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ABCDE Approach to Emergency Assessment

This document outlines the ABCDE approach for assessing and managing patients. It summarizes: 1) How to assess the airway for patency, obstruction, and appropriate maneuvers and adjuncts to open the airway. 2) How to evaluate breathing by assessing rate, pattern, inspection of chest, palpation, percussion and auscultation to diagnose problems like pneumonia, pulmonary edema, asthma, and pleural issues. 3) How to examine circulation by checking pulse, capillary refill time, temperature, and performing tests to diagnose causes of shock like hemorrhage, cardiac, septic or anaphylactic shock.

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Hala Bahaa
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49 views3 pages

ABCDE Approach to Emergency Assessment

This document outlines the ABCDE approach for assessing and managing patients. It summarizes: 1) How to assess the airway for patency, obstruction, and appropriate maneuvers and adjuncts to open the airway. 2) How to evaluate breathing by assessing rate, pattern, inspection of chest, palpation, percussion and auscultation to diagnose problems like pneumonia, pulmonary edema, asthma, and pleural issues. 3) How to examine circulation by checking pulse, capillary refill time, temperature, and performing tests to diagnose causes of shock like hemorrhage, cardiac, septic or anaphylactic shock.

Uploaded by

Hala Bahaa
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd

ABCDE APPROACH

Airway
Inspection
- Patent
- Partially obstructed
NOISY BREATHING
Snoring: partial airway obstruction by tongue or soft Wheezing (expiratory): lower airway obstruction
palate
Gurgling: fluid in upper airway
Stridor/croup/crowing (inspiratory): laryngeal
spasm or obstruction Crepitation/crackle: fluid in lungs
DD
Intramural: foreign body / secretion
Mural: angioedema / epiglottitis
Extramural: tumors
maneuvers
1. Foreign body? → attempt to remove
2. Secretions? → suction
3. Basic maneuvers
- Head-tilt-chin-lift
- Jaw thrust (if suspected cervical injury)
4. Basic adjuncts
- Oropharyngeal airway (unconscious)
- Nasopharyngeal airway (to avoid gag reflex)
5. Advanced adjuncts
- Laryngeal mask
- Endotracheal tube
- Unprotected Coma/confused (GC≤8) → Endotracheal tube
- Completely obstructed Silent chest – no pulse → ALS
O2 mask
_______________________________________________________________________________________________

Breathing
RR (N 12-20)
Pattern
PARADOXICAL BREATHING
A) Partial obstruction→ basic maneuvers SILENT CHEST → complete obstruction
B) Diaphragm fatigue→ assisted ventilation
Inspection look, listen, feel
- Accessory/abdominal muscles
- Depth. rhythm
- chest deformity , raised JVP
- Trachea in suprasternal notch , deviation to one side indicates mediastinal shift ( pneumothorax, lung fibrosis or
pleural fluid
Palpation
- Tenderness
- Feel the chest wall to detect surgical emphysema or crepitus ( suggest a pneumothorax until proven otherwise)
- Click (fracture)
Percussion
Hyperresonant→ pneumothorax (air)
Dull→ consolidation (solid) or effusion (fluid)

Auscultation
 Supramammary-mammary-inframammary
 Upper axillary-lower axillary
 Suprascapular-intrascapular-infrascapular

-types: normal vesicular, harsh vesicular, bronchial, wheezes


- bronchial breathing indicate lung consolidation with patent airway
- lungs end at 5th rib
- wheezes (late exp→whole exp→both exp & insp)
DD
- Pneumonia - Pulm. oedema - PE
- Asthma - ECOPD - Pleural pathology (air / fluid / blood)
+ Resp. fatigue / Opiates / Rib # or abdominal pain / Hyperoxygenation in retainers
Pulse O2→ mask
N.B. dyspnea = SOB w/↑ RR (respiratory, DKA,…) OR chest pain w/o RR (cardiac e.g. MI)

circulation
inspection → signs of shock (pale, clammy, cold)
palpation
 Pulse
o X Central (arrest)
o X peripheral (shock)
o Diff on both arms→aortic dissection
N.B. pain that quickly transfers from chest→subscapular→intraabdominal→loin→LL (think AD)
 CRT (N <2)
 Pulse different on both arms → aortic dissection
 temperature
2 wide pore IV cannulas DD
1. CBC, Bl. culture 1. Hypovolaemic (Internal or External bleeding /
2. ABG ( PH, lactate) D&V / Severe burns) → 1000 saline if not he
3. Urea, creatinine, Na, K or cardiac→ tranexamic acid for hemorrhagic
shock
4. ECG 2. Cardiogenic
5. Urinary catheter a. (MI
6. Dyspnea→ cardiac enz, DDimer i. (4aspirin+4plavix/2brilique)
7. Blood transfusion matching ii. Morphine (excpt inf or shocked or
8. Coag profile dinitra :pethidine)
b. - Acute HF – Arrhythmias)
3. Septic
4. Anaphylactic → adrenaline-hydrocortisone
5. Obstructive: (PE / Tamponade / Tension 7. Blood transfuisonO+ until matching results in 1
pneumothx) hr)
6. Electrolytes: K

Disability
1. GCS DD
2. Pupil
- Pinpoint: pontine, opiate, organophosphorus 1. Hypoglycemia →Glucagon IM 20% - 50% IV
- Dilated fixed: ↑ ICP (1 eye is dural sinus Dextrose
thrombosis, 2 eyes is midbrain lesion) 2. Opioid toxicity (morphine→naloxone)
3. Random blood glucose 3. Electrolytes (Na, Ca)
4. CVA or intracranial pathology
5. ?→ CT head
6. Fits→ lorazepam-diazepam

Exposure Segmental (temp rectal, tongue dentation, neck rigidity, rash, bed sores

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