Deteriorating Patient Flashcards
What are consequences of partial airway obstruction?
- Cerebral oedema
- Pulmonary oedema
- Exhaustion
- Secondary apnoea
- Hypoxic brain injury
- Cardiac Arrest (eventually)
What are symptoms of hypoxaemia and hypercarbia?
- Irritability
- Confusion
- Lethargy
- Depressed conciousness
- Cyanosis (late sign)
How would you assess someones breathing as part of an ABCDE assessment?
SO RIPPA
- SpO2 and Oxygen requirment
- Respiratory Rate
- Inspection - End of bed, front and back of chest, including trachea etc.
- Palpation
- Percussion
- Ausculation
What might an increasing/high respiratory rate indicate?
Warning that patient may deteriorate suddenly
What do rattling airway sounds indicate?
Airway secretions
What does audible stridor indicate?
Partial, but significant, airway obstruction
What can hyperresonance on examination of the chest indicate?
Pneumothorax
What would dullness of percussion indicate on examination of the chest?
Consolidation/pleural fluid
What might bronchial breathing indicate on ausculatation of the chest?
Lung consolidation with patent airways
What might absent/reduced breath sounds indicate on ausculatation of the chest?
- Pneumothorax
- Pleural fluid
- Lung consolidation caused by complete obstruction
What might you feel the chest wall for?
Surgical emphysema/crepitus
What does a barely palpable central pulse indicate?
Poor cardiac output
What would you consider doing as part of your assessment for Circulation?
PACE WEB O
- Pulses (central/peripheral) - rate, rhythm, volume, character
- AVPU - Are the cerebrating??
- CRT/Color
- ECG
- Wide bore cannula + take bloods
- Examine - JVP + Precodium + sites of active bleeding
- Bloods/BP
- Output - urine
What airway problems would make you call the medical emergency team?
Airway threatened
What breathing problems would prompt you to put out a MET call?
- RR < 5 or >36
- All respiratory arrests
