Table 1 Overview of the A-A-B-B-C-C-D-D-E-E's in the crashing patient.
From: Ten rules to assess and manage the acutely deteriorating patient: a practical mnemonic
A | Aortic Disasters | Do not rely on "typical" symptoms in aortic disasters. |
|---|---|---|
| Â | Â | - Use bedside ultrasound before administering thrombolytics. |
A | Acidosis (Metabolic) | Metabolic acidosis may worsen into bradycardia, asystole, or tachydysrhythmia. |
| Â | Â | - Simulate the preintubation rate when setting the ventilation respiratory rate. |
B | Bagging/Breathing | Hyperventilation may decrease survival rate. |
| Â | Â | - Ventilate at a frequency no greater than one breath every 6 to 8 seconds. |
B | Baby on Board | Consider normal/ruptured ectopic pregnancy in every female of child-bearing age. |
| Â | Â | - Manage ventricular dysrhythmia, resuscitation positioning, and perimortem C-section. |
C | Compressions | Limit interruptions and maintain a high rate of quality compressions. |
C | Cooling (Therapeutic Hypothermia) | Use cooling in unresponsive arresting patients with ROSC. |
D | Decline Position (Trendelenburg) | Avoid using the Trendelenburg position for shock. |
D | Defibrillation | Use defibrillation early, if indicated. |
| Â | Â | - Use a single biphasic shock and "hands-on" defibrillation. |
E | Effusion | Thrombolytics can worsen a preexisting effusion. |
| Â | Â | - Utilize bedside ultrasound and administer intravenous fluids judiciously. |
E | Embolism | Right heart strain can be made worse with intravenous fluids. |
| Â | Â | - Utilize bedside ultrasound and limit intravenous fluids. |