Recognising Sick Patients Flashcards
Definition?
A person who is systemically unwell and unable to perform their duties.
What 3 things are involved in management?
Assess, intervene and reassess
How do we assess a sick pt?
ABCDE
Clinical presentation of A?
Ability to speak Difficulty with breathing Noisy/silent breathing stridor, wheezing, gurgling, snoring, distress ‘See-saw’ breathing pattern
Management of A?
Airway opening Head tilt-chin lift Removing foreign object Suctioning Simple adjuncts OP, NP airways Advanced airway LMA, Intubation
Clinical Presentation of B?
Respiratory rate Low-neuro/drugs HIGH-Sick pt Work of breathing accessory muscles, distress Lung sounds- rales, creps, wheezing Oxygenation cyanosis
Management of B?
Oxygen Treating the cause: e.g. draining a PTX Assisting ventilation CPAP, NIV (type 2 resp failure) Nebs
Clinical Presentation of C?
Pulse: Heart rate, volume, Blood Pressure
Signs of heart failure: neck veins, oedema, creps
Perfusion-LOC, diuresis, CRT Bleeding, fluid loss
ECG: rhythm analysis
aBG/vBG - lactate
the peripheral window-pale, cold clammy skin
the renal window-decreased urine output: 0.5 mL/kg/h
the neurologic window-altered mental characterized by obtundation, disorientation and confusion
Management of C?
IV line, blood tests Fluid Monitor Electric cardioversion Bleeding control Vasopressors
Clinical Presentation of D?
AVPU (Alert voice pain unresponsive) or GCS
Pupils
Blood Sugar (BM)-4.4 to 6.1 mmol/L
Fast neurologic assessment
Management of D?
IV glucose
BM < 3mmol/l
IV thiamine
Clinical Presentation of E?
Remove clothes to enable thorough examination (maintain dignity)
Detailed history
Medications
Allergies
Management of E?
Take temperature
Avoid heat loss
Pathophysiology?
Increased glycolysis leads to increased lactate, CO2 and H+
Increased resp rate, BP ,HR and UO
Investigations?
History Background (comorbid state, how much is new)-EWS-escalate if not Obs chart - trends Drug Chart ABG pH pCO2 pO2 BE HCO3 Lactate Imaging
