ABCDE Approach in Clinical Assessment

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Questions and Answers

Which technique is appropriate for relieving a complete airway obstruction in an unconscious patient?

Jaw thrust maneuver (correct)

Head tilt, chin lift

Deliver back blows

Use of oropharyngeal airway

Which of the following is a sign of partial airway obstruction?

Cyanosis of the lips

Stridor (correct)

Silent breathing

Paradoxical breathing

What is the primary assessment to check the status of an airway?

Level of consciousness

Heart rate

Cough effectiveness

Pattern of breathing (correct)

Which condition commonly causes airway obstruction in an unconscious patient?

Vomit blocking the airway Signup and view all the answers

Which method is NOT recommended for airway management if there is a risk of cervical injury?

Head tilt, chin lift Signup and view all the answers

What is the immediate action to take when a patient is choking and can still cough effectively?

Encourage coughing Signup and view all the answers

What is the primary purpose of using airway adjuncts in emergency situations?

To prevent further obstruction Signup and view all the answers

Which accessory muscle involvement would indicate difficulty in breathing?

Sternocleidomastoid Signup and view all the answers

What is characterized by profound hypoxemia due to inadequate alveolar ventilation?

V/Q mismatch or shunt Signup and view all the answers

Which ECG lead configuration is considered the gold standard for accurate results?

12 lead Signup and view all the answers

What does the PR interval in an ECG represent?

Speed of electrical impulse through AV node Signup and view all the answers

What is the recommended compression-to-breath ratio during CPR?

30 compressions to 2 breaths Signup and view all the answers

Which of the following is NOT one of the '4 Hs' that can cause cardiac arrest?

Hydration Signup and view all the answers

Which emergency condition is indicated by air in the pulmonary space?

Tension pneumothorax Signup and view all the answers

What is the normal potassium level range in millimoles per liter (mmols)?

3.5-5.5 mmols Signup and view all the answers

What is the first step in the bystander CPR process after assessing the environment?

Check for response Signup and view all the answers

What is crucial for managing a tracheostomy patient to ensure airway patency?

Ensure emergency protocols are established Signup and view all the answers

What characteristic defines a fenestrated tracheostomy tube?

Has holes allowing air to pass through the vocal cords Signup and view all the answers

Which of the following is NOT a symptom of anaphylaxis?

Insomnia Signup and view all the answers

What is the minimum frequency for changing and cleaning the inner cannula of a tracheostomy tube?

Every 4 hours Signup and view all the answers

In case of anaphylaxis, what is the recommended medication to administer first?

Adrenaline (1:1000) Signup and view all the answers

What is the primary purpose of a nasopharyngeal airway?

It can be used without inducing gag reflex in conscious patients. Signup and view all the answers

What is an indicator of respiratory distress that involves abnormal muscle use?

Use of accessory muscles Signup and view all the answers

Why should the nasopharyngeal airway be inspected for nasal polyps before insertion?

To prevent potential obstructions and complications. Signup and view all the answers

What is a key feature of the laryngeal mask airway?

It is a supraglottic airway device. Signup and view all the answers

How often should a tracheostomy tube be changed to ensure proper care?

At least every 30 days Signup and view all the answers

For a stable patient, what is the normal range for respiratory rate?

12-20 bpm Signup and view all the answers

Which airway management technique is considered the gold standard for securing the airway?

Endotracheal tube intubation. Signup and view all the answers

What is the advantage of using a cuffed tracheostomy tube?

It creates a seal in the trachea to protect the lungs. Signup and view all the answers

In what situation is nasal intubation preferred over oral intubation?

For prolonged intubation. Signup and view all the answers

What should be done if resistance is felt while inserting a nasopharyngeal airway?

Stop and try the other nostril. Signup and view all the answers

What is the main purpose of a tracheostomy?

To create an artificial opening for airway maintenance. Signup and view all the answers

What is a common medication used for rate control in treating arrhythmias?

Digoxin Signup and view all the answers

What is a significant potential outcome of Acute Kidney Injury (AKI)?

Elevated urea leading to seizure Signup and view all the answers

Which symptom is indicative of appendicitis?

Constant sharp pain that migrates to the right iliac fossa Signup and view all the answers

What does the ABCDE assessment prioritize?

Establishing airway, breathing, and circulation Signup and view all the answers

Which condition is most likely to cause oliguria?

Acute Kidney Injury Signup and view all the answers

What is a common treatment for managing hyperkalemia in patients with AKI?

Insulin and glucose Signup and view all the answers

What is the Glasgow Coma Scale (GCS) score indicating a comatose state?

3-8 Signup and view all the answers

Which symptom is typically associated with cholecystitis?

Right upper quadrant pain radiating to the back Signup and view all the answers

What type of medication is used to control the rhythm in a patient with arrhythmias?

Amiodarone Signup and view all the answers

What complication can arise from renal colic?

Severe flank pain Signup and view all the answers

What method is generally used to assess a patient's level of consciousness?

Glasgow Coma Scale (GCS) Signup and view all the answers

Which of the following is a classic sign of metabolic acidosis in renal dysfunction?

Peaked T waves on ECG Signup and view all the answers

What is not a typical risk factor for diverticulitis?

