1. What are the three main components of the ABCDE approach to assess and manage a patient in

acute care? Explain the rationale for each component. (5 marks)

Answer: The ABCDE approach stands for Airway, Breathing, Circulation, Disability and Exposure. It is a

systematic and structured way of assessing and managing a patient who is critically ill or deteriorating.

The rationale for each component is:

- Airway: To ensure that the patient has a patent airway and is able to breathe adequately. This is the

first priority because without a clear airway, the patient will not be able to oxygenate their blood and

may suffer from hypoxia, brain damage or cardiac arrest.

- Breathing: To assess the patient's respiratory rate, rhythm, depth, effort and oxygen saturation. To

provide oxygen therapy, ventilation or other interventions as needed. This is the second priority

because breathing is essential for gas exchange and maintaining acid-base balance in the body.

- Circulation: To assess the patient's pulse, blood pressure, capillary refill time, skin temperature and

colour. To monitor fluid balance, electrolytes, blood glucose and haemoglobin levels. To provide fluid

resuscitation, blood transfusion or other interventions as needed. This is the third priority because

circulation is vital for delivering oxygen and nutrients to the tissues and organs and removing waste

products.

- Disability: To assess the patient's level of consciousness, pupil size and reaction, motor and sensory

function. To monitor neurological status, Glasgow Coma Scale, blood glucose and temperature. To

provide analgesia, sedation or other interventions as needed. This is the fourth priority because

disability can indicate brain injury, stroke, infection or metabolic disorders that may affect the patient's

outcome.

- Exposure: To expose the patient's body and look for any signs of injury, infection, bleeding or rash. To

maintain the patient's dignity, privacy and comfort. To prevent hypothermia or hyperthermia by

adjusting the environment or using blankets or fans. This is the fifth priority because exposure can

reveal hidden problems that may require immediate attention or treatment.

2. What are the common causes of chest pain in acute care settings? How would you differentiate

between cardiac and non-cardiac chest pain? (5 marks)

Answer: The common causes of chest pain in acute care settings are:

- Cardiac: Acute coronary syndrome (angina or myocardial infarction), pericarditis, aortic dissection,

pulmonary embolism.