Does 'stabilise, then call' mean I finish the ABCDE assessment before calling for help?

No. The Resuscitation Council UK ABCDE guidance says to call for appropriate help early and to ask a colleague to ensure help is coming during the first 30-second look. Stabilisation and the call run in parallel; you treat while the help you have called is on its way.

What oxygen saturation should I aim for in an acutely unwell adult?

The Resuscitation Council UK ABCDE guidance gives 94 to 98% for acute respiratory failure, and 88 to 92% for patients at risk of hypercapnic respiratory failure, such as those with COPD. Give it through a reservoir mask at 15 L/min initially in the first group, and controlled oxygen in the second.

How much fluid do I give a hypotensive adult in the ABCDE approach?

A 500 mL bolus of warmed crystalloid over less than 15 minutes, according to the Resuscitation Council UK guidance, with smaller volumes such as 250 mL in known cardiac failure or trauma. Reassess heart rate and blood pressure every 5 minutes, repeat if there is no improvement, and seek expert help if repeated boluses fail.

What is a normal capillary refill time?

Usually under 2 seconds. The Resuscitation Council UK guidance describes pressing a fingertip held at heart level for 5 seconds and timing the return of colour. A prolonged time suggests poor peripheral perfusion, though other causes such as a cold environment can lengthen it.

What do I do about a low glucose at D?

If blood glucose is below 4.0 mmol/L in an unconscious patient, the Resuscitation Council UK guidance says to give an initial dose of 50 mL of 10% glucose intravenously, then recheck. Glucose is the quickest reversible cause of reduced consciousness and the one candidates most often forget.

Which handover structure should I use when I call for help?

SBAR: Situation, Background, Assessment, Recommendation, which the Resuscitation Council UK ABCDE guidance names alongside RSVP. Four sentences that say who the patient is, what has changed, what you have found and done, and what you want the person you are calling to do.

ABCDE for the Anaesthetic CT1 — CT1 Anaesthetics Interview Clinical Judgement Answer

For the anaesthetic CT1, 'stabilise, then call' means treating each life-threatening problem at the letter where you find it while help is already coming, not finishing the assessment before you pick up the phone. The Resuscitation Council UK ABCDE guidance says to treat life-threatening problems before moving to the next part of the assessment, reassess regularly, and call for appropriate help early.

Key takeaways

The Resuscitation Council UK ABCDE approach is for all deteriorating or critically ill patients; the first look, listen and feel takes about 30 seconds and help is asked for during it, not after.
Breathing thresholds: normal respiratory rate 12 to 20, above 25 is a marker of illness; target saturations 94 to 98%, or 88 to 92% if at risk of hypercapnic respiratory failure.
Circulation thresholds: capillary refill time normally under 2 seconds; a 500 mL crystalloid bolus over less than 15 minutes if hypotensive, 250 mL in known cardiac failure or trauma; target the patient's normal blood pressure or a systolic above 100 mmHg.
Disability: check glucose, and give 50 mL of 10% glucose intravenously if it is below 4.0 mmol/L in an unconscious patient.
Reassess heart rate and blood pressure every 5 minutes after a fluid bolus, and seek expert help if there is no response to repeated boluses.
Hand over with SBAR: Situation, Background, Assessment, Recommendation.

What does the ABCDE approach mean by 'stabilise, then call'?

It means the call for help and the stabilisation run in parallel, with the call made as early as the first 30 seconds. The Resuscitation Council UK ABCDE guidance lists 'recognise when you will need extra help, call for appropriate help early' as a principle, and 'use all members of the team' so interventions happen simultaneously.

In a CT1 anaesthetics scenario, the phrase catches out candidates who hear it as a sequence: assess everything, fix everything, then phone. The guidance says the opposite: if the patient looks critically ill on the first glance, ask a colleague to ensure help is coming while you start.

So the spoken answer is: 'I go to the bedside, ask the nurse to call for help and bring the trolley, and start at A.' Stabilising is what you do with your hands while the help you have already called arrives.

How do you recognise the patient who needs ABCDE now?

By the first rapid look, listen and feel, which the Resuscitation Council UK guidance says should take about 30 seconds: does the patient look unwell, are they talking in sentences, what colour are they, and what are the observations trending towards.

The anaesthetic CT1 meets this patient in recovery, on the ward as the on-call, or in the emergency department. The trigger is any change: a rising respiratory rate, a new confusion, a nurse who says 'I am worried'. The guidance applies the approach to all deteriorating or critically ill patients, so the answer is never to wait for the score to cross a line.

A respiratory rate above 25, or one that is rising, is called out in the guidance as a marker of illness. In practice it is the observation candidates forget to ask for and the one that moves first.

What do you do at A and B?

At A, look for obstruction and treat it: open the airway, suction, an adjunct, and seek expert help immediately if obstruction is present. At B, count the rate, check saturations, listen, and give oxygen to a target.

Airway obstruction is an emergency; the Resuscitation Council UK guidance says to seek expert help immediately. For a CT1 that is the on-call anaesthetist or the crash team.
Give high-concentration oxygen through a reservoir mask, usually at 15 L/min, in acute respiratory failure, aiming for saturations of 94 to 98%.
In a patient at risk of hypercapnic respiratory failure, such as COPD, aim for 88 to 92%; the guidance names a 28% Venturi mask at 4 L/min or a 24% Venturi at 4 L/min as initial therapy.
Count the respiratory rate for a full minute. Normal is 12 to 20; above 25 or rising is a marker of illness.

