ABCD approach

Airway

Breathing

Circulation

Disability

Count the respiratory rate. The normal rate is 12–20 breaths min

Assess the depth of each breath, the pattern (rhythm) of respiration and whether chest expansion is equal on both sides.

Look, listen and feel for the general signs of respiratory distress: sweating, central cyanosis,

In acute respiratory failure, aim to maintain an oxygen saturation of 94–98%

Provide high-concentration oxygen using a mask with oxygen reservoir

Look for the sign of airway obstruction

Assess the limb temperature by feeling the patient’s hands: are they cool or warm?

Count the patient’s pulse rate listening to the heart with a stethoscope

Look at the colour of the hands and digits: are they blue, pink, pale

Measure the patient’s blood pressure

Look for other signs of a poor cardiac output, such as reduced conscious level

Measure the blood glucose to exclude hypoglycaemia

Nurse unconscious patients in the lateral position if their airway is not protected.

Examine the pupils (size, equality and reaction to light).

Is a systematic approach to the immediate assessment and treatment of critically ill or injured patients.