The ABCDEF protocol provides a systematic, life-saving framework for managing critically ill or injured patients in Nigerian emergency wards and pre-hospital settings. By addressing the most immediately life-threatening conditions first, healthcare providers prevent rapid deterioration and cardiac arrest. This structured approach ensures that no vital organ system is overlooked during high-stress resuscitations. Teamwork and rapid communication among nurses, doctors, and auxiliary staff are vital for successful execution.
Airway patency takes absolute precedence in any resuscitation scenario. Nurses must quickly inspect the oral cavity for foreign bodies, vomitus, or blood, and clear obstructions using suction.
Once the airway is secure, the nurse evaluates the adequacy of breathing by observing chest rise, listening for breath sounds, and checking respiratory rate and depth. Cyanosis, tracheal deviation, and asymmetrical chest expansion point toward immediate life threats like tension pneumothorax or flail chest.
Supplemental oxygen must be administered immediately through a non-rebreather mask to maintain oxygen saturations above 94 percent in most acute emergencies. If spontaneous ventilation is inadequate, bag-valve-mask ventilation is initiated while preparing for advanced airway placement.
Circulatory assessment focuses on identifying shock and stopping external bleeding. Nurses check peripheral pulses for rate, rhythm, and volume, alongside capillary refill time and skin temperature.
The disability assessment checks central nervous system function. The AVPU scale offers a rapid initial check:
For more detailed monitoring, nurses use the Glasgow Coma Scale (GCS), assessing eye-opening, verbal, and motor responses. Pupillary light reflex is also checked to rule out severe intracranial pathology or herniation syndromes.
Exposure requires removing the patient's clothing to perform a thorough head-to-toe physical examination for hidden injuries, rashes, or deformities. However, healthcare workers must protect patient dignity and prevent hypothermia, especially in air-conditioned Nigerian hospital environments. Blankets and warmed intravenous fluids should be used immediately after inspection is complete.
The final step involves obtaining a baseline set of physiological measurements and addressing psychosocial needs. Vital signs include blood pressure, heart rate, respiratory rate, temperature, and pulse oximetry.
Additionally, allowing family members to remain nearby during resuscitation can provide comfort to the patient and offer support, provided a designated staff member guides and reassures them throughout the procedure.