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D & E

D & E. Lecture aim. How to assess disability & everything else How to treat disability & other problems. Assess Treat Re-assess. Disability– How to assess. What does “disability” mean in ABCD?. Disability = Conscious Level. How can you assess conscious level?.

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D & E

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  1. D & E

  2. Lecture aim • How to assess disability & everything else • How to treat disability & other problems

  3. Assess Treat Re-assess

  4. Disability– How to assess What does “disability” mean in ABCD?

  5. Disability = Conscious Level How can you assess conscious level?

  6. Conscious Level (D=Disability) AVPU Alert A Responds to Voice V Responds to Pain P Unresponsive U Glasgow Coma Scale is hard to remember!

  7. Low Conscious Level – how to treat • Protect airway • Lateral Position • Consider hypoglycaemia

  8. Hypoglycaemia Common cause of unconsciousness & fitting Easy, cheap treatment For all unconscious, semiconscious or fitting patients: Check blood sugar urgently or give a bolus of sugar 5ml/kg 10% dextrose

  9. Seizures Dont put anything in mouth! Diazepam IV or rectal not IM 0.2-0.3mg/kg (iv) 0.5mg/kg (pr) Repeat treatment if needed

  10. E = “Everything Else” • Diagnose underlying disease and treat • Secondary Survey • Call for help • Admit ICU? • Maintain clear airway • Lateral position, suction

  11. Summary • Disability = Conscious Level = AVPU • Everything Else = Diagnose underlying disease and treat Treatments for unconsciousness are: Protect the Airway – Lateral position Consider hypoglycaemia

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