A-E Assessment

A Simple Guide To… An A-E Assessment

About 90% of you may have heard about A to E assessments.

If you fall into the 10% who haven’t heard of it, then fear not! Once you join the NHS, you will either observe it being done on the wards or you will have teachings on Managing unwell patients where you can learn more in depth.

A to E assessment is an assessment used by medical professionals in the NHS when reviewing an unwell patient.

It is a step by step, systematic review which includes clinical assessment, investigations and interventions.

This system ensures problems being identified and addressed. Re-assessment is required to ensure patient is responding to your interventions.

To teach you how to do this assessment is past the scope of this guideline and because it’s more of a practical lesson (tune in for our Weekend Webinar!), we’ve simply provided a basic guide of the key components which make up your assessment.

A – AIRWAY

  • Assessment: Is the airway patent? Is the patient able to communicate? Any stridor?
  • Investigation: Open mouth and see if anything visibly obstructing
  • Intervention: ITU involvement for ?Intubation, Jaw thrust, Oropharyngeal/nasopharyngeal airways, CPR – etc

B - BREATHING

  • Assessment: respiratory effort? Use of accessory muscles? Resp distress? Coughing?
  • Investigations: Respiratory rate, Oxygen saturation, VBG/ABG, auscultation, chest xray
  • Intervention: ??15L oxygen via non-rebreather mask needed

C – CIRCULATION

  • Assessment: Pallor, drowsy, oedema
  • Investigations: Heart rate, blood pressure, JVP, CRT, urine output, heart ausculation
  • Interventions: ??Fluid bolus, 2 cannulas, ECG, take bloods (FBCs, LFTs, U&Es, CRP, Clotting, VBG/ABG)

D – DISABILITY

  • Assessment: GCS, AVPU, pupils (PEARL), new neurology?
  • Investigations: CT? Glucose
  • Interventions: dependant on the cause

E – EXPOSURE

  • Assessment: Expose body (with dignity) and assess for sites of infection/bleeding etc, abdominal examinations, check limbs.
  • Investigations/ Interventions: depends on your findings: ??XR, ??CT

RE-ASSESSMENT IS NECESSARY

Documenting this assessment can be found above under “Documentation”

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