A-E Respiratory Assessment: Difference between revisions

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== Introduction ==
== Introduction ==
The A-E assessment; Airway, Breathing, Circulation, Disability, Exposure (ABCDE) approach is a systematic approach to the immediate assessment and treatment of critically ill or injured patients<ref>Thim T, Krarup NH, Grove EL, Rohde CV, Løfgren B. Initial assessment and treatment with the Airway, Breathing, Circulation, Disability, Exposure (ABCDE) approach. ''Int J Gen Med''. 2012;5:117-121. doi:10.2147/IJGM.S28478</ref>, it has become widely adopted as a way of documenting the assessment of respiratory patients. This systematic approach should allow you to determine if the patient has one of the following problems:
The A-E assessment; Airway, Breathing, Circulation, Disability, Exposure (ABCDE) approach is a systematic approach to the immediate assessment and treatment of critically ill or injured patients<ref>Thim T, Krarup NH, Grove EL, Rohde CV, Løfgren B. Initial assessment and treatment with the Airway, Breathing, Circulation, Disability, Exposure (ABCDE) approach. ''Int J Gen Med''. 2012;5:117-121. doi:10.2147/IJGM.S28478</ref>, it has become widely adopted as a way of documenting the assessment of respiratory patients. This systematic approach should allow you to determine if the patient has one of the following problems:
 
* Sputum retention
▫Sputum retention
* Loss of [[Lung volumes|lung volume]]
 
* Increased work of breathing (breathlessness)
▫Loss of [[Lung volumes|lung volume]]
* Respiratory failure
 
▫Increased work of breathing (breathlessness)
 
▫Respiratory failure


=== Airway ===
=== Airway ===
Is the airway patent? is it their own?
* Is the airway patent? is it their own?
 
* Occluded/Obstructed: indicated by stridor, hoarse voice, orthopnoea, drooling, dysphagia
Occluded/Obstructed: indicated by stridor, hoarse voice, orthopnoea, drooling, dysphagia
* Are they self ventilating? If not, what is the mode of ventilation? CPAP, BiPAP, Ventilated   
 
Are they self ventilating? If not, what is the mode of ventilation? CPAP, BiPAP, Ventilated   


=== Breathing ===
=== Breathing ===
What is their respiratory rate? Is it regular?   
* What is their respiratory rate? Is it regular?   
 
* Work of breathing, are they using their accessory muscles?  
Work of breathing, are they using their accessory muscles?  
* What are the saturation levels? Are they on any oxygen? How is it delivered.  
 
* Have they had [[Arterial Blood Gases|ABG]]<nowiki/>s? what are the PaO2 and PaCO2 levels?  
What are the saturation levels? Are they on any oxygen? How is it delivered.  
* What did their chest Xray show?  
 
* Chest expansion: is it even  
Have they had [[Arterial Blood Gases|ABG]]<nowiki/>s? what are the PaO2 and PaCO2 levels?  
* [[Auscultation]]: Are there breath sounds throughout? Are there any added sounds e.g. crackles, a wheeze crepitation?  
 
* Palpation: What can you feel? secretions? tactile fremitus. Do they feel hot/cold? compare centrally to peripherally. Is there any Oedema?  
What did their chest Xray show?  
* What is their cough like? Strong or weak? Dry or Wet? productive or unproductive.  
 
* Are they able to expectorate their secretions?  
Chest expansion: is it even  
* Percussion:  
 
[[Auscultation]]: Are there breath sounds throughout? Are there any added sounds e.g. crackles, a wheeze crepitation?  
 
Palpation: What can you feel? secretions? tactile fremitus. Do they feel hot/cold? compare centrally to peripherally. Is there any Oedema?  
 
What is their cough like? Strong or weak? Dry or Wet? productive or unproductive.  
 
Are they able to expectorate their secretions?  
 
Percussion:  


=== Circulation ===
=== Circulation ===
Heart Rate
* Heart Rate
 
* [[Blood Pressure]]
[[Blood Pressure]]
* Skin colour
 
* Sweating
Skin colour
* Urine Output
 
* Blood Sugar levels (BMs)
Sweating
 
Urine Output
 
Blood Sugar levels (BMs)


=== Disability ===
=== Disability ===
Level of consciousness; Alert, Voice, Pain, Unresponsive  
* Level of consciousness; Alert, Voice, Pain, Unresponsive  
 
* Are they sedated?  
Are they sedated?  


