Prioritization Beyond ABCs

ABC’s Highest Breathing = RR & Oxygenation Circulation

PRIORITY Low PaO2 (Norm: 80 - 100) Bleeding:
60 or less = HypOXemic Internal:
Respiratory failure Hypotension “Low BP”
Airway = blockage High CO2 Hard stiff “board-like” abdomen
Stridor “squeak” - Postoperative 50 or MORE = HyperCapnic Skin: Pale, dusky, cool & clammy
Thyroid / Parathyroid Respiratory failure Coagulation:
Anaphylaxis: throat swelling - Hypoxia Platelets (norm: 150k - 400k)
Epipen 1st! Change LOC: Level of consciousness Less than 150k - Thrombocytopenia
Ruptured esophageal varices - Mental changes: Restless, agitation Less than 50k - VERY RISKY!
Turn to side lying position Skin: Pale, dusky, cool & clammy Heparin: PTT 46 - 70
SpO2% (Norm: 95 - 100%) Warfarin: INR 2 - 3
COPD - Low 90% is normal 3 x MAX range
1st
HIGH CO2 HeParin WarfarIN
HyperCapnic 46 - 70 2-3

CO₂
PTT
CO₂
CO₂
CO₂ CO₂
CO₂

6 7 8 9
5
4 10
11
3

12
2

13 14
0 1

S S T
Circulation TROPONIN > 0.5

Shock Severely low Shock - Severe low BP 100

blood pressure Urine output 30ml/hr or less

10

0.1

0.01

0 1 2 3

Skin: Pale, dusky, cool & clammy

Chest pain (any kind)
NORMAL
> 180 sys
Troponin Over 0.5
HIGH
LOW

HTN crisis (over 180 systolic) NORMAL

HIGH
LOW
Infection Labs Pain
Low Glucose
Infection After any surgery! Less than 70 “Hypoglycemia” Lose life or limb
Red, warm, smelly drainage at Hypogly = Brain will DIE!
Chest Pain = #1 priority
surgical site Kidney problem Cast / broken limb pain
WBC over 10,000 Creatinine OVER 1.3 = Bad kidney!
Priority: Neutropenia Urine output 30 ml/hr or less = = Pain Unrelieved with pain meds
(Less than 1,500 WBC) Kidneys in distress

Chemotherapy, Side note Kidney Killers

Immunosuppressants CT contrast
Antibiotics: Vancomycin & Gentamicin
Low grade fever will KILL!
Toxic lab levels #1 PRIORITY
Lithium 1.5 + LIMB
Neutropenia Low Grade FEVER <100.4 F Digoxin 2.0 +
Theophylline 20 +
Phenytoin 20 + (brand: Dilantin)

Creatinine > 1.3 Urine Output < 30ml/hr

Compartment Syndrome
<1,500 BUN/Creatinine

Notes