Introduction.
Your name
Wash hands and close door
Ask for their name, date of birth and allergies - check with wristband (a coloured wristband indicates allergies)
Explain what the A-E assessment is and ask for consent
Positioning
Sit down at a ten to two position
Ask them if it is ok to sit close - if they say no, then sit away but ask if they can hear you
What must you do when measuring each vital sign
state what value patient got and what it indicates
How to assess airway
look for signs of obstruction
Is patient clearly talking
Sounds of obstruction
Signs of obstruction
Cant speak or cough
Stridor = sound on inspiration that demonstrates struggle
Sounds of obstruction
stridor
wheezing
gurgling
rhonchi (deep rumbling caused by mucus)
How to assess breathing
Respiratory rate
use of accessory muscles
oxygen saturation
sounds of uneven air entry
breathing rhythm
How to measure respiratory rate
say you are measuring their pulse for 2 minutes and use one of the minutes to measure respiratory rate
what to assess for circulation
heart rate, rhythm and strength
blood pressure
capillary refill
When they last passed urine (its colour and volume normal)
pallor
how to measure capillary refill
patient to place hand across their chest
press their nail bed with you finger and release
The colour should return in finger with 2 seconds
Why is it important to ask when they last passed urine
How to assess disability
ACVPU
pupil reaction
blood glucose
assess pain level asking them to rate their pain on a scale (if they are presenting with a pain)
How to assess exposure
ask them to undress so I can carry out a head to toe assessment of their skin, checking for wounds, rash and bruises
record patient’s temperature
last steps
SAMPLE
comment on next steps: SBAR
Ask patients if they have any questions - want a drink
what to do if patient is pain
ask if they want pain relief, ask if they have recently had any medication
automatic fails
Not gaining informed consent
Not checking patient identity
Not washing hands
Not completing skill correctly to obtain accurate value
Not mentioning that they are handing or escalating over their care
Act unprofessionally
