ABCDE Assessment and Airway Obstruction

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What does a low diastolic blood pressure suggest in the context of shock?

Arteriolar vasoconstriction

Arteriolar vasodilatation (correct)

Normal heart function

Increased blood volume

When managing a patient who is normotensive and in need of a fluid challenge, how much fluid should be administered?

250 cc over 5-10 min

750 cc over 5-10 min

500 cc over 5-10 min (correct)

1000 cc over 5-10 min

Which assessment method is NOT used to evaluate a patient's conscious level?

Pupil dilation measurement

AVPU method

Glasgow Coma Scale score

Palpation of pulse (correct)

In a patient with primary chest pain suspected to have acute coronary syndrome, which of the following should be given early for treatment?

Nitroglycerine Signup and view all the answers

What does a narrow pulse pressure indicate in a patient experiencing shock?

Arteriolar vasoconstriction Signup and view all the answers

Which of the following is NOT a common cause of unconsciousness?

Severe headache Signup and view all the answers

What is the primary investigation to rule out hypoglycemia?

Random Blood Sugar Signup and view all the answers

Which organ systems should be included in a structured examination during the secondary survey?

All major organ systems including the Abdominal system and Central nervous system Signup and view all the answers

What must be prioritized when examining a patient who requires full exposure?

Respecting the patient’s dignity and minimizing heat loss Signup and view all the answers

Which of the following is an essential step before considering safe transfer to the ICU?

Conducting a secondary survey and reassessing Signup and view all the answers

What is the primary aim of the initial assessment of critically ill patients?

To keep the patient alive and achieve clinical improvement Signup and view all the answers

What immediate action should be taken in case of airway obstruction?

Clear the airway using head tilt and chin lift Signup and view all the answers

Which of the following indicates complete airway obstruction?

Silent chest Signup and view all the answers

What does a prolonged capillary refill time (CRT) suggest?

Poor peripheral perfusion Signup and view all the answers

Which method is NOT a simple airway clearance technique?

Insertion of a laryngeal mask Signup and view all the answers

What is the significance of monitoring oxygen saturation levels via a pulse oximeter?

It indicates the effectiveness of oxygen therapy Signup and view all the answers

In the breathing assessment phase, hyper-resonance suggests what condition?

Pneumothorax Signup and view all the answers

What should be the response when central cyanosis is observed in a patient?

Immediate assessment for airway obstruction Signup and view all the answers

Study Notes

ABCDE Assessment

The method for assessing critically ill patients is consistent.
Use the ABCDE approach for assessment and treatment.
Perform a thorough initial assessment.
Regularly reassess the patient, starting with life-threatening problems before moving to other areas.
Evaluate the effect of the treatment given.
Anticipate needing extra help early on.
The initial assessment aims to keep the patient alive and improve their condition, allowing time for further treatment and diagnosis.
Work as a team and utilize all team members simultaneously for various tasks.
Airway obstruction is an emergency. Untreated, it can lead to hypoxia and damage to the brain, kidneys, and heart. This can result in cardiac arrest and death.

Airway Obstruction

Airway obstruction causes paradoxical chest and abdominal movements and the use of accessory respiratory muscles.
Partial airway obstruction results in reduced air entry and noisy sounds.
Complete airway obstruction leads to a silent chest.
Central cyanosis is a late sign of airway obstruction.
Obtain expert help immediately.
Simple airway clearance methods, such as head tilt, chin lift, and jaw thrust, may be necessary.

Airway Management (methods)

Insertion of oropharyngeal or nasopharyngeal airways can be used.
More advanced methods, such as laryngeal mask and tracheal intubation, might be needed.

Breathing

Assess respiratory rate, chest expansion, and chest deformity (including flail chest).
Palpate for crepitus and tenderness in the chest wall.
Percussion can detect hyperresonance (suggestive of pneumothorax) or dullness (suggestive of pleural effusion) in the lungs.
Auscultation involves listening to lung sounds in various areas.
Record the inspired oxygen concentration via pulse oximetry.
Pulse oximetry does not detect hypoxemia.

Circulation

Inspect the skin color of hands and digits for signs of compromised circulation, and assess vein condition (collapsed or congested).
Measure capillary refill time to evaluate peripheral perfusion.
Prolonged capillary refill time could indicate poor peripheral perfusion, which may be due to cold conditions, inadequate lighting, or patient age.
Assess limb temperature and count the patient's pulse rate.
Palpate central and peripheral pulsations.
Measure blood pressure bilaterally; even in shock, it may remain normal.
Assess for abnormal heart sounds (murmurs).
Insert two or more wide-bore intravenous cannulae.

Other Procedures

Take blood samples for cross-matching, blood chemistry tests, hematological studies, and coagulation tests.
Give a rapid fluid challenge (for example, 500 cc for normal blood pressure in 5–10 minutes or 1000 cc for hypotension in 5–10 minutes). Smaller fluid volumes could be indicated as well.
If a heart failure patient is involved, administer smaller fluid volumes slowly.
Evaluate the patient after each fluid administration to assess for any changes, particularly crackles.
If the patient presents with primary chest pain and suspected acute coronary syndrome (ACS), record a 12-lead ECG immediately and treat with morphine, supplemental oxygen, nitroglycerin, and aspirin.
Assess the patient's conscious level via the AVPU method (Awake, Verbal, Pain, Unresponsive).
Use the Glasgow Coma Scale to evaluate the patient's responsiveness, using both adult and pediatric scales.
Inspect the pupils for size, equality, and light responsiveness.

Neurological Functions

Identify signs of lateralization indicating neurological deficits, such as aphasia or stroke-related symptoms.
Measure random blood sugar levels to rule out hypoglycemia.
Examine patients for any other potential causes of unconsciousness, including hypoxia, hypercapnia, and cerebral hypoperfusion.

Secondary Survey

Examine detailed information on the patient's condition, medical history, chronic diseases, previous hospital admissions, medications and allergies, and family history.
Perform a structured examination of organ systems (respiratory, cardiovascular, abdomen & genitourinary, central nervous, musculoskeletal).
Order further investigations (laboratory and radiological tests).

Other Important Considerations

Ensure the patient's full exposure is performed while maintaining comfort and dignity and preventing heat loss.
Safe transfer to the intensive care unit (ICU) must be considered.
Remember to reassess the patient frequently.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

This quiz covers the ABCDE approach for assessing critically ill patients, emphasizing the importance of initial and ongoing assessments in emergencies. It also includes key points on airway obstruction, its effects, and necessary interventions. Test your knowledge on these critical evaluation techniques and treatment strategies.