How to perform an A-E
🫁 A – Airway
- The airway is clear if the patient can speak normally and has no noisy breathing.
- Signs of airway compromise include secretions, aspiration, snoring (GCS <8), or stridor.
- Examine the mouth for obstructions or mucosal swelling.
🌬️ B – Breathing
- Assess respiratory rate and oxygen saturation (SpO₂).
- Observe for cyanosis, tracheal deviation, accessory muscle use, or chest deformities.
- Perform inspection, percussion, and auscultation to assess lung function.
- Key investigations:
- ABG (if SpO₂ is low or GCS is reduced).
- CXR (if respiratory pathology is suspected).
❤️ C – Circulation
- Check capillary refill (centrally), pulse rate, rhythm, and blood pressure trends.
- Evaluate for fluid overload (JVP, heart sounds, peripheral oedema).
- Monitor fluid balance by assessing inputs (IV fluids, oral intake) and outputs (catheter, drains, vomiting).
- Key investigations:
- IV access (wide-bore cannula) and take blood samples (consider VBG for rapid results).
- ECG (if cardiac concerns).
- 3-lead cardiac monitoring if necessary.
🧠 D – Disability
- Assess consciousness level (GCS/AVPU scale).
- Examine pupillary size, symmetry, and reaction to light.
- Evaluate pain levels and review the medication chart.
- Remember to check blood glucose
- Key investigation: CT brain if neurological pathology is suspected.
🩺 E – Exposure & Everything Else
- Fully assess the patient for bleeding, rashes, injuries, or abnormal drain/catheter output.
- Conduct an abdominal examination and assess for relevant signs.
- Perform a focused examination of other systems based on the presenting complaint.
- Maintain patient dignity while ensuring a thorough assessment.
🔄 Regular reassessment is crucial. Escalate concerns early!
Click here to find more information on how to approach a deteriorating patient
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