Basics

Any regular readers will know that I occasionally rant about the importance of not forgetting the basics.

D - Danger to yourself, the patient or bystanders.
R - Responsiveness of the patient.

A - Airway is clear?
B - Patient is Breathing?
C - Circulation is adequate?
D - The Patient has a disability?

In a healthcare service which is full of cool toys, allowing us to test, probe and prod a patient it is sometimes easy to forget the above come first.

I was once faced with a patient who had a potential spinal injury. We had immobilised as best we could but we only had our first aid kits on us and we were awaiting the arrival of one of our nice, fully kitted out ambulances(including a spinal board). They were still three minutes away when the inconsiderate patient decided it was time to stop breathing. Now you have a choice. I moved the patient into a position where I could start resuscitation. This meant comprimising his spine. Guarentee of Death trumps chance of getting paralysed.

This was a fairly easy decision however similar situations can occur with greater stakes. My advice is, and always will be, REMEMBER THE BASICS.