Recognising the Acutely Unwell
Recognising the acutely unwell and prevention of Cardiac Arrest is the first link in the Resuscitation Council’s Chain of Survival. It’s the first link because if we can recognise problems earlier they are easier to deal with. We are also more likely to prevent them from deteriorating further and having a cardiac arrest. Recognising and managing an acutely unwell adult or child is key and this is where our ABCDE approach is so important. During my sessions I spend half the time discussing recognising and responding to the acutely ill person and how to carry out an ABCDE approach. I’m currently working on an emergency record and handover sheet for my customers which I’m hoping will act not only as a record sheet but also a prompt.
When I attended the Resuscitation Council Symposium there was a presentation on Recognising an unwell adult. The speaker said that Respiratory Rate and Heart Rate are still the two biggest predictors of deterioration, followed by age. She also said that carer’s concern is also important – that sense we have that someone is ‘not right’.
The good thing is that respiratory rate and heart rate are two things we can measure wherever we are as neither require any fancy equipment. Therefore, please continue to measure your patient’s respiratory rate and feel their pulse. An increasing respiratory rate is a sign of deterioration, as is an increasing pulse or a weak fast pulse. A very slow breathing rate or very slow pulse rate can also be a sign of illness. I’ve provided links below to blogs I’ve written previously that might be useful.
I always feel that assessing someone when you may be sending them home carries its own difficulties. We rely on them knowing when to come back, so our ‘safety netting’ is very important. We need to ensure that our patients know when and how to access emergency help.
Please continue to record respiratory rates and heart rates as this will help you to help your patients.
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