R ecognition of E mergency signs, A ssessment of C ause and T reatments. WELCOME TO REACT!. OUTCOMES OF REACT TRAINING. Multidisciplinary Team approach to Patient Care Sharing of knowledge and skills All singing from the same hymn sheet Use of the MEWS scoring system within HCA
Multidisciplinary Team approach to Patient Care
Sharing of knowledge and skills
All singing from the same hymn sheet
Use of the MEWS scoring system within HCA
NCEPOD (2005) report: ‘An acute problem’
Reviewed 1,677 pts admitted to medical ICU’s in
NPSA (2007) report: ‘Safer care for the acutely ill patient: learning from serious incidents’
Reviewed 1,804 serious incidents that result in death. 576 deaths could be interpreted as potentially avoidable!
Key theme 1: clinical or physiological
deterioration not recognised or not acted upon
Key theme 2: resuscitation after
A & B : Treat what kills first!
A B C D E
Communicate results, and document
Achieves a comprehensive & universal approach to caring for sick patients
= RED FLAG
Aims to assist the MDT improve the quality of care provided by:
Look Rate, colour, depth, chest movement, agitation, accessory muscle use
ListenSpeech, Noises, Cough, Auscultation.
FeelExpansion, Pulse, Percussion, Palpation
Other Tests: SpO2, CO2, PaO2, Blood Gases
Respiratory rate <8 WHY?
Respiratory rate >20 WHY?
Is this a red flag?
Give high flow oxygen
Call expert help!
To revise the principles of
circulatory physiology and
place into context for
To maintain hemodynamic stability we need to maintain perfusion, transportation and excretion. Therefore we require a healthy:
Vessels Blood Pressure
Reduced filling due to hypovolaemia (Preload)
Reduced muscle power due to a heart muscle damage (Contractility)
Reduced vessel tone, vasodilatation (SVR)
CONSIDER THE CIRCULATION AS A WHOLE
Heart / peripheries / volume
Assessing the patient’s level of consciousness (LOC)
Direct (Neuro) Causes
The 5 H’s:
1-3 result in cerebral oedema which leads to cerebral ischemia.
Verbal, responds to voice -
Pain. Responds to painful stimuli -
If a patient is only responding to :
Call for help immediately
regardless of any other observation
Check blood sugar level!
What can cause an altered blood sugar level?
Don’t forget to assess the patients
AVPU ( Newly confused)
Fully examine your patient
Look Top to toe
(remember privacy/ dignity)
U’s & E’s
To be completed when ever a patient triggers a MEWs of 4 of more
ALERT (2006) Acute Life Threatening Events
Recognition and Treatment. Portsmouth Hospital
NHS Trust. Alert.firstname.lastname@example.org
British Thoracic Society (2008) Guidelines for
Emergency Oxygen use in Adult Patients.
Dr Terris, M. (2007) Queens University Belfast.
Clinical Skills Education Centre. www.qub.ac.uk