Emergency Response Case Study Analysis(HLTAAP002 Confirm Physical Health Status)

Case Study 1 Case Study You encounter a patient, Mary, a 42yo F, who is experiencing shortness of breath and chest pain.  You perform an assessment and find the following:    Mary was at work when she had a sudden onset of chest pain. The pain felt like it was crushing her chest, so she asked for help from a colleague who then called an ambulance. On arrival Mary is saying that her chest feels like “there is an elephant sitting on me” She tells you it feels like 9 out of 10 pain. Mary tells you the pain is right in the middle of her chest, and her left arm and the left side of her jaw also feels painful.  Mary states that she also feels like she can’t catch her breath.   You assess Mary’s vital signs and find:   Mary is hypertensive, tachycardic, and tachypnoeic Mary’s ECG shows a STEMI Mary’s BSL is 5.2, temp is 36.C Mary’s skin is pale and slightly grey and she is sweating   Mary tells you that she has never had pain like this in the past. She knows she has high cholesterol and high blood pressure and takes medications to control both conditions. Mary is a non-smoker. Mary also tells you that her father died young from a heart attack. During your assessment Mary also says to you “I think I’m dying”.     Task Your task is to answer the following questions in the text box below (you should write your answers in a word document and then cut and paste them into the textbox below to avoid loosing your work. Q2-Explain the pathophysiology of the condition you believe this patient is suffering from? In your answer provide a basic summary of the physiological processes that can lead to the symptoms the patient is experiencing. Q3-Given the disease process you have identified, which types of medication do you think the patient’s doctor has prescribed (and provide an example medication name). In your answer explain in basic terms what they do and why are they beneficial for someone with this condition?  Q4-Given the disease process you have identified, what kinds of medications or treatments can be given prehospitally and how would they likely benefit this patient?  comment (note) Q2- What happens when the artery becomes blocked due to a rupture of an atherosclerotic plaque and how does it result in the symptoms within the case study? Q3 – This question is looking at what medication the patient is currently taking and has been prescribed by their doctor prior to you attending them. The patient only takes 2 medications. Q4 – Please ensure you are referring to APC Drug Therapy Protocols, as you need to identify vital medication(s) which are available to you within your scope of practice.(Drug Therapy Protocols ( Drug Therapy Protocols Adrenaline (Epinephrine)AmiodaroneAspirinCeftriaxoneFentnyl,FexofenadineGlucagonGlucose GelGlucose 10%,Glyceryl Trinitrate (GTN),Ibuprofen, Ipratropium Bromide,Methoxyflurane,Midazolam,Morphine,Naloxone,Ondansetron,Oxygen, Paracetamol,Salbutamol, Sodium Chloride 0.9%,Tranexamic Acid (TXA), Water For Injection, PreviousOral Medication, NextAdrenaline (Epinephrine)   You have identified oxygen as a treatment for this patient- under what circumstances would you give oxygen to this patient, please refer to APCs hypoxia guideline. Oxygen can be detrimental to a STEMI patient when not indicated. What parameter spo2 reading would be indicated to give this patient oxygen? -       Please provide the names of each medication that you can administer within your scope. Imagine you are handing this patient over at hospital, you wouldn't say “I gave Nitroglycerin” you would provide them with the drug name instead.     Case Study2 You are working at a music festival when you encounter Lin, a 78yo F, who came to your first aid tent when she was feeling short of breath. You perform an assessment and find the following:   Lin is very active for her age and was dancing to music when she started to feel short of breath. Lin stopped dancing, but her breathing didn’t go back to normal. Lin is speaking in short sentences and is taking big deep breaths.   You assess Lin’s vital signs and find:   Lin is tachycardic and tachypnoeic. Lin has a normal ECG Lin’s BSL is 4.8, and her temp is 37.0. Lin’s skin is pale and slightly sweaty   Lin tells you that she gets short of breath quite regularly, whenever she dances or does other physical activities. She says that her GP told her that it was because she was a smoker for 40 years, even though she quit smoking 20 years ago. Lin tells you that right now it feels like even though she can take normal breaths, she doesn’t feel like she is getting enough oxygen. Lin usually takes two inhalers, one she uses every day regardless of how she feels, and the other she uses when she feels short of breath to make her breathing go back to normal, but she didn’t bring either with her and she can’t remember their names. Lin gets frequent chest infections, though she doesn’t think that’s happening now as she was feeling fine before dancing. She has no other medical history and doesn’t take any other medications (other than the two inhalers)     Task Your task is to answer the following questions in the text box below (you should write your answers in a word document and then cut and paste them into the textbox below to avoid loosing your work):   Q3-Given the disease process you have identified, which medications do you think the patient’s doctor prescribed. In your answer explain in basic terms what each medication does and why they would be beneficial for someone with this condition?  Q4-Given the disease process you have identified, what kinds of medications or treatments can be given prehospitally and how would they likely benefit this patient?  Q5-Given the disease process you have identified, what is the most appropriate referral option for this patient and why? Comment ( notes) Q3 – This question is looking at what medication the patient is currently taking and has been prescribed by their doctor prior to you attending them. You have only provided 1- the patient takes 2 medications. -          This question is also looking for an example of the name and type of medication you suggested that the GP has provided this patient. Explain how they work to treat the condition.  - Q4-   You have identified oxygen as a treatment for this patient- under what circumstances would you give oxygen to this patient, please refer to APCs hypoxia guideline. -       This question is also asking how each medication would specifically benefit the patient. Please refer to each medications pharmacology/mechanism of action when answering this question. Would you administer just one of the medications or both. Q5- Not addressing the question. What would you like to do with the patient as it is not within your scope to refer a patient to a specialist.       Case Study3 You encounter a patient, Jack, a 25yo M, who was found on the ground in the local supermarket by one of the supermarket team members who called 000.  You perform an assessment and find the following:  As you approach Jack you note that he is conscious and breathing, but he is staring off into space and reacts very slowly when you talk to him. Over the 5 minutes of your assessment, Jack slowly becomes more and more ‘awake’, eventually reacting normally. The supermarket team member states that when Jack was found he was face down and was ‘shaking’ for about a minute before he became still. You notice the team members from the supermarket have placed towels around the patient as he appears to have been incontinent during the episode.    You assess Jack’s vital signs and find: Jack is hypotensive and tachycardic Jack has a normal ECG Jack’s skin appears pale and sweaty Jack is speaking normally and he has good strength in both arms Jack’s BSL is 5.0 and his temperature is 37.3C   Jack tells you that he has been having more and more of these ‘weird turns’ over the last year or so, he says they started after he had a motorcycle accident and hurt his head pretty badly. Jack tells you that he is seeing a doctor about them, and they told him they thought it was related to a specific condition but he can't remember the name of it.  Jack tells you that his doctor gave him a medication to make the ‘turns’ stop, and it does seem to work, but he keeps forgetting to take it.  You notice a small red lump on the front of Jack’s head but don’t find any evidence of a fracture or serious injury.     Task Your task is to answer the following questions in the text box below (you should write your answers in a word document and then cut and paste them into the textbox below to avoid loosing your work): [login to view URL] the disease process you have identified, what is the most appropriate referral option for this patient and why comment ( note) Q5. Within your scope are you able to refer a patient to a specialist? There is a specific process required for this outcome in the prehospital environment. Where would you transport the patient to?