=== Exposure ===
=== Exposure ===
Injuries
* Injuries
 
* Are there any surgical wounds? Are these contraindications for any interventions?
Are there any surgical wounds? Are these contraindications for any interventions?
* Do they have any drains? Are they swinging and bubbling
 
* Attachments: Catheter, Arterial line, NG tubes,
Do they have any drains? Are they swinging and bubbling
 
Attachments: Catheter, Arterial line, NG tubes,
 
<ref>Harden, B. Cross, J. Broad, M A. Quint, M. Ritson, P. Thomas, S. Respiratory Physiotherapy; An on call Survival Guide. Churchill Livingstone Elsevier 2009</ref><ref>Respiratory Physiotherapy 2002 98;23 58 Available at https://www.nursingtimes.net/clinical-archive/respiratory-clinical-archive/respiratory-physiotherapy-21-03-2002/ Accessed 26 August 2020<article>
<ref>Harden, B. Cross, J. Broad, M A. Quint, M. Ritson, P. Thomas, S. Respiratory Physiotherapy; An on call Survival Guide. Churchill Livingstone Elsevier 2009</ref><ref>Respiratory Physiotherapy 2002 98;23 58 Available at https://www.nursingtimes.net/clinical-archive/respiratory-clinical-archive/respiratory-physiotherapy-21-03-2002/ Accessed 26 August 2020<article>
</article></ref>  
</article></ref>  

Revision as of 19:01, 26 August 2020

Introduction[edit | edit source]

The A-E assessment; Airway, Breathing, Circulation, Disability, Exposure (ABCDE) approach is a systematic approach to the immediate assessment and treatment of critically ill or injured patients[1], it has become widely adopted as a way of documenting the assessment of respiratory patients. This systematic approach should allow you to determine if the patient has one of the following problems:

  • Sputum retention
  • Loss of lung volume
  • Increased work of breathing (breathlessness)
  • Respiratory failure

Airway[edit | edit source]

  • Is the airway patent? is it their own?
  • Occluded/Obstructed: indicated by stridor, hoarse voice, orthopnoea, drooling, dysphagia
  • Are they self ventilating? If not, what is the mode of ventilation? CPAP, BiPAP, Ventilated

Breathing[edit | edit source]

  • What is their respiratory rate? Is it regular?
  • Work of breathing, are they using their accessory muscles?
  • What are the saturation levels? Are they on any oxygen? How is it delivered.
  • Have they had ABGs? what are the PaO2 and PaCO2 levels?
  • What did their chest Xray show?
  • Chest expansion: is it even
  • Auscultation: Are there breath sounds throughout? Are there any added sounds e.g. crackles, a wheeze crepitation?
  • Palpation: What can you feel? secretions? tactile fremitus. Do they feel hot/cold? compare centrally to peripherally. Is there any Oedema?
  • What is their cough like? Strong or weak? Dry or Wet? productive or unproductive.
  • Are they able to expectorate their secretions?
  • Percussion:

Circulation[edit | edit source]

  • Heart Rate
  • Blood Pressure
  • Skin colour
  • Sweating
  • Urine Output
  • Blood Sugar levels (BMs)

Disability[edit | edit source]

  • Level of consciousness; Alert, Voice, Pain, Unresponsive
  • Are they sedated?

Exposure[edit | edit source]

  • Injuries
  • Are there any surgical wounds? Are these contraindications for any interventions?
  • Do they have any drains? Are they swinging and bubbling
  • Attachments: Catheter, Arterial line, NG tubes,

[2][3]

References[edit | edit source]

  1. ↑ Thim T, Krarup NH, Grove EL, Rohde CV, Løfgren B. Initial assessment and treatment with the Airway, Breathing, Circulation, Disability, Exposure (ABCDE) approach. Int J Gen Med. 2012;5:117-121. doi:10.2147/IJGM.S28478
  2. ↑ Harden, B. Cross, J. Broad, M A. Quint, M. Ritson, P. Thomas, S. Respiratory Physiotherapy; An on call Survival Guide. Churchill Livingstone Elsevier 2009
  3. ↑ Respiratory Physiotherapy 2002 98;23 58 Available at https://www.nursingtimes.net/clinical-archive/respiratory-clinical-archive/respiratory-physiotherapy-21-03-2002/ Accessed 26 August 2020<article> </article>
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