Intended for healthcare professionals

Student Practical skills

The ABCDE approach explained

BMJ 2016; 355 doi: (Published 24 October 2016) Cite this as: BMJ 2016;355:i4512
  1. Marina Soltan, foundation year 1 doctor1,
  2. Michael Kim, consultant in emergency medicine2
  1. 1Burton Hospital, Burton upon Trent, West Midlands Deanery, UK
  2. 2Homerton University Hospital, London, UK

The ABCDE approach may help you deal with acutely ill patients systematically

The resuscitation room (“resus”) in the emergency department is where patients with immediately life threatening illnesses and injuries are managed. For a medical student it can be a daunting environment to enter for the first time: the resus team has to move quickly to keep patients alive, and it can be hard to keep up to speed with what’s going on.

Despite what might seem like chaos, the team uses a systematic method for managing all acutely ill patients called the ABCDE (A-E) approach. It is a way of systematically assessing each of a patient’s vital systems—airway, breathing, circulation, disability, and exposure.

The aim of the assessment is to identify and stabilise the patient’s most life threatening problems first, before moving on to the next vital system to achieve some clinical improvement to buy time for further treatment and making a diagnosis.1 Once the team has completed an A-E assessment, it repeats the steps to reassess each system to determine if clinical features are improving or deteriorating.

As a student, you will not be expected to manage patients in resus on your own, but an understanding of the steps entailed in an A-E assessment (table 1) before your first placement in the emergency department can help you follow the interventions. As a foundation doctor, you will learn more about the specifics of giving lifesaving treatment by attending the compulsory advanced life support course. For more detailed information on how to perform the steps of an A-E assessment, read the guidance provided by the Resuscitation Council UK.1

View this table:
Table 1

ABCDE assessment of an acutely ill patient

This article uses a clinical scenario to show you how the team in resus would use the A-E approach to manage a …

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