Critical Care Course

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UNIVERSITY OF WEST LONDON COLLEGE OF NURSING, MIDWIFERY AND HEALTHCARE Introduction to Care of the Critically Ill Patient (January 2013 Course 2) Critically Analyse the Objective Structured Clinical Examination Student Nr: 21228546 London, 18th April 2013 Nr of words: 1067 Introduction This essay consists of a critical analysis of an ABCDE (Airway, Breathing, Circulation, Disability, Exposure) assessment, of a given study case (see appendix 1) in the context of the course: Introduction to Care of the Critically Ill Patient. An ABCDE assessment was completed, and the patient’s observations recorded on a NEWS (National Early Warning System) chart. Care was escalated appropriately, using SBAR as a communication tool. Professional Behaviour Dignity and respect were demonstrated when approaching Mrs Sarah, by closing the curtains before starting the assessment, and asking Sarah’s permission to start the assessment (Kacmarek et al 2013). Universal precautions were taken regarding infection control, by washing hands and using apron and gloves (NICE 2012). A – Airway Patient’s airway was patent, but Mrs Sarah was unable to complete sentences, due to breathlessness, which corresponds to a moderate asthma exacerbation (Holgate and Douglass, 2010). Airway assessed for snoring, stridor gurgling, and none of these were found. Wheezing was present, which suggests constriction or spasm of the lower airways (Margereson and Withey, 2012) Sarah was able to cough and clear secretion, green sputum was produced, Rwhich can suggest bacterial infection. Risks of aspiration can be assessed by asking a patient to cough effectively (Margereson and Withey, 2012). B – Breathing No signs of central cyanosis were present (seen in oral mucosa). Sarah appeared pale and with bluish fingers, a sign of peripheral cyanosis, which might be a result of hypoxaemia, as per Margereson and Withey

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