Objective Ax 2023

Session Objectives

  • Understand differing approaches to objective assessment.

  • Recognize ‘normal’ versus ‘abnormal’ findings.

  • Adapt skills for different contexts.

  • Interpret objective findings.

  • Identify relevant objective markers.

What is Objective Assessment?

  • A systematic approach to problem-solving in clinical settings.

    • Identify the problem.

    • Analyze the cause.

    • Develop, plan, and evaluate intervention strategies.

    • Ensure the integrity of implementation processes.

Aims of CVR Assessment

  • Identify patients needing CPR, respiratory support, and medical input.

  • Facilitate rehabilitation and management plans.

  • Refer patients to appropriate services and promote health.

Assessment Approaches

  • Systems-Based Assessment: Focus on body systems.

  • Functional Assessment: Assess patient functionality.

  • Goal-Oriented Assessment: Tailor assessment to specific patient goals.

Levels of Care

  • Level 3 Care (ITU): For life-threatening conditions, advanced support needed. Cost: ~£1881/day.

  • Level 2 Care (HDU): Detailed observation/intervention for single organ failure. Cost: ~£901/day.

  • Level 1 Care (Ward): Basic care costs ~£345/day.

Overview of CVR Assessment

Subjective Data

  • Presenting complaints, histories, and patient information.

Objective Data

  • Patient charts, observations, auscultation, A,B,C assessments, etc.

  • Tools: BORG, MRC, spirometry, etc.

Observations

  • Assess bed space:

    • Position, posture, consciousness, apparatus, sputum expectoration.

Assessment Components

Airway

  • Mode of ventilation: self-ventilating vs. mechanical support.

Breathing

  • Assess breathing pattern, chest expansion, cough quality, and document parameters.

  • Normal rate: 12-16 breaths/minute.

Circulation

  • Heart rate (60-100 bpm): monitor rhythms and abnormalities.

  • Blood pressure: average 120/80 mmHg, assess stability and function.

Disability

  • Level of consciousness via AVPU and GCS (normal is 15). Assess pupil reactivity.

Exposure

  • Assess general condition, including skin and abdomen.

National Early Warning Score (NEWS)

  • Scoring based on respiratory rate, oxygen saturation, blood pressure, heart rate, and consciousness.

Interpretation of Objective Findings

  • Understanding context of observed metrics (e.g., abnormal RR, mBORG).

Outcome Measures

  • Include lung function testing, quality of life metrics, and activity assessments.

Putting It All Together

  • Use subjective information to formulate objective assessments and develop treatment strategies.