"improving intensive care in Scotland"

Assessment and treatment of the acutely ill adult

Task one

Read Chapter 2 of the Lothian Adult Medical Emergencies Handbook

This details the approach which the immediate responder should adopt. This could be any of us and some of the concepts are explored here.

Initial approach

'Advanced first aid'

A = Airway assess and manage

B = Breathing assess and manage + O2 therapy

C = Circulation assess and manage + IV access & blood tests

D = Disability assessment (what's the glucose ?)

E = Evidence, environment, examination (targeted)

F = Frequent re-assessment and establish monitoring

As you walk up to the patient and introduce yourself shake hands and ask "how are you doing ? " Immediately (ie within 5 seconds) you will have assessed airway (they can/can't talk, noises eg stridor, snoring/gurgling, none), breathing (rate, symmetry, work of breathing: accessory muscle use, paradoxical or see-saw pattern), circulation (warm/cold peripheries) and conscious level (their response to you). In this short time you should be thinking " can I take some time to assess or should I ?"

a) start treatment

b) call for help

c) both a and b

Page 3

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