The following highlights resources available for nurses, midwives, and health professionals in Scotland to support care of the deteriorating adult including those with Covid 19.
This is not fully inclusive and is designed to be a starting point for individual exploration and learning.
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The Airway, Breathing, Circulation, Disability, Exposure/Examination (ABCDE) approach is a systematic approach to the immediate assessment and treatment of critically ill or injured patients.
Introducing the ABCDE assessment
Obstruction of the airway is an emergency which requires immediate expert help. Untreated, airway obstruction causes hypoxia and risks damage to vital organs and death.
This slide set details considerations when a deteriorating patient requires intubation outside the critical care environment. Topics include : indications and risks of intubation; equipment review and assisting an intubation.
Best practice guidelines outlining risks associated with ETT and standards of care.
This short video examines how a practitioner who is new to intensive care can support the intubation of a patient.
Ventilator management essential skills for non-ICU nurses assiting duration intubation : video (8.32)
Immediate assessment of breathing, is vital to diagnose and treat life-threatening conditions such as acute severe asthma and tension pneumothorax.
A patient centred approach to Acute Non-Invasive Ventilation
Review of ARDS and specific considerations in the context of COVID-19.
How to prone and unprone a patient in critical care
Arterial Blood Gas (ABG) course 2 : Medical Acid Base Balance, disorders & ABGs explained clearly
Arterial Blood Gas (ABG) course 2 : Medical Acid Base and ABGs explained clearly
(Note these ABG resources were not produced in the UK and as such the units of measurement will likely vary from those used locally)
Additional Resources
In most medical and surgical emergencies, hypovolaemia should be the considered the primary cause of shock until proven otherwise.
Hemodynamic Basics for Nursing Students
An introduction to vasopressors
Arterial blood pressure monitoring : learning resource for critical care nursing staff ( Download, 2 MB)
Central venous access devices (CVADs) workbook ( Download, 304 KB)
Central venous catheter : learning resource for critcial care nursing staff ( Download, 2 MB)
Invasive monitoring [updated July 2020] ( Download, 2 MB)
Invasive monitoring 2 [updated July 2020] ( Download, 844 KB)
Use of vasoactive drugs ( Download, 203 KB)
The Resuscitation Council UK, report common causes of unconsciousness which include profound hypoxia, hypercapnia, cerebral hypoperfusion, or the recent administration of sedatives or analgesic drugs.
SIGN: Care of deteriorating patients
Comprehensive examination of the patient will require them to be exposed, with clothing, bedding adjusted or removed as necessary.
Examine the patient for signs of trauma, bleeding, skin reactions, needle marks, or other potential causes for the deterioration in their condition. Care should be taken to minimise heat loss and preserve the patient’s dignity.
Additional information will also be required as detailed by the Resuscitation Council UK - The ABCDE Approach | Resuscitation Council UK
Assessment of COVID-19 in primary care (sign.ac.uk)
Coronavirus (Covid 19) learning materials
Recognising and responding when a patient is deteriorating
Feeding Patients on Critical Care Units in the Prone Position
Non-critical care staff in critical care
Edinburgh Napier University Interactive game – Covid 19 training
We hope you enjoy exploring the site and have found it useful. We welcome your feedback to inform ongoing development of deteriorating patient resources. If you have any comments, ideas or suggestions, please complete the short feedback form or email us directly at PerioperativeNMaHP@nes.scot.nhs.uk