How to perform an A-E
š« A ā Airway
- The airway isĀ clearĀ if the patient can speak normally and has no noisy breathing.
- Signs of airway compromiseĀ includeĀ secretions, aspiration, snoring (GCS <8), or stridor.
- Examine the mouthĀ for obstructions or mucosal swelling.
š¬ļø B ā Breathing
- AssessĀ respiratory rateĀ andĀ oxygen saturation (SpOā).
- Observe forĀ cyanosis, tracheal deviation, accessory muscle use, or chest deformities.
- PerformĀ inspection, percussion, and auscultationĀ to assess lung function.
- Key investigations:
- ABGĀ (if SpOā is low or GCS is reduced).
- CXRĀ (if respiratory pathology is suspected).
ā¤ļø C ā Circulation
- CheckĀ capillary refill (centrally), pulse rate, rhythm, and blood pressure trends.
- Evaluate forĀ fluid overloadĀ (JVP, heart sounds, peripheral oedema).
- MonitorĀ fluid balanceĀ by assessing inputs (IV fluids, oral intake) and outputs (catheter, drains, vomiting).
- Key investigations:
- IV accessĀ (wide-bore cannula) and take blood samples (consider VBG for rapid results).
- ECGĀ (if cardiac concerns).
- 3-lead cardiac monitoringĀ if necessary.
š§ D ā Disability
- AssessĀ consciousness level (GCS/AVPU scale).
- ExamineĀ pupillary size, symmetry, and reaction to light.
- EvaluateĀ pain levelsĀ and review theĀ medication chart.
- Remember to check blood glucose
- Key investigation:Ā CT brain if neurological pathology is suspected.
š©ŗ E ā Exposure & Everything Else
- Fully assess the patient forĀ bleeding, rashes, injuries, or abnormal drain/catheter output.
- Conduct anĀ abdominal examinationĀ and assess for relevant signs.
- Perform aĀ focused examination of other systemsĀ based on the presenting complaint.
- MaintainĀ patient dignityĀ while ensuring a thorough assessment.
š Regular reassessment is crucial. Escalate concerns early!
Click here to find more information on how to approach a deteriorating patient
Click here to access the Webinar on Managing the Deteriorating Patient as part of the FY1 Survival Guide series
