Yes: if the patient can talk, their airway is patent and you can move on to the assessment of breathing. Airway Clinical assessment Can the patient talk? If the patient is unconscious or unresponsive, start the basic life support (BLS) algorithm as per resuscitation guidelines. Make sure the patient’s notes, observation chart and prescription chart are easily accessible.Īsk for another clinical member of staff to assist you if possible. Introduce yourself to the patient including your name and role.Īsk how the patient is feeling as this may provide some useful information about their current symptoms. Introduce yourself to whoever has requested a review of the patient and listen carefully to their handover. You may be asked to review a patient with UGIB due to tachycardia, hypotension, malaena and/or haematemesis. Initial stepsĪcute scenarios typically begin with a brief handover from a member of the nursing staff including the patient’s name, age, background and the reason the review has been requested. You might also be interested in our medical flashcard collection which contains over 1000 flashcards that cover key medical topics. Your assessment and management should be documented clearly in the notes, however, this should not delay initial clinical assessment, investigations and interventions.Any medications or fluids will need to be prescribed at the time (in some cases you may be able to delegate this to another member of staff).Make use of your local guidelines and algorithms in managing specific scenarios (e.g.Review results as they become available (e.g.If you require senior input, call for help early using an appropriate SBARR handoverstructure.Clearly communicate how often would you like the patient’s observations relayed to you by other staff members.All critically unwell patients should have continuous monitoring equipment attached for accurate observations.Make use of the team around you by delegating tasks where appropriate.Re-assess regularly and after every intervention to monitor a patient’s response to treatment.Treat all problems as you discover them.General tips for applying an ABCDE approach in an emergency setting include:
Haematochezia: the passage of fresh red blood per rectum, which can occur in the context of profuse upper gastrointestinal haemorrhage due to rapid transit of blood through the gastrointestinal tract.
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