Diagnosis of breathing problems:

Diagnosis of circulation problems:

Look, Listen, Feel, ABG, pulse oximetry
Signs & symptoms:
SOB
Hypoxia
Hypercarbia
Irritability
Confusion
Lethargy
Cyanosis

Call for expert help early

Management of breathing problems:

Give oxygen 15 L/min through a non
rebreathe bag mask
Aim for sats of 94-98%

Capillary refill, pulse, BP

Causes of breathing problems:

Decreased respiratory drive (CNS
depression, drugs)
Decreased respiratory effort (neurological,
muscular, weakness)
Lung disorders (asthma, COPD, ARDS)
Tension pneumothorax

Treat cause (salbutamol/ipratropium asthma, adrenaline -anaphylaxis)

Management of airway obstruction:

Head tilt / chin lift
Removal of obstruction (finger sweep,
suction)
Recovery position
Nasopharyngeal airway (better tolerated
than Guedel)
Oropharyngeal (Guedel)

Primary heart disease or secondary heart

abnormalities. Cardiac arrest is most
commonly secondary to MI.
Commonest arrest rythm is VF (ACS,
hypertensive cardiac disease, valve
disease, drgs, etc.)

Breathing

Diagnosis of airway obstruction:

Patient choking
Cyanosis
Stridor
Patient straining to breathe
"see saw" breathing (uncoordinated chest &
abdominal breathing

Causes of circulation problems:

Circulation

Causes of airway obstruction:

Mechanical (eg. Blood, vomitus, foreign
bodies)
Trauma (bamage to airways)
Anaphylaxis (angioedema)
Infection (epiglotitis)
CNS depression
Neurological (Guillame-Barre, myasthaenia
gravis)
Laryngospasm
Bronchial secretions

Help:
If unable to solve threat quickly call
anaethetist to insert airway

Signs & symptoms:

Chest pain
SOB
Tachycardia
Bradycardia
Inreased RR
Hypotension
Syncope
Decreased GCS
Management of circulation problems:
Cannula insertion
Bloods (FBC, U&E, LFTs, cardiac markers >
6hrs)
Fluids if hypotension (be wary of fluids in
cardiac problems - possibility of fluid
overload. Try fluid challenge of 250ml but if
unsure wait for expert help)
If cardiac arrest then follow ALS algorithm

Airway

Diagnosis of disability (unconciousness):

ABCDE
Disability
Common causes of unconciousness:
Profound hypoxia
Profound hypercapnia
Cerebral hypoperfusion
Drugs (sedatives, analgesics)

Handover:
It is important to give a structured
description about the patient &
situation to seniors

A - alert
V - response to verbal communication
P - response to pain
U - unresponsive
Pupils (size, equality and reaction to light)
Glucose (diabetes)

Management of Disability (unconciousness):

Reassess A, B, & C
Treat underlying causes

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S -situation
B - background
A - assessment
R - recomendation

Exposure:
Examine the patient thoroughly!
Remember to respect the patients dignity
Minimise heat loss