Assessing the Acutely Ill
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Assessing the Acutely Ill







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Assessing the Acutely Ill. M.Lynch BSc(Hons).PGCertEd.RM.RN Lecturer/Practitioner Critical Care &Surgery. Introduction.
Assessing the Acutely Ill

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Slide 1

Assessing the Acutely Ill

M.Lynch BSc(Hons).PGCertEd.RM.RN

Lecturer/Practitioner

Critical Care &Surgery.

Slide 2

Introduction

  • Healthcare workers should be competent in undertaking a systematic and comprehensive approach to patient assessment to enable early recognition of potential or actual deterioration in the patients condition

  • (DOH, 2001)

Slide 3

ASSESSMENT

  • Assessment is the first step in caring for a patient.

  • Careful assessment is fundamental in order to recognise when a patient is becoming compromised,

  • .

Slide 4

Structured Assessment

  • A AIRWAY (with c spine protection in trauma)

  • B breathing

  • C circulation

  • D disability (central nervous system function)

  • E exposure (with temp. control)

Slide 5

Assessment.con

  • Norman and Cook (2000)

  • What nurses know

  • What nurses see

  • What nurses find a quick physical assessment.

Slide 6

Mini assessment

Slide 7

Airway Assessment

  • Determine patency of the airway.

  • Look. Listen. Feel.Count the Resp. Rate.

Slide 8

AIRWAY OBSTRUCTION

  • Inspiratory Stridor : a rasping sound heard during inspiration as a result of obstruction above or involving the larnyx

  • Wheeze : is usually heard on expiration as a result of the lower airways collapsing

Slide 9

AIRWAY OBSTRUCTION

  • Gurgling occurs when secretions or liquid is present in the upper airways.

  • Snoring occurs during partial occlusion of the oropharynx due to relaxation of the oropharyngeal muscles and tongue

  • High pitched crowing sounds occur during laryngeal spasm

Slide 10

BREATHING

  • LOOK

  • LISTEN

  • FEEL

Slide 11

Circulation

  • Look : skin colour. CRT. Dehydration

  • drug chart.electrolytes.signs of

  • haemorrhage/fluid loss

  • Listen : accurate assessment of the heart

  • rate,pulse blood pressure

Slide 12

Circulation

  • Feel : pulse why? What can it tell us?

Slide 13

Disability

  • Neurological assessment

Slide 14

Disability

  • URINE OUTUT.

  • HALF A ML.X KG. X 24HRS.

    OLIGURIA. Production of between 100 –

    400mls x 24hrs.

    ANURIA. Below 100mls in 24hrs

    ABSOLUTE ANURIA NO URINE

Slide 15

EXPOSURE

  • TEMP.

  • Also a top to toe assessment allow us to see any areas that may have been missed in the initial ABCD eg wounds, areas of inflammation

Slide 17

Conclusion

  • A B C D E

  • Coupled with the MINI ASSESSMENT TOOL.

  • Provides a structured approach to patient

  • Assessment and a basis for further intervention / treatment.


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