Who to assess first?
When your exam decides to throw you a tricky question about which patient you assess first, always remember your ABC nemonic and try to stick to it as close as possible.
For example “After receiving report, which patient would you first assess?
1. A 2 year old with decreased pedal pulses with a coarctation of the aorta
2. A 4 year old with rheumatic fever who is complaining of severe knee pain.
3. A 5 year old with endocarditis who has crackles audible throughout both lungs
4. A 12 month old with a strawberry tongue and an increase in temperature.
What did you answer? Carefully go through and ask yourself if any of the answers have to do with the airway of the patient first. If your answer was no, then check Breathing and circulation next. Luckily we got to stop at letter “A” because option 3 fit the airway category. Because hypoxemia is extremely likely in the case of fluid in the lungs, a rapid assessment of oxygen saturation and administration of oxygen would be needed.
Of course, all of the patients needed assessing, it is just a matter of which patient needs it FIRST. Who is in the worse condition. Which patient would rapidly decrease in stability if you did not check them first.