5th yr- DENTAIM > ABCDE > Flashcards

ABCDE Flashcards

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1
Q

What is the ABCDE approach

A
  1. A decision procedure
  2. treat as you find
  3. Cyclic reassessment
  4. Systematic
  5. Universal
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2
Q

What is the core principle of the ABCDE approach

A

Treat as you find

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3
Q

When is the ABCDE approach used

A

As an assessment for an acutely unwell patietn

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4
Q

What does ABCDE stand for

A 
Airway
Breathing 
Circulation 
Disabilty 
Exposure
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5
Q

What are the stages of checking airway

A
  1. Initial observation
  2. Aural inspection
  3. Visual inspection
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6
Q

How can visual observations be made

A

Either reported by the patient or observed buy the dental practitioner

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7
Q

How is a compromised airway reported or observed as

A
  1. Strange or uncomfortable sensation in the mouth, throat or chest
  2. Difficulty breathing
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8
Q

What can be the signs of a strange or uncomfortable sensation in the mouth, throat or chest

A
  1. Sudden hoarseness of voice
  2. Itching
  3. Burning
  4. Swallowing difficulty
  5. Chest tightening
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9
Q

Give examples of abnormal airway sounds

A
  1. Wheeze
  2. Stridor
  3. Cough
  4. Snore
  5. Gurgle
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10
Q

What causes wheezing

A

Inflammation or narrowing or the airway

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11
Q

What conditions can cause a wheezy airway sound

A
  1. Asthma
  2. Chronic obstructive pulmonary disease (COPD)
  3. Anaphylaxis
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12
Q

What are the common causes of wheezing

A
  1. Infection
  2. Allergic reaction
  3. Physical obstruction
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13
Q

What should we do if we detect a wheezing sound

A

Treatment with bronchodilator (salbutamol)

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14
Q

What is stridor a sign

A

Blockage within the upper airways

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15
Q

When can stridor occur

A

Can occur at any phase of respiration and may be uni-basic or biphasic

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16
Q

How can identification of stridor be supported

A

With a bronchodilator (salbutamol)

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17
Q

What is a cough

A

Short explosive expulsion of air from the lungs

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18
Q

Why does our body cough

A

Aims to clear irritants from the always

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19
Q

What is coughing associated with

A
  1. Asthma
  2. Anaphylaxis
  3. Allergic reaction
  4. Infection
  5. Partial obstruction choking episodes
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20
Q

What can partial airway obstruction be caused by

A

A flaccid tongue and soft palate

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21
Q

What can increased airway turbulence be caused by

A

Can be caused by soft pallet to vibrate resulting in an audible snore

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22
Q

What can a snore suggest in an acutely unwell patient

A

May suggest that deterioration in the patients conscious level has impacted on their ability to protect their airway

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23
Q

When can gurgling be heard

A

May be heavy if liquids are present within the oropharyngeal airway, such as excessive saliva, vomit, blood or mucus

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24
Q

How can we assess breathing

A
  1. Pulse oximetry
  2. Respiration rate
  3. Peak expiratory flow (PEF)
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25
How can we assess circulation
1. Reported symptoms 2. Heart rate and rhythm 3. Blood pressure capillary refill times
26
What symptoms might a patient report of if their circulation is compromised
1. Palpitations/ chest pain 2. Peripherals affected 3. Central pain
27
What are palpitations
Sudden awareness of a fast or irregular heart beat
28
What can palpitations suggest
Cardiac arrhythmia
29
What can a reported symptom of chest pain suggest
Cardiac ischaemia | Panic attack
30
How can the peripherals be affected if circulation is compromised
Experiencing feeling of coldness and/or tingling in the limbs may be a sign of compensation in response to shock
31
How can the central be affected if circulation is compromised
Patient may experience visual. auditory disturbances, dizziness and/or feeling faint
32
How does the body accommodate changed in blood flow and oxygen
By increasing or decreasing heart rate as necessary
33
When does our body normally lower our heart rate
Sleep | High physical fitness
34
When does our body normally increase our heart rate
Physical exertion | Emotional stress
35
Why does heart rate drop during sleep
In response to a drop in oxygen consumption in the resting state
36
What can capillary refill time be used to assess
To assess perfusion status in addition to blood pressure measurements or as an alternative if blood pressure monitors are not available
37
State a healthy capillary refill time
2 seconds
38
What happens if the body is unable to meet the demands for blood flow and oxygen
It prioritises the body core with the aim to maintain perfusion to vital organs
39
How does the body prioritise blood flow to the organs
Reduces blood flow to the peripheries
40
What is blood pressure a measure of
Circulatory state
41
What does Systolic pressure measure
Measures the force as the heart contracts
42
What does the diastolic pressure measure
Measures try force when the heart relaxes and refills
43
What is the systolic blood pressure used to assess
Assess perfusion status during acute illness
44
What is a critically low systolic blood pressure
Less than 90 mmHg
45
What can the possible inference be from a systolic blood pressure of less than 90mmHg
Critical cardiovascular collapse and risk of organ failure
46
What is a very low systolic blood pressure
91-100 mmhg
47
What can the possible inference be from a systolic blood pressure of 91-100mmHg
Signs of cardiovascular collapse
48
What is a low systolic blood pressure
101-110 mmHg
49
What can the possible inference be from a systolic blood pressure of 101-110 mmHg
Early signs of cardiovascular collapse
50
What is a normal systolic blood pressure
111-219 mmHg
51
What can the possible inference be from a systolic blood pressure of 111-219 mmHg
Circulation sufficient to maintain normal central and peripheral perfusion
52
What is a high systolic blood pressure
more than 220mmHg
53
What can the possible inference be from a systolic blood pressure of more than 220mmHg
Acute risk of ACS, stroke, kidney damage, eye damage and seizures
54
How can we assess disability
1. Capillary blood glucose 2. AVPU 3. Pain assessment
55
When do we take capillary blood glucose
In EVERY acutely unwell patient | If hypoglycaemia, seizure or syncope is suspected
56
What is a normal blood glucose level
4.0-8.0 mmol/L
57
What is AVPU
A simple neurological assessment
58
What does AVPU aim to do
Aims to identify what level of stimulus is required for a patietn to open their eyes and make an attempt to verbalise
59
What does the AVPU scale stand for
Alert Verbal Pain Unresponsive
60
What stimulation is associated with an alert patient
None
61
What stimulation is associated with a verbal patient
Loud voice eg shouting
62
What stimulation is associated with a patient in pain
Touch or shaking | Pinching earlobe
63
What do we use when taking a pain assessment
SOCRATES
64
What does SOCRATES stand for
``` Site Onset Character Radiation Associated symptoms Time Exacerbating factors Severity ```
65
How can we assess exposure
1. Visual Inspection | 2. Professional judgement review
66
When is an exposure assessment useful
When you have an unclear working diagnosis, a working diagnosis of asthma/ hyperventilation/ acute cardiac ischaemia
67
What must you obtain before carrying out a visual inspection
Patient consent
5th yr- DENTAIM
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