Clinc2: ABCDE assessment Flashcards
(40 cards)
How might you assess a patients airway?
Ability to speak
Listen for coughing, gasping, choking - indicate an obstruction
Look for obstructions, swelling, secretions, see-sawing and colour (Cyanosis)
Feel for airflow at the mouth and nose
What are some different added breathings sounds?
Wheeze
Crackles
Pleural Rub
Stridor
What causes snoring?
When the pharynx is partially occluded by the tongue or palate
What causes stridor breathing sounds?
High pitched sound, squawking and continuous.
Causes by an upper airway obstruction
Causes by anrrowing of trachea/larynx, typically caused by croup, foreign body obstruction and epiglottitis.
What is gurgling as an abnormal breathing sound?
Caused by liquid accumulation such as blood or vomit.
May also be described as course crackles
Typically in inspiration.
What causes choking as a breath sound?
Due to a foreign body obstruction in the upper airway
What are some abnormal breath sounds?
Diminished breath sounds
Bronchial breathing
How should you respond to a patient with a compromised airway?
Crash call immediatly, urgent anaesthetic input to secure airway
Encourage to cough
Recovery position/ change position so more upright
Airway maneouvres (chin lift, head tilt, jaw thrust)
Remove visible secretion
Consider suction for secretions
Airway adjuncts
What are some common causes of upper airway obstruction?
Anaphylaxis
Tumour
CNS depression
Foreign body inhalation
Secretions
Infection (epiglottitis or pharyngeal abscess)
Larynospasm
Trauma
Blocked tracheostomy
What is the escalation of airway maneouvres?
Heal tilt/chin lift
Jaw thrust is noisy breathing persists or cervical injury suspected
Consider an airway adjunct
Is semi-conscious use a nasopharyngeal airway
If seriously unwell and no longer has a gag reflex consider and orophayngeal ariway
How do you assess a patients breathing?
Oxygen saturation
Respiratory rate
Auscultate both the lungs
Check for even chest expansion
Percuss for resonance/dullness
Check for chest deformity and tracheal position
Look for respitaroty distress - sweating, central cyanosis and use of accessory muscles
What is tachypnoea?
Increased RR
Response to hypoxia or hypercapnia
What is bradypnoe?
Reduced RR
Due to impaired consciousness or drugs (such as opiods)
What different percusion noises does a chest percussion indicate
Hyperresonance - Suggests a pneumothorax
Dull - fluid/infection/blood
What does coarse crackles int he airway indicate?
Also called crepitations
Represents pus in the lung
What can fine crackles in the lung indicate?
Fluid in the lungs
E.f from heart failure
What does a pleural rub sound indicate on auscultation?
Creaking/snow crunchind sound
Heard at level of pleural effusion
What does a lung wheeze of auscultation indicate?
Polyphonic - bronchoconstriction
Monophonic - distal airway obstruction
What are some causes of respiratory failure?
Reduced consciousness (may be from CO2 narcosis)
Reduced respiratory effort (chest wall deformities, trauma, neuro-muscular disorders)
What are some common respiratory pathologies?
Infection - pneuomina, empyema
Pulmonary embolus
Pneumothorax/ haemothorax
Tumour
Broncho/laryngospasm
Pulmonary odema
What investigations may you perform if patient breathing is abnormal?
Arterial blood gases
Chest x-ray
What interventions are commonly used if breathing is abnormal?
Oxygen through a non rebreath mask. (Aim for lower saturation in COPD patients using a venturi mask)
If unconscious use assisted ventilation through a bag-valve-mask aim for 12-15 bpm.
How do you assess the circulation of a patient?
Look at the colour of hands and digits
Check for signs of bleeding
Listen - auscultate the heart
Feel - central and peripheral pulses - rate, rhythm, character and volume
Check blood pressure and capillary refill time
What investigations may request if patient circulation is abnormal?
Request an ECG to check the patient rhythm
Take a blood sample to investigat possible causes of acute compromise
