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What to do when you don’t know what to do…
Christopher D Mills Medical and Intensive Care Registrar Monash Health
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D Danger
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D Danger Don’t Panic
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R Response
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D Response Reminisce
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A Airway Maintained? Own? Tubed? Can I Fix This?
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Signs of respiratory compromise?
B Breathing Can they talk to me? Signs of respiratory compromise? RR? SaO2? Chest Examination? Blood Gases? CXR? CT Chest? Can I Fix This?
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C Circulation Can I Fix This? Pulse? Blood Pressure? Rhythm? Rate?
ECG? Cardiac Sounds? Can I Fix This?
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DON’T EVER FORGET GLUCOSE!
Disability GCS? Moving all 4 limbs? Coherent / Oriented? CT Brain? LP? DON’T EVER FORGET GLUCOSE! Can I Fix This?
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?
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Electrolytes and Metabolic
EUC? CMP? Can I Fix This?
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F Fluid What? How much? Volume Status? Urine? Can I Fix This?
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Abdominal Examination?
G GIT Abdominal Examination? Surgery? Scars? Output? PR? CT Abdomen? LFT? Lactate? MOVE THE BED SHEETS! Can I Fix This?
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H Hb / Clotting Can I Fix This? Hb? Platelets? INR / aPTT?
D Dimer / Fibrinogen? Declotting Stuff? Can I Fix This?
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I Infection IS THIS PERSON SEPTIC? Can I Fix This? Temperature? WCC?
Ferritin? CRP? IS THIS PERSON SEPTIC? Can I Fix This?
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J Juice (Drugs) Can I Fix This? Medications? Do I need anything now?
What have we given? Can I Fix This?
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Are they aware of what is going on?
K (Next of) Kin Are they present? Are they aware of what is going on? Prognosis? Can I Fix This?
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L Lines IF YOU CAN’T GET IT – ASK! Can I Fix This? What do I have?
What do I need? IF YOU CAN’T GET IT – ASK! Can I Fix This?
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Significant Injury (eg. NOF #)
M Musculoskeletal Significant Injury (eg. NOF #) Bleeding into muscle? Can I Fix This?
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Do they have a Toxidrome?
N Narcotics / Toxins Have they had any? Do they have a Toxidrome? Have we checked? Can I Fix This?
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Is there anything else unique to this patient that is important?
Other Stuff Is there anything else unique to this patient that is important? Can I Fix This?
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Will they have any with what I’m about to do?
P Pain Do they have any? Will they have any with what I’m about to do? Can I Fix This?
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Q Transfusion Have they had one? Do they need one? Can I Fix This?
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Should we be doing what we are doing?
Resus Status Documented? Should we be doing what we are doing? Can I Fix This?
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Is there any other treatment?
Skin and Wounds Documented? Is there any other treatment? Can I Fix This?
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