Editing CCrISP assessment (section)

== '''Circulation:''' ==

* Assume hypovolaemia in circulatory dysfunction until proven otherwise (for surgical patients)
** Large canula (says 16G in CCrISP), with bloods sent incl G+H
** IVF 10-20ml/kg stat (10mL/kg if normotensive, 20mL/kg if hypotensive, but obviously be more tentative in cardiac patients maybe 5mL/kg)
* LOOK: (assess PERFUSION rather than BP)
** Reduced peripheral perfusion: (easiest to see in skin, kidneys and brain)
*** Confusion/reduced LoC
*** Prolonged cap refill time - easiest and best way - press for 5 seconds over nailbed and sternum
*** Pallor
*** Coolness
*** Collapsed or underfilled veins (including JVP)
*** Peripheral cyanosis - low cardiac output
** Obvious external haemorrhage from either wounds or drains
** Evidence of concealed haemorrhage (thoracic or abdominal, into the gut, pelvic/femoral fractures)
* LISTEN:
** Auscultate chest and heart
* FEEL:
** Pulses - both central and peripheral
*** First radial, then carotid/femoral
*** Assess rate, quality, regularity, equality
* TREAT:
** Obviously exsanguinating - need immediate definitive treatment
** Unstable - rapid resuscitation and reassessment over a short period
*** '''<nowiki/>'Transient responder''''
*** '''<nowiki/>'Non-responder''''
**** Different treatment
**** If this is a bleeding patient, call for help, cross-match 6 units and alert theatre, anaesthetist and PSAs
** Stable patients with a minor problem - '''<nowiki/>'responder''''
** Don't 'blindly' fill up patients with blood - if they are not stabilising with reasonable resus, they are not stable, and need definitive management