Initial Assessment and Management of Emergency Patients
Primary Survey: ABCDE Approach
- The American Heart Association recommends assessing airway patency and providing immediate intervention if compromised, administering supplemental oxygen to hypoxemic patients, and checking oxygen saturation via pulse oximetry within the first 10 minutes of arrival 1, 2
- The American Heart Association suggests establishing or confirming IV access immediately, obtaining blood samples for baseline studies, and measuring blood pressure to assess for signs of poor perfusion 1, 2, 3
- The European Society of Cardiology recommends assessing pulse rate, rhythm, and quality, and applying cardiac monitoring for all patients with suspected cardiac or neurological issues 1, 2, 4
Critical Actions Based on Presentation
- For suspected stroke, the American Heart Association recommends assessing the patient within 10 minutes of arrival, verifying exact time of symptom onset or last known well, and ordering emergent CT scan of the brain 1, 2, 5
- For suspected cardiac issues, the American College of Cardiology recommends obtaining 12-lead ECG, administering aspirin 160-325mg orally, and considering sublingual nitroglycerin unless contraindicated 1, 4, 6
- For pediatric patients, the American Academy of Pediatrics suggests using age-appropriate assessment tools and equipment, and triaging as P-CTAS Level 2 in most cases 5, 8, 9
Communication and Documentation
- The International Journal of Stroke recommends obtaining detailed handover from EMS personnel, including time of symptom onset or last known well, vital signs, and interventions performed pre-hospital 3, 5
- The European Heart Journal suggests documenting all findings and interventions with accurate timestamps, and using structured communication tools when escalating care to specialists 3, 5