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Acute care Assessment and Management

Acute care Assessment and Management. Airway Obstruction because of…. CNS depression Blood, vomit, foreign body Trauma Infection, inflammation Laryngospasm. Airway……. Symptoms and signs Difficulty breathing, distressed, choking Shortness of breath Stridor, wheeze, gurgling

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Acute care Assessment and Management

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  1. Acute care Assessment and Management

  2. Airway Obstruction because of… • CNS depression • Blood, vomit, foreign body • Trauma • Infection, inflammation • Laryngospasm

  3. Airway…….. Symptoms and signs • Difficulty breathing, distressed, choking • Shortness of breath • Stridor, wheeze, gurgling • See-saw respiratory pattern

  4. Breathing Inadequacy because of... • Pulmonary disorders • infection • collapse • pneumothorax • asthma • Decreased respiratory drive • CNS depression • Decreased respiratory effort • muscle weakness • restrictive chest defect

  5. Breathing…….. Symptoms and signs • Short of breath, anxious, irritable • Decrease in conscious level • Tachypnoea • Cyanosis

  6. Primary Cause Ischaemia Myocardial infarction Hypertensive heart disease Valve disease Drugs Electrolyte abnormalities Secondary Cause Asphyxia Hypoxaemia Blood loss Septic shock Any Shock Circulatory/cardiac inadequacy

  7. Circulation………. Symptoms and signs • Tachycardia • Bradycardia • Hypotension • Poor perfusion (CRT) • Poor cerebration • Poor urine output

  8. Primary Trauma CVA Infection Poisons Secondary Hypoxia Metabolic Disability/CNS Abnormality

  9. Disability….. Any CNS depression can lead to severe airway, breathing and circulatory problems (and vice versa)

  10. Aim of assessing acutely ill patients • Ensure early anticipation and detection of disordered physiology at a stage before organ failure is established. • Initiate simple/preventative therapies to the limit of your capabilities, and call for senior help early. • Patients who do not make a prompt and sustained response to these measures should be considered for early referral to a HDU or ICU facility.

  11. Assessing the Sick Patient Elementary Skills (History Examination and Investigations) & a Systematic approach • Airway • Breathing • Circulation • Disability • Exposure

  12. + Chin lift,head tilt Protect c spine Suction Airway adjuncts Assessing the Sick Patient Airway Upper airway obstruction Do you need help now ?

  13. Assessing the Sick Patient Breathing • Rate • Rhythm/Symmetry • Depth • Auscultate/Percuss • WOB • Colour • O2 saturations Do you need help now ?

  14. Capillary refill time • Limb temperature • Peripheral pulses • Central pulses • Heart rate & rhythm • BP • O2 saturation • Urine output Assessing the Sick Patient Circulation Do you need help now ?

  15. Recovery position Assessing the Sick Patient Disability • AVPU • Pupils/posture • Blood glucose • “DEFG” Do you need help now ?

  16. Assessing the Sick Patient Exposure Examination vs Environment Consider Hypothermia & Dignity Looking For………

  17. Do you need to call for help now?

  18. Any Questions?

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