CASTest 2.

1
Please mark your responses by filling in the appropriate boxes like this Name:

Clinical setting and history

S: 25-year-old patient who has become acutely short of breath B: Known asthmatic Course Centre:
A: Now wheezy, unable to complete sentences R: Urgent assessment D: you agree to come
urgently.
Date:
Clinical Course
 A: clear; B: RR 40 min-1, audible wheeze; accessory muscles ++; quiet breath sounds
bilaterally, SpO2 – 86% (60% if not on O2); C: PR 120 min-1 (sinus tachycardia), BP 110/70
mmHg, CRT <2 s; D: verbal response; E: nil Assessor 1:
 Patient collapses
 Initial rhythm PEA (sinus tachycardia rate 120 min-1); continue for one further cycle if
reversible causes not identified
Assessor 2:

INTERVENTIONS – KEY TREATMENT POINTS IN BOLD

NOT
Initial approach EXCELLENT ACCEPTABLE BORDERLINE
ACHIEVED
ST ABCDE approach
Oxygen, IV access
Recognise acute severe asthma
Nebulised salbutamol
IV steroids, nebulised anticholinergic, IV magnesium,
IV bronchodilator
Request CXR, ABG
Cardiac arrest management
PEA Confirm cardiac arrest / check rhythm
Call resuscitation team / help
2 min CPR (30:2)
Airway / ventilation / oxygen
Attach ECG monitoring (if not already)
Give adrenaline 1 mg IV
Recognise relevant reversible causes
(hypoxia – oxygenation; tension pneumothorax – needle decompression /
thoracostomy) (further cycle as required)

Please add any comments below. Pass

Retest

Fail

ALS Provider Course | CASTest | May/2020 | Version 1 1