Transcript ABCD - What to do when you don`t know what to do

Christopher D Mills
Medical and Intensive Care Registrar
Monash Health
Danger
Danger
Don’t Panic
Response
Response
Reminisce
Airway
Maintained?
Own?
Tubed?
Can I Fix This?
Breathing
Can they talk to me?
Signs of respiratory compromise?
RR?
SaO2?
Chest Examination?
Blood Gases?
CXR?
CT Chest?
Can I Fix This?
Circulation
Pulse?
Blood Pressure?
Rhythm? Rate?
ECG?
Cardiac Sounds?
Can I Fix This?
Disability
GCS?
Moving all 4 limbs?
Coherent / Oriented?
CT Brain?
LP?
DON’T EVER FORGET GLUCOSE!
Can I Fix This?
?
Electrolytes and
Metabolic
EUC?
CMP?
Can I Fix This?
Fluid
What?
How much?
Volume Status?
Urine?
Can I Fix This?
GIT
Abdominal Examination?
Surgery?
Scars?
Output?
PR?
CT Abdomen?
LFT?
Lactate?
MOVE THE BED SHEETS!
Can I Fix This?
Hb / Clotting
Hb?
Platelets?
INR / aPTT?
D Dimer / Fibrinogen?
Declotting Stuff?
Can I Fix This?
Infection
Temperature?
WCC?
Ferritin?
CRP?
IS THIS PERSON SEPTIC?
Can I Fix This?
Juice (Drugs)
Medications?
Do I need anything now?
What have we given?
Can I Fix This?
(Next of) Kin
Are they present?
Are they aware of what is going on?
Prognosis?
Can I Fix This?
Lines
What do I have?
What do I need?
IF YOU CAN’T GET IT – ASK!
Can I Fix This?
Musculoskeletal
Significant Injury (eg. NOF #)
Bleeding into muscle?
Can I Fix This?
Narcotics / Toxins
Have they had any?
Do they have a Toxidrome?
Have we checked?
Can I Fix This?
Other Stuff
Is there anything else unique to this patient that is important?
Can I Fix This?
Pain
Do they have any?
Will they have any with what I’m about to do?
Can I Fix This?
Transfusion
Have they had one?
Do they need one?
Can I Fix This?
Resus Status
Documented?
Should we be doing what we are doing?
Can I Fix This?
Skin and Wounds
Documented?
Is there any other treatment?
Can I Fix This?
?