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Diagnosis Reveal

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Initial steps

• [ ] Introduces themselves to the patient and whoever has requested the review (if relevant)
• [ ] Confirms the patient’s name and date of birth
• [ ] Ask how the patient is feeling (if possible)
• [ ] Take a brief history
• [ ] Ask other member of staff to assist where possible (including task delegation

Airway

• [ ] Checks patency of airway including inspection of mouth
• [ ] Performs appropriate manoeuvre if airway compromised (e.g. head-tilt-chin-lift or jaw-thrust)
• [ ] If no signs of life, puts out crash call and commences CPR
• [ ] Re-assesses after any intervention

Breathing

• [ ] Reviews the patient’s respiratory rate
• [ ] Reviews the patient’s oxygen saturation
• [ ] Inspection of chest
• [ ] Assesses chest expansion and trachea position
• [ ] Percuss the lungs
• [ ] Auscultate the lungs to assess air entry and for added sounds
• [ ] If no signs of life, pits out crash call and commences CPR
• [ ] Re-assesses after any intervention

Circulation

• [ ] Assesses pulse rate
• [ ] Assesses blood pressure
• [ ] Assesses CRT and peripheries temperature
• [ ] Performs IV cannulation using appropriate gauge and number of cannulas
• [ ] Request appropriate blood test: FBC, U&Es, LFT, coagulation profile, group and save
• [ ] Request ECG
• [ ] If no signs of life, puts out crash call and commences CPR
• [ ] Re-assesses after any intervention

Disability

• [ ] Assesses level of consciousness (using ACVPU or GCS)
• [ ] Assesses pupils using pen torch
• [ ] Checks capillary blood glucose +/- ketones
• [ ] Requests appropriate imaging: non-contrast CT head
• [ ] If no signs of life, puts out crash call and commences CPR
• [ ] Re-assesses after any intervention

Exposure

• [ ] Checks temperature
• [ ] Inspects for rashes, bleeding, bruising, wounds
• [ ] Examines abdomen and legs
• [ ] If no signs of life, puts out crash call and commences CPR
• [ ] Re-assesses after any intervention

Referral and handover

• [ ] Recognise need to request senior review
• [ ] Suggest review by trauma team
• [ ] Seeks review from appropriate team (e.g. neurosurgery)
• [ ] Uses a structured format for handover (e.g. SBAR) </aside>