Volume 26 Number 1
Critical Care Check List
By Frank Hubbell, DO
The Big Idea is that, occasionally, significant life-threatening injuries do occur, and when they do, we have to be able to quickly react to them. The last time that we did a review article on these life-saving skills was in 2007.
The life-saving, critical care skills are not used nearly as often as the more common non-critical care skills. The vast majority of the time our patients are conscious, coherent, and can tell us exactly what happened, when it happened, and where it hurts. They usually have only one primary injury, and it is rarely life-threatening.
Because of this, our critical care skills tend to get a little dusty. It is well worth it to every once and a while to take the time to blow off the dust and polished these skills.
What follows is a concise, step-by-step review list to help practice and remember these life-saving skills, so they will come to mind when they are needed. For life-saving skills to be effective, the life-threat has to be recognized quickly and dealt with effectively. Time is of the essence, but it is also equally important not to miss anything.
To make this task as efficient and accurate as possible, it is best to use a step-by-step list, trying to avoid any detours that will only result in confusion and the possibility of missing a critical step and diagnosis.
These are the Principles of Rapid Critical Care Evaluation for Detecting and Managing Life-Threats:
Change in Level Of Consciousness – CVA, diabetes
Shortness of Breath – asthma, chocking, anaphylaxis, pneumothorax
Chest Pain – acute coronary syndrome
Shock – hypovolemic, neurogenic, cardiogenic, obstructive
RAPID CRITICAL CARE EVALUATION:
(aka the primary survey)