Rapid Assessment of the Acutely Ill Patient sets out the principles and practices needed for early recognition and assessment of patients either at risk of or showing signs of acute deterioration, or those recently relocated from higher levels of care. The focus is on patient assessment, interpretation and evaluation of data, immediate management of significant problems, ongoing and further assessments in order to improve clinical outcomes.

Rapid Assessment of the Acutely Ill Patient provides a framework for a systematic initial patient assessment and explores principles of effective assessment. Body systems are considered in order of life-threatening priority following the ABCDE approach, dealing with the assessment and management of airway, breathing, circulation, disability - and everything else; covering topics such as visual, palpatory and auscultatory assessment, use of additional documented information (charts, notes etc), and interpreting diagnostic investigations. Methods to ensure effective communication and team-working are also discussed.

• Part of the Essential Clinical Skills for Nurses series
• Aimed at nurses working in wards and specialist departments
• Explores the assessment skills required for a rapid response to a patient at risk of becoming acutely unwell
• Enables students and practitioners to develop practical and interpretative skills
• Provides a framework for assessment and principles of first line treatment
• Includes 'Look', 'Listen', 'Feel' and 'Measure' icons

Sheila Adam is Head of Nursing, Specialist Hospitals Board, UCL Hospitals NHS Foundation Trust and author of Nursing in Critical Care: Science and Practice (now in its 2nd edition), The Oxford Handbook of Critical Care Nursing and Nutrition in the Critically Ill.

Mandy Odell is Nurse Consultant in Critical Care, Royal Berkshire NHS Foundation Trust, Nurse and Allied Health Professional representative for the Intensive Care Society and former Chair of the British Association of Critical Care Nurses.

John Welch is Nurse Consultant in Critical Care, University College London Hospitals NHS Foundation Trust, and former Chair of the National Outreach Forum.

Foreword vi

Preface viii

1. Why Rapid Assessment Is Essential for Ward Staff 1

2. Track and Trigger Systems: Early Warning Scores, Calling Criteria and Rapid Response Teams 13

3. Assessment Techniques 30

4. A-B-C-D-E: Airway Assessment and Management Techniques 43

5. A-B-C-D-E: Breathing (and Failure to Breathe) 61

6. A-B-C-D-E: Circulation (and Circulatory Failure) 98

7. A-B-C-D-E: Acute Neurological Care (Disability) 153

8. A-B-C-D-E: Everything that Should Be Considered for Other Potential Problems 181

9. Patient-centred Care, Team Working and Communication 198

Appendix 1: Acid-Base Balance and Arterial Blood Gases 221

Appendix 2: Oxygen Delivery Devices 227

Index 232