AimThe systematic Airway, Breathing, Circulation, Disability, and Exposure (ABCDE) approach is a priority-based consensus approach for the primary assessment of all categories of critically ill or injured patients. The aims of this review are to provide a wide overview of all relevant literature about existing ABCDE assessment tools, adherence to the ABCDE approach and related outcomes of teaching or application of the ABCDE approach by healthcare professionals. MethodsA comprehensive scoping review was conducted following the Joanna Briggs Institute guidelines and reported according to the PRISMA-ScR Checklist. An a priori protocol was developed. In March 2024, MEDLINE, EMBASE, CINAHL and Cochrane library were searched to identify studies describing healthcare professionals applying the ABCDE approach in either simulation settings or clinical practice. Two reviewers independently screened records for inclusion and performed data extraction. ResultsFrom n = 8165 results, fifty-seven studies met the inclusion criteria and reported data from clinical care (n = 27) or simulation settings (n = 30). Forty-two studies reported 39 different assessment tools, containing 5 to 36 items. Adherence to the approach was reported in 43 studies and varied from 18–84% in clinical practice and from 29–35% pre-intervention to 65–97% post-intervention in simulation settings. Team leader presence and attending simulation training improved adherence. Data on patient outcomes were remarkably scarce. ConclusionMany different tools with variable content were identified to assess the ABCDE approach. Adherence was the most frequently reported outcome and varied widely among included studies. However, association between the ABCDE approach and patient outcomes is yet to be investigated.

BackgroundRurality has been shown to have a strong effect on survival from out-of-hospital cardiac arrest (OHCA), with survival in rural areas approximately half that of metropolitan areas. Western Australia provides a unique landscape to understand the impact of rurality, with 2.6 million people spread across 2.5 million km2. We conducted a scale geospatial analysis with respect to population density and proximity to services, to understand the impact of rurality on bystander interventions, prehospital management and survival of OHCA patients. MethodsWe conducted a retrospective cohort study with a geospatial analysis of ambulance-attended, medical OHCA cases from 2015 to 2022. We compared bystander interventions, distances to services, population density and survival outcomes, stratified by a four-scale regional (broad scale) categorisation of rurality, and proximity to town scale. ResultsThere were a total of 6,763 cases within the study cohort (Major Cities- 5,186, Inner Regional- 605, Outer Regional-599 and Remote- 373). The majority of OHCAs occurred within towns, and within close proximity to people and health services. Bystander interventions were higher for more remote cases. Increased distance from town was associated with a 5 % decrease per kilometre in the odds of Return of Spontaneous Circulation (ROSC) on arrival at hospital (OR = 0.95 [95 % Confidence Interval 0.92–0.98]). Despite close proximity to ambulance services, ambulance response times were more prolonged with increasing remoteness. ConclusionsOHCA cases within regions classified as Regional and Remote typically occurred within towns, and in close proximity to emergency services. However, ambulance response times within rural and remote towns were long relative to their proximity to ambulance stations. These findings provide a new perspective on the issue of remoteness for OHCA cases.