Management - GO DR SHAVPU &#8249C› ACBC

Gloves On

Danger - To yourself and others, this could be a domestic in progress in which case delay entering until police arrive. Fallen rubble or inaccessibility due to other reasons, call for fire and rescue. Use your common sense, If you feel unsure for any reason then call for the relevant help

Response  - Is the patient responding

Scene History - What has happened? Mechanism of Injury. Are there any clues relevant to the situation e.g. Empty drug packets, How is the patient found, are they unconscious on ground or slumped in a chair, sitting upright, standing?

Patients Level of Consciousness - Is the Patient,

Alert - Patient fully conscious and responds normally

Verbal - Responds to voice. Hello, are you OK?

Pain - Responds to pain stimuli. Pinch earlobe, Sternum rub, Trapezium squeeze, Pressure applied to the patients nail bed

Unconscious - No Response to any stimuli

&#8249C&#8250</b>atastrophic Haemorrhage - Extreme bleeding (likely to cause death within minutes)</p> <p><b>A</b>irway - Check that airway is clear. In a <strong>medical</strong> scenario a clear airway in a patient with a reduced consciousness is obtained using head tilt and chin lift, however, in a <strong>Trauma</strong> scenario it is essential you prevent cervical manipulation so only use a jaw thrust manoeuvre while maintaining in-line cervical immobilisation. Perform a finger sweep if any foreign object is noticed (except for a fitting patient) or use suction. Once the airway has been opened it should be secured with an adjunct such as an appropriately sized oropharyngeal or nasopharyngeal airway.</p> <p><b>C</b> Spine - Does the mechanism indicate C Spine injury? Apply inline immobilisation and rigid collar if suspected injury. <i>Once inline immobilisation has been initiated then the person holding the head stays there unless somebody else takes over or until the patient is supine on an appropriate immobilisation device, e.g - Vacuum Mattress.</i></p> <p><b>B</b>reathing - Look, Listen and Feel to ascertain whether the patient is making adequate effort in respiration. Identify the appropriate (depends whether Paediatric or adult) respiratory rate of the patient. During the Look, Listen, Feel phase of breathing assessment it is important to identify any life-threatening problems such as Flail chest, chest wounds (open) and any potential tension pneumothorax. During this stage it maybe appropriate to give oxygen therapy but this is dependant on specific oxygen guidelines. Assisted ventilations may be necessary if inadequate effort is noted or respirations are absent. <p><b>C</b>irculation - Feel carotid pulse for 10 seconds or look for signs of circulation, if not present perform Basic Life Support (BLS) as per your relevant guidelines *.</p> <p> A basic circulatory assessment can be performed easily by feeling for pulse volume and rate. Capillary refill can be undertaken on the peripherals to ascertain perfusion. This is performed by pressing on the nail bed for 5 seconds and then counting the time it takes for the nailbed to return to a pink colour. However this test is unreliable if the fingers/toes are cold.</p> <p>Controlling external haemorrhage is also important at this stage - Apply direct pressure and elevation. In severe cases of haemorrhage it may be necessary to apply a tourniquet.</p> </bs> <p><strong>Time Critical Factors</strong> are usually identified during the primary survey but can occur at any point during your care. If any ABC problems are identified these must be rectified, if possible, and immediate removal to definitive care is then called upon.</p> <p><a name="Time"> Some Time Critical conditions:</a></P> <ul> <li>Anaphylaxsis</li> <li>Asthma</li> <li>Pulmonary Embolism</li> <li>Acute Myocardial infarction</li> <li>Aortic Dissections</li> <li>Circulatory Collapse</li> <li>Ectopic Pregnancy</li> <li>Sepsis</li> <li>Status Epilepticus</li> <li>Reduced Level of Consciousness</li> <li>Cardiac Arrest</li> <li>Severe Haemorrhage</li></ul> <p align="center">* Refer to the revised ERC <a href="http://www.erc.edu/index.php/bls_aed_overview/en/" target="_parent">resuscitation</a> guidelines</p> <p align="center">Updated April 2012</p> <div id="footer">Thanks to <a href= "http://www.nixonmcinnes.co.uk">Nixon Mcinnes</a> for their support in producing this site <p>SJW 2012</p> </div> </div> <div id="lefty"> <center> <a class="addthis_button" href="http://www.addthis.com/bookmark.php?v=250&amp;pubid=ra-4ff0069663644e88"><img src="http://s7.addthis.com/static/btn/v2/lg-share-en.gif" width="125" height="16" alt="Bookmark and Share" style="border:0"/></a> <script type="text/javascript">var addthis_config = {"data_track_addressbar":true};</script> <script type="text/javascript" src="http://s7.addthis.com/js/250/addthis_widget.js#pubid=ra-4ff0069663644e88"></script> </center> <div id="menu"><a href="/javascript:window.close();">Close Window</a> <a href="/javascript:window.print()">Print Page</a></div> </div> </div> </body> </html>