circulation: (start at finger tips)
capillary refill time, (within 2 secs), temperature of skin, take the pulse, take the blood pressure, cyanosis (central or peripheral)

consider urine output - as associated with blood pressure (as BP falls, perfusion to kidney falls, urine output falls)

Ciculation - nausea or vomiting

Disability

Assess using the Glasgow Coma Scale
ACVPU - resuscitation council - alert, newly confused, responds to voice, responds to pain, unresponsive
Blood glucose - hyper or hypo

Exposure - rashes, fractures and bleeding, respect dignity and minimise heat loss

Question 6

Conditions which can be assessed by ABCDE?

Answer 6

asthma, anaphalyaxis,

but, however - offer discussion / critical analysis

Question 7

Collapse, whos guidance would you follow?

Answer 7

Resuscitation council

Question 8

Normal values

Respiratory rate

Pulse

o2 saturation

Capillary Refill

Urine output

Answer 8

12-20 25, sepsis campaign worried about 22 p/min or above
51-90 pulse

Urine output - 0.5ml per kg per hour