System of Five Flashcards
What is system of five?
An approach to make sure you do not miss out of any vital investigations or management steps.
It is done in any acute surgical admission and can be applied regardless of their diagnosis.
Initial assessment in System of Five
10 second assessment of their clinical state at bedside.
If critically unwell, start initial steps to stabilise and call for help early.
System of Five can be divided up into investigations and management.
What investigations should be done?
Bedside observations should always be done and redone during any examination
Microbiology if indicated. (All acute admissions should be screened for MRSA)
Blood tests - FBC, U&Es, LFTs, Amylase and Clotting profile. G&S if there is a significant operation.
Imaging - like ECG or CXR can be used to assess the baseline health of the patient pre-op.
Specialist tests - Depending on underlying pathology.
System of Five management
VTE prophylaxis in form of LMWH should be prescribed as per local trust guidelines + TED stockings as long as no hx of arterial disease
Start a drug chart and consider analgesia, anti-emetics, abx, any normal reg. medicaitons
IV access and consider inputs and outputs such as IV cannula 16G or larger + start a fluid balance charts.
Oxygen - Sat should be 94-98% in most patients or 88-92% in known CO2 retainers
Senior referral and Involvement of the MDT if indicated
Inputs and outputs to consider
Does patient require NBM?
Do fluids need to be prescribd?
NG tube to decompress stomach?
Urinary cath?
