3BDS: Human disease ABDCE, NEWS, handover

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when to use an ABCDE assessment?
Any patient who is acutely unwell or deteriorating
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why to do an ABCDE assessment
Gives a baseline of physiology of that patient (vital signs and when comparing vital signs later to see if patient gets getter or not)
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true or false
• Do not move onto next stage before you’ve completed and sorted the current stage
true
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what would you do if you're assessing C but B gets worse
go back to B
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why do we assess A before B and etc
because we assess in order of importance
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before you see your patient for their dental treatment: what should you know and make sure?
Make sure you know what their medical history is. And what you could expect to happen
Check they have emergency meds with them (such as salbutamol inhaler, GTN spray, glucose tabs). if they don’t have these meds with them, make sure you know where emergen
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how do you know the airway is okay ?
- If the patient is talking
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How do you know the airway is not ok?
- If the breathing is noisy then likely airway obstruction (by vomit, laryngeal spasm etc)
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How do you open the airway if it is occluded?
- If you can see the object: remove it
- Airway opening manoeuvres- head tilt and chin lift +/- jaw thrust
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what if patient is unconscious? and air way obstructed
insert airway adjunct (oropharyngeal or nasopharyngeal airway) + ventilate with bag valve mask and high flow oxygen via rebreather bag
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How do you assess the breathing?
Look, listen and feel- count respiratory rate ) and effort, look at colour, listen for wheeze, not being able to finish sentences
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What is a normal respiratory rate?
what is not great but you wouldn't be concerned? what is very bad
- 12-20 breaths per minute
- Around 10 is not great but you wouldn’t be overly concerned about the patient
- Below 8 is very concerning especially if you’ve given them respiratory depressant drugs like OPIOIDS, benzodenzopins*
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What is a normal oxygen saturation?
- 96% and above
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what if someone has an oxygen saturation below 96%?
indicates significant respiratory problem
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If someone is not breathing, what will you do?
- If a person is unresponsive and not breathing, start CPR (30 chest compressions, 2 rescue breaths, get AED)
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what do you assess at circulation stage
- Heart rate
- Blood pressure
- Capillary refill time
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where do you assess heart rate?
radial pulse: underneath the thumb but Feel for carotid pulse in the neck if radial absent this will mean blood pressure is low and they are ill
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what is the normal HR
Normal heart rate in an adult= 60-100 bpm
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What is normal systolic blood pressure? what is a concerning systolic blood pressure
o Systolic 110 mmHg to
140mmHg
o Concerning if less than 100mmHg systolic, below than 90 VERY worrying
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how would you check pulse and respiratory rate at the same time
- Count pulse for 30 seconds and double to get bpm
- Count respiratory rate for 30 seconds and double to get breaths per minute
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when would you use a manual BP?
if someone has an irregular heart beat AF
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what is capillary refill time
time taken for compressed emptied capillaries to refill once you remove pressure from them)
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what is the usual capillary time
around 2 seconds
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why would the capillary refill time be longer if the person is cold
due to vasoconstriction
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what do you check in the disability section
- Diabetes: check blood glucose
- ACVPU scale
- FAST: face (no asymmetry), arms (working symmetrically/ sensation), speech (normal or difficult)
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what do you check in the exposure section ?
- Temperature (low <36 or high >38 can be a marker of sepsis
- Any rashes?
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in what people should NEWS not be used in
children under 16, pregnant women
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what is news used for
standardising the assessment of acutely ill people. alerting clinicians to severity of physiological compromise and urgency of intervention required
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what do you use to write a handover? what does it stand for
SBAR
situation, background, assessment, recommendation
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what is under situation?
introduce yourself, summarise main problem
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what is under background
relevant positive and negative findings in medical and dental history, sequence of events
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what is under assessment
what the observations are, news score if you know it, what do you think is the diagnosis
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what is under recommendation
communicate clearly what you would like from the other clinical
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Other cards in this set

Card 2

Front

why to do an ABCDE assessment

Back

Gives a baseline of physiology of that patient (vital signs and when comparing vital signs later to see if patient gets getter or not)

Card 3

Front

true or false
• Do not move onto next stage before you’ve completed and sorted the current stage

Back

Preview of the front of card 3

Card 4

Front

what would you do if you're assessing C but B gets worse

Back

Preview of the front of card 4

Card 5

Front

why do we assess A before B and etc

Back

Preview of the front of card 5
View more cards

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