2. ABDCE Approach Flashcards
What does ABCDE stand for
Airway Breathing Circulation Disability Exposure and everything else
Before you start the ABCDE what kind of things are you thinking
- What are your initial impressions of the patient
- Can you take a quick focuses history
- Ask for a set of vital signs and monitoring if available
When assessing the airway what kind of things are you asking yourself?
- is the patient talking?
- is the patient responsive?
- are there an added sounds to breathing? (snoring, gurgling, stridor)
when assessing the airway what thing would make you move on to breathing?
if the patient is talking
What potential interventions could you give if you suspect there is an issue with the airway in an ABCDE approach?
- open airway (if they are only responding to pain or unresponsive)
- Suction (gurgling)
- Nebulised adrenaline (for stridor)
- simple airway adjunct- oral nasal (if having to do airway manoeuvres)
Under what circumstances would you open a patients airway in an ABDCE approach?
if the are only responding to pain or if they are unresponsive
When assessing breathing in an ABDCE approach, what are you specifically looking at (think PIPPA)
Inspection • Respiratory rate? • Respiratory effort? • O2 saturations? Palpation • Trachea central? • Expansion equal? Percussion • Areas of dullness or hyper-resonance? Auscultation • Breath sounds? • Added sounds? • Inequality to the sides?
What investigations would you want to consider in regards to breathing in an ABCDE approach?
ABG
CXR
What potential interventions could you do for breathing in an ABCDE approach?
- Sitting them up if they are struggling to breath
- Oxygen if SpO2 less than their expected normal
- Ventilation if they are drowsy, resp rate <8, open airway
when assessing circulation in an ABCDE approach, what are you specifically looking for?
- what is the heart rate, rhythm and character of the pulse
- are the peripheries warm and what is cap refill
- what is the blood pressure
- is there any signs of haemorrhage
- what is the temperature
- Are there any heart sounds or murmurs
- what does the ECG show
what would you do if you suspect something is wrong with circulation in an ABCDE approach?
- Obtain IV access
- Get bloods (VBG, FBC, U&Es, X-match, LFTs clotting)
- fluid challenge - 250ml 0.9% NaCl stat (tachycardia, cap refill time > 2 secs +/- hypotension)
When assessing disability as part of an ABCDE approach, what are you looking for?
- Assess responsiveness (AVPU) ie are they alert +/- confusion
is there any reduction in alertness or new onset confusion (ie check blood glucose, check pulls and posturing and check drug chart)
What potential interventions would you consider when assessing disability as part of an ABDCE approach?
optimise airway, breathing and circulation to ensure the brain is well oxygenated
give glucose if they are hypoglycaemic
Acute brain injury (unequal, unresponsive pupils, abnormal posturing) - CT scan and expert help
Drugs/medication overdose (recreational or iatrogenic) - support ABCDE, reversal agent where possible
What do you want to do in the exposure and everything else section as part of ABCDE approach?
- examine the patient more closely if appropriate (rashes, swelling and bleeds)
- take a more detailed history if possible
- review notes, blood results, ECGs, X rays
If there is a global wheeze then what could the potential diagnosis be and therefore what would be the most appropriate treatment
Asthma
- Peak flow to asses severity
- nebulised salbutamol
- Nebulised ipratropium
- oral or IV cortiocosteriods