For the anaesthetic CT1, the B decision that matters is whether this patient is heading for a ventilator. Say it: 'If saturations do not recover with 15 litres, I want the anaesthetic registrar and critical care outreach now.'

What do you do at C?

Assess perfusion, get access, take bloods and treat hypotension with a measured fluid bolus. The Resuscitation Council UK guidance says to check capillary refill time by pressing a fingertip at heart level for 5 seconds; the normal value is usually under 2 seconds.

Insert one or more large-bore cannulae, 14 or 16 G, and take bloods as you do.
If the patient is hypotensive, give a bolus of 500 mL of warmed crystalloid over less than 15 minutes; use smaller volumes, for example 250 mL, in known cardiac failure or trauma.
Aim for the patient's normal blood pressure or, if unknown, a systolic above 100 mmHg.
Reassess heart rate and blood pressure every 5 minutes after the bolus; if there is no improvement, repeat the challenge, and seek expert help if repeated boluses do not work.
If the patient has a catheter, urine output below 0.5 mL/kg/h is a sign of poor perfusion.

The C mistake in a CT1 anaesthetics answer is a fluid bolus with no plan for failure. The guidance's own wording gives you the contingency: repeat, then get help. Say both.

What do you do at D and E?

At D, check conscious level, pupils and glucose, and at E, expose the patient fully while keeping them warm. The Resuscitation Council UK guidance says that if blood glucose is below 4.0 mmol/L in an unconscious patient, give an initial 50 mL of 10% glucose intravenously.

Reduced consciousness is also an airway problem waiting to happen. An anaesthetic CT1 who finds a patient with a falling GCS should say they are returning to A, and that airway protection is now the question for the senior they have called.

At E, look at the wound, the drains, the calves, the skin and the temperature. The guidance's point is that you cannot find what you have not looked for, and the diagnosis is often here: the bleeding drain, the rash, the swollen leg.

When do you escalate, and who do you call?

Escalate at the first sign of critical illness, and say who: the on-call anaesthetic registrar or consultant, the crash team via 2222 if the patient is peri-arrest, and critical care outreach for a patient who is not responding to first-line treatment.

The Resuscitation Council UK 2025 adult ALS guideline states that hospitals should adopt a standard 2222 cardiac arrest call number and that all staff should be able to recognise cardiac arrest, call for help, start CPR and defibrillate. A patient who becomes unresponsive and is not breathing normally has crossed that line.

Use SBAR for the call. The ABCDE guidance names Situation, Background, Assessment, Recommendation, or the alternative RSVP, as the way to communicate effectively. Assessors frequently ask you to make the call in the room.

What does reassessment look like in the answer?

Reassessment is saying, after each intervention, what you expect to see and when you will look. The guidance's principles include 'assess the effects of treatment' and the reminder that it can take a few minutes for treatments to work, so wait a short while before reassessing.

So the anaesthetic CT1 says: 'I have given oxygen and a 500 mL bolus. I recheck saturations now and blood pressure in 5 minutes. If the pressure is still low I repeat the bolus and ask the registrar to come.' That single sentence covers treatment, reassessment and contingency.

The aim of the initial treatment, in the guidance's words, is to keep the patient alive and achieve some clinical improvement. You are buying time for the definitive diagnosis, which is usually made by the person you called.

What are the human-factors points the assessors listen for?

They listen for a candidate who uses the team, communicates in a structure, and knows their limits. ANRO's 2026 Working Under Pressure descriptor scores 'insight into own limitations within scenario' and 'clear task prioritisation and decision making'.

The ABCDE guidance's principle 'use all members of the team' is a human-factors instruction: allocate tasks aloud. 'Could you get the trolley, could you put out the call, could you draw up the fluids.' A CT1 who does that has shown leadership without claiming expertise.

For reflective practice, have an ABCDE moment of your own ready: the patient whose respiratory rate you did not count, the bolus you gave without a plan for failure, and what you now do differently. ANRO scores the example and the change, not the sentiment.

What are the common mistakes with ABCDE at interview?

The commonest is finishing the whole assessment before treating anything, which is the opposite of the guidance's 'treat life-threatening problems before moving on'.

Not calling until the end. The guidance says call early, and a CT1 who assesses for three minutes alone has missed the point of the scenario.
Giving oxygen without a target. Say 94 to 98%, or 88 to 92% and why.
A fluid bolus with no volume, no time and no reassessment. The guidance gives all three.
Skipping D: glucose is quick, treatable and forgotten.
Announcing a diagnosis at A. The letters are the structure that keeps you safe while the picture develops.

How this comes up at the CT1 anaesthetics interview

ABCDE is the spine of nearly every clinical judgement scenario at the CT1 anaesthetics interview, whatever the diagnosis turns out to be, and each of the three scored domains has a foothold in it.

Clinical judgement and decision-making: treating at each letter with a threshold, a dose and a reassessment demonstrates the 'clear plan of action' and 'correctly prioritised tasks' in ANRO's descriptor.
Reflective practice: an ABCDE example from your own foundation years, with what changed afterwards, meets the 'example of scenario they have reflected upon and how' descriptor.
Working under pressure: calling early, allocating tasks and staying with the structure when the scenario turns is 'maintained perspective through developing scenario'.

Practise the approach aloud on scenarios you have not seen; the anaestheticinterview bank of 340 questions with AI-marked spoken practice is built around exactly this station.

ABCDE for the Anaesthetic CT1: What 'Stabilise, then Call' Means in Practice