Reminder on the ABCDE assessment

When we assess a patient who is critically ill or deteriorating, it is recommended by the Resuscitation Council that we use the Airway, Breathing, Circulation, Disability, Exposure (ABCDE) Approach. This is a systematic way to ensure nothing is missed, and to treat life threatening problems before moving on to the next part of the assessment. This can be done by a single rescuer, or by a full team and once it is completed, re-assess regularly to check for the effects of any of the treatment instigated.

So what does the ABCDE Approach mean? When we are using this, we look for problems with each section and rectify the issue before moving on. Here are just some examples of what to look for:


  • Look for signs of airway obstruction, such as choking or noisy breathing.


  • Look, listen and feel to check there is breathing. Check for signs of respiratory distress such as the use of accessory muscles, an increased or decreased rate (a normal rate is 12-20 breaths per minute for an adult), check for depth of breaths and that both sides of the chest are equal. You may be able to check oxygen saturations.


  • Look for signs of poor circulation, such as pale and clammy skin, blue tinges to the skin, fast and weak pulse, delayed capillary refill time, a low blood pressure.


  • This looks at the neurological status of our patient. Are they conscious, unconscious, or in the scale in between (using the AVPU scale). Check the blood sugar level to exclude hypoglycaemia as a cause.


  • This means getting down to skin level, when appropriate. Look for rashes, injuries or anything else that will give us a clue about the cause of the illness. Always make sure we respect the patient’s dignity and minimise heat loss.


This approach can be used for any critical illness including chest pain, breathing difficulties, anaphylaxis or sepsis and its use ensures we can treat our patients most effectively. This approach is covered in many of our courses, where it can be discussed, made relevant for your job role and environment, demonstrated and practised to ensure you are really familiar with it. Call our office to see how we can help you.

Written by Sophie McCracken 7th May 2017