Younger age Signup and view all the answers

What is the normal serum range for urea?

2.5-6.6 mmol/L Signup and view all the answers

What is a key indicator of hypoxia that involves changes in skin color?

Cyanosis Signup and view all the answers

Which treatment is NOT associated with managing hypovolaemia?

Oxygen therapy Signup and view all the answers

What is the first step in treating hypothermia?

Check core temperature Signup and view all the answers

Which symptom is NOT typically associated with hypoxia?

Low blood pressure Signup and view all the answers

What is a significant cause of cardiac arrest in opioid overdose?

CNS depression Signup and view all the answers

Which electrolyte disturbance would most likely be indicated by tall T waves on an ECG?

Hyperkalaemia Signup and view all the answers

What is an effective method for shifting potassium into cells during hyperkalaemia?

Insulin and glucose IV infusion Signup and view all the answers

Which of the following is NOT a symptom of hypovolaemia?

Nausea Signup and view all the answers

What immediate intervention follows assessing a person's core temperature in cases of hypothermia?

Remove wet clothes Signup and view all the answers

In hypoxia, what is the recommended target SpO2 level to be aware of during monitoring?

92-96% Signup and view all the answers

Which ECG finding is NOT typically associated with hypokalaemia?

Peaked T waves Signup and view all the answers

What indicates a loss of more than 20% of blood volume?

Hypotension Signup and view all the answers

What laboratory test is used to assess electrolyte imbalances prominently?

U and E blood test Signup and view all the answers

During oxygen therapy for hypoxia, what type of mask provides the highest concentration of oxygen?

Non-rebreather mask Signup and view all the answers

Study Notes

ABCDE Approach

A systematic assessment and treatment for acutely unwell/deteriorating patients
Progress through each stage, ensuring safety at each step
Uses ISBAR handover tool (Identity, Situation, Background, Assessment, Recommendation)
NEWS2 tool for assessment (Respiratory Rate, Heart Rate, Blood Pressure, O2 saturations, Temperature, ACVPU, On oxygen?)
The tool should be used with clinical judgment

Physiological Parameter Scoring

Respiration rate: Values ranging from ≤8 to ≥25 breaths per minute, each with a corresponding score
SpO2 Scale 1 & 2 (%): Values with associated oxygen requirements and scores; values range from less than 91 to ≥97
Systolic blood pressure (mmHg): Values ranging from ≤90 to ≥220, with scores assigned
Pulse (per minute): Values from ≤40 to ≥131, each with an assigned score
Consciousness: From Alert to CVPU (Circulation, Ventilation, Perfusion, and Unresponsiveness), with increasing degrees of impairment
Temperature (°C): Ranges from ≤35.0 to ≥39.1, with corresponding scores.

Airway Assessment

Airway obstruction is a medical emergency
Assess for airway obstruction by observing breathing patterns, speaking ability, accessory muscle use, and skin color changes.
A clear airway is the first concern in acute situations
Airways are divided into upper and lower airways.

Causes of airway obstruction

External pressure: Swelling of soft tissues, neck tumors, enlarged thyroid, or physical pressure.
Internal blockage: Vomit, blood, secretions, inhaled foreign bodies, airway swelling, or tongue blockage in unconscious patients.
The airway is assessed by observing the patient's breathing patterns, ability to speak, and use of accessory muscles.

Management of Airway

Head tilt, chin lift (avoid if cervical injury suspected.)
Jaw thrust.
Airway adjuncts, oxygen.
Choking intervention (5 back blows, 5 abdominal thrusts for conscious, CPR for unconscious patient)
Gentle suction with wide-bore device.
Oropharyngeal Airway

Artificial Airways

Used for longer-term airway protection
Includes Laryngeal Mask Airway (LMA), supraglottic airway device above glottis; quick and easy intubation.
Endotracheal Tube (ETT) intubation is the gold standard; inflated cuff prevents aspiration, appropriate for unconscious or heavily sedated patients.
Tracheostomy creates a surgical opening into the trachea; used for long-term airway maintenance and protection.

Weaning from Ventilation

Various tracheostomy tubes are used, with specialized tubes for particular needs (cuffed for lung protection, uncuffed for improved airway, etc).
Necessary equipment should be available at bedside.
Inner cannulas need regular cleaning.
Cuff pressure should be less than 25cm H20 to prevent permanent damage to trachea.
Regular suction and site care are important. Tubes should be changed every 30 days at minimum.

Anaphylaxis

Food (peanuts, tree nuts, shellfish, cows milk), medications (antibiotics, contrast dyes), insect stings, or other triggers often cause anaphylaxis.
Life-threatening reaction often involving airway, breathing, or circulation
Typically shows typical skin symptoms and other associated symptoms
Immediate emergency treatment includes getting help, positioning, adrenaline, and fluids.

Relevant Vital Signs

Respiratory rate assessment for deterioration risk; normal range 12-20 breaths/min
SpO2 monitoring assessed based on a two scale method with target range

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Description

This quiz focuses on the ABCDE approach for assessing and treating acutely unwell or deteriorating patients. It covers the systematic steps ensuring safety, the ISBAR handover tool, and the NEWS2 assessment tool for monitoring physiological parameters. Test your knowledge on this critical method used in clinical settings.