The COAT & Review Approach: How to recognise and manage unwell patients
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About this ebook
This manual provides junior healthcare workers with a simple structured approach which can be used to assist them in the early recognition of the deteriorating patient. It also provides a format for approaching the unwell patient which prioritises identifying and correcting immediately life-threatening problems.
Nicholas Chrimes
Nicholas Chrimes is a specialist anaesthetist in Melbourne, Australia and an experienced simulation instructor. He has particular interests in education of junior healthcare staff and in simplifying clinical reasoning in emergency situations.
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Book preview
The COAT & Review Approach - Nicholas Chrimes
The COAT & Review Approach:
How to recognise and manage unwell patients
By Nicholas Chrimes & Julia Harrison
Smashwords Edition
Copyright Nicholas Chrimes & Julia Harrison 2013
Smashwords Edition License Notes
Although this is a free manual, it remains the copyrighted property of the authors, and may not be reproduced, copied or distributed for commercial or non-commercial purposes. If you found this manual useful please encourage your friends to download their own free copy. Thank you for your support.
Click HERE to view COAT & Review related resources, including a video demonstrating the COAT & Review Approach in action.
Table of Contents
Foreword
Identifying the Deteriorating Patient
Overview of the COAT & Review Approach
Confirm
Optimise
Assess
Treat
Review
Acknowledgements
About the Authors
Other Publications by these Authors
Monash Simulation
Clinical Cred
References
Foreword
by Stuart Marshall
The clinical complexity of patients in hospital environments is becoming greater. Patients are generally older, have more co-morbidities and are taking more medications prior to admission than ever before [1]. Given this change in demographic it would be reasonable to expect that hospital patients have fewer physiological reserves before they suffer any clinical deterioration and become critically ill.
Deteriorating patients are common on the wards. A recent survey showed that 1 in 25 patients breach physiological criteria for activating systems for more help, however less than half of these patients receive such help [2].
Identifying, stabilising and treating clinically ill patients is a key concern of all health professionals. All too often patients on the ward deteriorate without adequate assessment or basic supportive measures being implemented [3]. The recognition and subsequent care of the deteriorating patient has been a concern of many professional groups in the last few years, including international groups such as the World Health Organization [4].
Physiological criteria are available in most hospital settings to help remind staff what the danger signs are. Some hospitals have adopted observation charts that have these abnormal physical signs displayed prominently to visually represent what requires action (Fig 1).