The Airway, Breathing, Circulation, Disability and Exposure (ABCDE) approach
The ABCDE algorithm is a widely used systematic approach to assessing and treating acutely unwell patients in a variety of settings. It forms the basis of the UK and several other international resuscitation guidelines and is also a key part of the Advanced Life Support (ALS) algorithm all qualified junior doctors are expected to know in the UK (1). It can be applied to any critically unwell patient and can be used on the street without any equipment, or in well-stocked emergency departments, hospital wards, or intensive care units (2). The aim of the ABCDE algorithm is to rapidly assess and provide life-saving treatment by systematically breaking down complex clinical situations into simpler, more manageable chunks. This systematic approach helps to assess and administer the most critical interventions sequentially while working towards a definitive diagnosis requiring specific investigations, interventions, and management. The order of the ABCDE approach is such that it optimizes blood oxygenation in a logcal manner, ie if the algorithm is not done in the correct order, the patient may unexpectedly deteriorate due to inadequate oxygenation.
Broadly speaking, the main aims of the ABCDE approach are (3):
Recognizing and managing life-threatening problems before assessing further
Ensuring the airway remains patent and the lungs are ventilated
Ensuring cardiorespiratory function is adequate to oxygenate vital organs
The ABCDE approach is an important aspect of assessing acutely unwell patients and is a vital skill for junior doctors to confidently manage these patients as part of a clinical team or by themselves while on-call during weekends and nights. This educational resource aims to familiarize medical students with the approach and act as a formal resource to look back on for revision. It will cover the following learning objectives:
Briefly introduce the ABCDE approach
Apply the algorithm to a common clinical case to demonstrate its application
Clicking on the start button will take you to the beginning of the case, good luck!