Detection and Response to the Deteriorating Adult Patient

Study days are from 9am to 5pm.

The course will focus on:

Assessment in acute care 

• Systematic approach to clinical assessment using the ABCDE approach 
• Recognising changes in clinical status
• Using National Early Warning Score (NEWS2) ​
• SBAR as a multidisciplinary communication tool.

The patient with breathing difficulties

• Airway management, using adjuncts to support the airway
• Airway and breathing assessment  
• Acute, chronic, and acute exacerbations of respiratory problems
• Identifying problems with oxygenation - hypoventilation, hypoxaemia, V/Q mismatch
• Recognising the need for immediate interventions to support the patient with breathing difficulties - positioning, oxygen therapy, emergency oxygen use in adults, nebulisers. Management of Acute Asthma and COPD in Adults.

The patient with low blood pressure

• The physiological factors involved in maintenance of blood pressure and cardiac output
• Cardiovascular assessment
• Recognition of signs of reduced organ blood flow
• Measuring and interpreting, blood pressure, mean arterial pressure, pulse characteristics
• Recognising potential septic, hypovolaemic, cardiogenic causes of altered cardiac output
• Assessment of the patient with cardiac/circulatory problems, early identification, recognition and of 'sepsis'
• Understanding fluid challenge principles.

The patient with low urine output

• Recognising low urine output 
• Mechanisms of acute kidney injury. Biochemical alteration with deteriorating renal function.  Assessing and management strategies for low urine output
• Management of fluid balance.

The patient with altered conscious level

• Common causes of reduced consciousness 
• Electrolyte (and glucose) balance (recognising diabetic keto-acidosis)
• Assessment of the patient with neurological deficit
• Immediate emergency management of a patient with a disordered conscious level.

Managing medical emergencies, transfer to a higher level of care

• Transfer of the acutely ill patient.

National and professional strategies in acute care

• Professional values with an emphasis on Competence, Care, Courage and Communication, in meeting the needs of the patient at risk of deterioration
• Professional and national strategies.