Prioritizing Treatment in Emergency Care
Have you ever witnessed an emergency take place? Whether it’s a vehicle accident, medical emergency, or fall; have you ever wondered what you would do or where you would even start to assist someone who’s experiencing an emergency? Well, that’s exactly what this blog post will be covering! We will be giving you the exact treatment algorithm that is utilized by licensed paramedics on emergency scenes. This simple acronym can prepare you to make a difference in a loved one’s life when the unexpected happens.
Emergency medical providers follow a systematic approach when treating patients at the scene of an accident or medical emergency. The ABCDE acronym stands for Airway, Breathing, Circulation, Disability, and Exposure. The purpose of the ABCDE acronym is to break down complex emergency medical situations into manageable parts. This approach helps ensure critical life-saving interventions and prioritizes treatment to maximize positive patient outcomes.
When it comes to saving a life, just remember the first 5 letters of the alphabet!
A – Airway: The airway refers to the passage that allows air to flow into the lungs- the trachea. Assessing and clearing a patient’s airway is the top priority. Responders will check for airway obstruction or compromise and perform life-saving interventions like clearing the airway or securing airway access through basic to advanced means. This is initially accomplished utilizing a head-tilt/chin-lift maneuver for medical patients and the jaw-thrust maneuver for trauma patients. This could further include placement of basic devices such as oropharyngeal or nasopharyngeal adjuncts, to advanced interventions such as endotracheal intubation (life support). In extreme cases, when a foreign body cannot be removed or an airway is swollen shut, interventions such as a surgical cricothyrotomy may be necessary to establish airway patency.
B – Breathing: Once the airway is open and clear, the responder will assess if the patient is breathing normally. They will check for adequate respiratory rate, depth, and oxygenation. The provider will also examine chest rise and fall for any asymmetrical chest movement or unilateral breath sounds during auscultation. If breathing is compromised, they will provide oxygenation support and ventilation using a bag valve mask or other device such as a ventilator.
C – Circulation: Responders will then assess the patient’s circulation by checking a central pulse (carotid/femoral) rate, capillary refill time (normal is <2 seconds), and blood pressure. They will check for findings such as pallor, cyanosis, distended neck veins, and treat any major bleeding as it is discovered during the initial assessment. IVs or interosseous catheters may be placed to provide fluids and medications to support circulation.
D – Disability: A neurological assessment is performed to determine a patient’s current mental status or level of consciousness using AVPU or the Glasgow Coma Scale. AVPU is the simplest acronym for assessing a patient’s mental status, AVPU stands for how the patient responds to stimuli from the medic.
- A: Alert- is the patient alert?
- V: Voice- do they respond to verbal stimuli?
- P: Pain- do they respond to painful stimuli? Such as applying pressure to the patient’s fingernail bed.
- U: Unresponsive- is the patient unresponsive to all stimuli?
For patients with altered mental status, blood sugar is checked, the provider may administer a stroke scale such as a FAST exam, or naloxone may be administered if a narcotic overdose is suspected.
E – Exposure: Be mindful of the environment that the patient resides in, prevent and treat for hypo/hyperthermia. While respecting patient dignity, remove the patient’s clothing if necessary to fully assess for unseen injuries. Patient temperature must be monitored during this stage especially on scene to prevent hypothermia. Modesty is provided using blankets and sheets once the full body assessment is complete.
In summary, the ABCDE approach provides a systematic way for emergency responders to establish a patient’s critical life functions, prioritize treatment, and maximize the chances of survival and positive outcomes in emergency situations. By following this approach, responders can stabilize a patient’s condition as quickly as possible before transporting them to a hospital for further care. Remember to record all findings and treatments provided during patient contact to relay to receiving agency or facility.
Stay Response Ready.