ABCD Assignment

Shayne Michelle B.
Dela Cruz
SXN23S1BE
The principles of ABCDE approach is the assessment and treatment of the patient sequentially
starting through the airway, breathing, circulation, disability, and its exposure. Treat life
threatening problems before moving to the next part of the assessment. First, assess the airway
of the patient, make sure that the airway is open. You can assess by talking to the patient, look,
listen and feel the air. You may check the movement of the abdomen and also hear the air from
the nose. You can also check the Oxygen Saturation (SpO2) of the patient, normal SpO2 should
be between 96% to 99%. If airway is blocked the patient will be unconscious and it may cause
hypoxic brain damage. We need to open the airway immediately, assess what may cause the
blockage and treat. One of the most common thing that blocks airway in an unconscious patient
is that their tongue falls back, extend the neck and pull the tongue forward and reassess the
patient. Some also may cause of airway obstruction is inhaling or swallowing a foreign object,
allergic reaction, trauma of the chest, head or neck. Jaw Thrust maneuver can also be used
in any other situation in which an unconscious person with a potential spinal injury is at risk of
blocking their airway. High concentration of oxygen can be given for a short period of time.
Reassess the patient before going to the next step. Second, assess for breathing, assess the
depth of each breath, the pattern of respiration and whether chest expansion is equal on both
sides. Check the respiratory rate and also oxygen saturation. The normal respiratory rate of an
adult patient is 12-20 breaths per minute. Check for tachycardia and bradycardia, give proper
ventilation. You may hear stridor for partial obstruction of upper airway and no sounds for
complete obstruction. Percuss the chest, for hyper-resonance it may suggest a pneumothorax
and if there is dullness it will usually indicate pleural fluid. We can improve breathing by sitting
up for normal patients, and for emergency if the patient is not breathing, we need to breathe for
them. Use bag-mask or pocket mask ventilation to improve oxygenation and ventilation.
Reassess the patient before going to the next step. Third assessment is for the circulation. You
should learn how to check and palpate peripheral and central pulses. Normal pulse rate is 60-
100 beats per minute. Barely palpable central pulses suggest a poor cardiac output, whilst a
bounding pulse may indicate sepsis. Also check for blood pressure. Normal blood pressure level
is less than 120/80 mmHg. Measure the capillary refill time, the normal value is usually less than
2 seconds. A prolonged capillary refill time indicates a poor peripheral perfusion. Check for other
signs of a poor cardiac output, such as reduced conscious level. Also check if there are
hemorrhage. If there is hypovolemia, give the right fluids. Reassess the heart rate and BP
regularly. For fourth part, assess for disability, use the principles of GAP – glucose, AVPU, and
pupils. Glucose normal level, for fasting blood glucose test the normal is between 70 and 100
mg/dL. AVPU stands for alert, responsive to voice, pain, use the Glasgow Coma Scale score. A
normal GCS score is equal to 15, which indicates a person is fully conscious. For pupils,
examine the size, equality and reaction to light. And for the exposure, examine the patient’s
whole body, properly full exposure may be necessary. Maintain a private environment and
respect the patient’s dignity. Monitor for body’s temperature, the average body temperature is
98.6 F (37 C). When using ABCDE approach is assessing and treating a patient, assess in
sequential order and assess the effectiveness of the approach. Reassess regularly, call for
appropriate help if needed. Use SBAR for communication – Situation, Background, Assessment,
Recommendation. The ABCDE method is a potent clinical tool for the preliminary evaluation and
management of patients. It aids in determining the severity of a disease and prioritizing early
treatment interventions.

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Shayne Michelle B.

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