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Putting it into a physical assessment - Coggle Diagram
Putting it into a physical assessment
The aim of A - E
To save life
To provide rapid interventions
To break down complex clinical issues into manageable parts
To be used as an assessment and treatment algorithm
To establish situational awareness
To buy time to determine the diagnosis
When doing the A-E assessment it should not be used in isolation you must remember to obtain history, use appropriate communication skills, use age-appropriate actions and finally include the family.
How to assess airway
Look for a voice and breathing sounds.
Interventions - look, listen, feel, open airway - head tilt and chin lift and intubation if required.
Breathing
How to assess breahting
Respiratory rate
Consider the age of a child
Activity
Position
Work of breathing
Chest movement
Auscultation
Pulse Oximetry (94%+)
Use of accessory muscles
Three E’s - Effort, efficacy and effect of breathing.
Intervention
Position
Exposure
Oxygen
BVM if necessary
How to assess cirulation
Heart rate
Consider age and activity
Auscultation
Colour
Pallor, mottling, cyanosis
Capillary refill time
Blood pressure
Blood gas and sugar
Intervention
FluidsConsider optimum route
Oral/IV/IO
IV/IO: 20ml/kg (5-10ml/kg Trauma, Neonates Cardiac shock}. Current thinking – 10-20ml/Kg.
How to assess disability
Determine normal behaviour for a child
AVPU
Alert, voice, pain, unresponsive
Position
BM
Respiratory Rate/Heart Rate/BP
Intervention
GCS: Modified for children
How to assess environment and exposure
Temperature
Glucose: if not already measured
Rashes
Skin integrity
Intervention
Manage pyrexia
Manage hypoglycaemia
Manage wounds
How to escalate
Use SBAR
Situation - describe the current situation or problem
Background - provide relevant context and info
Assessment - present findings/ patient conditions
Recommendation - actions to be taken