Objective assessment

Question 1

Aspects of assessment

Answer 1

Airway
Breathing
Circulation
Disability
Exposure

Question 2

Airway observation

Answer 2

Self-ventilating or requiring assistance of artificial airway?

Question 3

Checking artificial airways

Answer 3

Check inner lumen of tracheostomy tube to ensure it isn’t blocked by secretions
Suction endotracheal tube to check if catheter can pass through.

Question 4

Visual inspection of self-ventilating patients

Answer 4

Check swelling or abnormality of mouth, teeth, tongue or soft palate
Colour of oral mucosa, lips and facial skin
Blueness on tongue and mouth- central cyanosis, caused by hypoxia.

Question 5

What is cyanosis a sign of?

Answer 5

Airway obstruction

Question 6

Airway- feel

Answer 6

Observe chest rise and fall

Question 7

Airway- listen

Answer 7

Gurgling, wheezing, stridor, crowing, grunting, snoring

Question 8

Gurgling indicates…

Answer 8

Fluid in the upper airway

Question 9

Wheezing indicates…

Answer 9

Obstruction of lower airway

Question 10

Stridor indicates..

Answer 10

Obstruction of upper airways

Question 11

Crowing indicates…

Answer 11

Laryngeal spasm

Question 12

Grunting indicates..

Answer 12

Flail chest

Question 13

Snoring indicates…

Answer 13

Pharyngeal obstruction by tongue

Question 14

Breathing observation

Answer 14

Short of breath?
Distressed?
How do they speak?

Question 15

Chest shape

Answer 15

Kyphosis, scoliosis, kyphoscoliosis, pectus excavatum, pectus carinatum, hyperinflation

Question 16

Chest and abdominal movement

Answer 16

Asymmetry- one side reduced or excessive movement
Abdominal distension
Intercostal indrawing- skin between ribs drawn inwards
Supraclavicular indrawing- skin above clavicle drawn inwards during inspiration.
Flail chest- loose segment drawn inwards
Paradoxical breathing- entire chest wall moves inwards on inspiration and outwards on expiration
Hoover sign- paradoxical movement of lower chest wall