Undifferentiated Patients Flashcards
approach to undifferentiated ed patient
- initial actions and primary survey
- initial differentials
- secondary survey
- refinement of differential diagnoses
- essential ed diagnostic evaluation
- patient reevaluation
- treatment and disposition
assessment of abcde
airway breathing circulation disability exposure
steps in airway assessment
- can the patient talk normally?
- yes = proceed to abcde
- no = can the patient talk at all?
- yes but not normally: look for fluid, foreign body, swelling, or altered mental status; swallowing
- no: check chest movement and air movement @ nose and mouth
if a patient is unconscious without normal breathing you ___
open the airway using head tilt or chin lift maneuver
if cervical spine trauma is suspected __
maintain cervical spine immobilization and use jaw-thrust maneuver for trauma patients
life threatening breathing conditions (breathing)
- tension pneumothorax
- asthma
- copd and acute exacerbation
- pleural effusions
- hemothorax
- suspected opiate overdose
breathing assessment
read
breathing management
unconscious with abnormal breathing = bag-valve-mask ventilation + oxygen support
conscious but inadequate breathing = o2 support
hypoxia and tachypnea = o2 support or o2 therapy
large pleural effusion and pneumothorax = o2 support and chest tube thoracostomy
emergent interventions for breathing management
- saba (salbutamol) for wheezing
- epi for anaphylaxis
- needle decompression for tension pneumothorax
- immediate transfer for chest tube thoracostomy
life threatening conditions (circulation)
- external bleeding from trauma
- pericardial tamponade
- dehydration
circulation assessment
- pulse
- bp
- capillary refill time
- skin changes
circulation management
- no pulse and cardiac arrest: cpr
- weak pulse, hypotension, poor perfusion = iv crystalloids or fluids
- direct pressure on external bleeding
- pelvic biner or splint
avpu scale
alert
verbal response
pain
unresponsive
disability assessment
- level of consciousness
- blood sugar level/ capillary blood glucose
- pupillary size and reactivity
- movements and sensation in limbs
- seizures or convulsions
life threatening conditions (disability)
hypoglycemia, increased icp, seizures
