Professional Documents
Culture Documents
Airway, Breathing
Airway, Breathing
1. Walk into the room and perform my 5 moments of hand hygiene. This is to avoid cross
contamination with my patient
2. I am now checking my environment, making sure there are no hazards around.
3. Checking whether the bed brakes are on
4. Hello, I am Raj and I am going to be your nurse today.
5. Can I please check your name and date of birth against your ID band please
6. That perfect. It matches your ID band so that is all correct
7. How are you feeling today
8. Did you sleep ok last night
9. I have conducted my normal A-D assessment.
10. With airway, it is patent as my patient is talking to me.
11. With breathing, the patient is breathing cause he is talking to me. I can also see the chest
rising and falling
12. With circulation, I felt the pulse of the patient while I was talking to him. Skin colour is nice
and pink. So sign of cyanosis. Skin is nice and warm on touch. Therefore circulation is normal
13. With disability, the patient has responded to me coherently which shows cognitive ability.
Patient is alert and oriented. GCS can range from 14-15
14. A-D is normal
15. I am now going to do a set of obs for my patient. Is that okay with you? I will be doing your
blood pressure, checking your heart rate and temp and your oxygen saturation
16. Put the oxygen saturation probe on the patient first.
17. Clean stethoscope and while waiting to dry check pulse
18. Check pulse for a full minute
19. Check resp for a full minute
20. At this point verbally say what the resp, heart rate and O2 sat is and write it down as well
21. I am now going to check the tympanic temperature. Can I please get a temp. Joint it down
22. I am now going to check your blood pressure. Is that okay?
23. Say what the blood pressure is and write it down
24. I am now going to clean my equipment. Clean the stethoscope
25. Check on the patient. How are you feeling
Airway