RRAPID thorough Flashcards
what is RRAPID and what does it use?
it is recognition and response to acute patient illness and deterioration
uses ABCDE
what is A and the recognition?
airway - is the patient talking? - look, feel and listen - are there signs of obstruction - grunting/gurgling, paradoxical chest movements and abdo movements, foreign bodies - silent chest means complete obstruction
cyanosis / hypoxia is a late sign
what is the airway response?
call for help head lift, chin tilt, jaw thrust oro and nasopharyngeal airway suction secretions - Yankauer give oxygen call anaesthetist for definitive airway management
what is the recognition in B?
breathing - look feel listen - is the patient breathing? are there signs of respiratory distress such as sweating, use of accessory muscles and central cyanosis ? respiratory rate, rhythm and depth equal air entry added sounds percussion note central trachea
what is the B response?
sit the patient up and give O2 - 15L/min via a reservoir mask aiming for 94-98% or in COPD and risk of hypercapnia 88-92% sats. PEFR, arterial blood gas, chest Xray and If not breathing then ventilate w bag and mask
what is C recognition?
circulation - look and feel peripheries using JVP, BP, PR - rate an character, cap refill and auscultating heart sounds, look at signs of poor end organ perfusion with agitation and reduced consciousness and urine output of less than 0.5mls/kg/hr. Look for evidence of blood loss
what is C response?
treat the underlying problem and use 2 large bore cannula - 14G or 16G - blood tests using routine haematological, biochemical, coagulation and group and save, 12 lead ECG and fluid challenge and assess response
what is D recognition?
disability - patient response - AVPU (alert, verbal, pain, unresponsive), GCS - glasgow coma scale, pupil size and reaction to light, focused neurological exam, blood glucose, evidence of seizures, check for reversible drug causes such as opioid use
what is the D response?
use benzodiazapines for seizures
endotracheal tube for GCS <8
glucose if hypoglycaemic where glucose <4mmol/L
recovery position if airway not protected
protect airways
what is E recognition?
exposure - expose to see injury, bleeding or infection, check temperature, focused history and exam, chart review and drug chart and investigation results
what is the response for E?
senior medical advice, communication using SBARR, management plan, documentation and organise transfer to HDU or ICU
what is SBARR?
situation, background, assessment, recommendation, response
what is situation?
who where what when why
what is background?
name gender PMHx diagnosis progress interventions key investigation results DNAR status order
what is assessment?
the diagnosis, underlying cause and NEWS
