HLTOUT005 Assess and deliver standard clinical care Assessment Task 3: Case studies

HLTOUT005 Assess and deliver standard clinical care Assessment Task 3: Case studies

Student NameABNINDER SINGHDate20/04/2022
Unit code/nameHLTOUT005 Assess and deliver standard clinical care
Assessment NameCase studiesAssessment No.AT1.2
Student Declaration: I declare that by submitting this assessment, I confirm the assessment within is my own work. I am aware of and understand the rules and responsibilities related to assessment, as outlined in the Student Code of Practice, Student Handbook and related policies. I acknowledge that my failure to comply with the Academic Integrity Policy and Student Code of Conduct will be regarded as misconduct and will be subject to disciplinary action and may result in my enrolment being withdrawn by the Australian Paramedical College (APC). Privacy Disclaimer: Australian Paramedical College is collecting your personal information for assessment purposes. The information will only be accessed by authorised employees of the College . Some of this information may be given to the Australian Skills Quality Authority (ASQA) or its successor for audit and/or reporting purposes. Your information will not be given to any other person or agency unless permitted or we are required by law.
Assessment InformationAssessment Submission: You are required to complete the name and date fields on the first page of this document. Failure to do so will result in your submission counting towards an attempt and will not be assessed as it is incomplete.   Number of Attempts: Students receive three (3) attempts at this theoretical assessment task.   Should your 1st and 2nd attempt be deemed as Not Yet Satisfactory (NYS), your assessor will provide feedback informing you of the areas requiring additional or further information. You will be required to submit your updated attempt on a resubmission form template. If your 3rd attempt is deemed Not Yet Satisfactory (NYS), you will be required to schedule a call with an assessor to address the areas deemed Not Yet Satisfactory (NYS). If you fail to attend the scheduled call for discussion, you will receive an overall Not Yet Satisfactory (NYS) result for this assessment task.   General information: Each unit will have theoretical and practical components. The practical components for this unit will be addressed within the clinical practice workshop which you are required to attend to finalise individual unit outcomes.   Students are advised to read the Student Unit Guide prior to beginning assessment to ensure a clear understanding of the unit requirements and assessment tasks involved. Students must satisfactorily complete all associated assessment tasks to be deemed competent overall in this unit of competency.   Students are permitted to use the Student Learner Guide and additional resources available to support responses, however where relevant it is expected that references are listed or identified for any work that is not your own words. Academic misconduct is monitored and plagiarism will be penalised as per the Academic Integrity Policy.   Students are required to submit this completed assessment task via the online learning portal, or as directed by the assessor.   If you require assistance with content, please email trainer@apcollege.edu.au with the unit code, AT number and question you are stuck on or call (07) 5520 2522 for assistance.   If you require assistance with anything else, please email support@apcollege.edu.au with your question or call (07) 5520 2522 for assistance.

Case studies

Case Study 1: Motor Vehicle Accident

Dispatch informs you at 1600 hours of a male patient who has been involved in a single motor vehicle accident. Communication from dispatch states that the patient has suffered multiple injuries but is conscious and alert. The patient is located on a country back road with minimal traffic, but police are on the way for scene safety.

On arrival at the scene, you identify that the police are on scene managing any potential traffic related risks or dangers to ensure scene safety.

The patient is lying on the ground next to the vehicle, bleeding profusely from a head wound. He is holding his shoulder, groaning, and appears to be in significant pain.

On assessment you determine the patient is a 65-year-old male, Trent Turner. He informs you that he was driving when, for no apparent reason that he could identify, he just left the road and hit a large tree.

You identify that Trent also has a fracture to his right shoulder, a swollen and distorted left ankle and is experiencing numbness in his right fingers and wrist.

Trent starts to show signs of shock; he is pale, has clammy skin, below range BP, presenting with rapid breathing and pulse rate, and his pupils are somewhat dilated.

The weather is warm, currently 32-degrees and the environment does not indicate any apparent hazard or cause for the accident.

Trent is having difficulty answering any additional questions and is presenting as confused. He is a smoker.

Answer the following questions. You must answer all questions correctly to receive a satisfactory outcome for this task.

  1. Identify the most likely cause for Trent’s accident. You can list more than one cause.

Stroke and age factor are the most likely cause for Trent’s accident. Due to stroke Trent’s body starts doing involuntary movements because of which he loses control on his movements to handle the car properly. It is observed that elderly people include slowed reaction time that might be cause

2.           List four (4) potential complications of Trent’s injuries.

  1. Death due to shock
    • Right shoulder fracture, can loose sensation in arm due to nerve injury
    • Hemodynamic shock can lead to brain damage
    • Left ankle fracture

3.           Identify the pathophysiology and Mechanism of Injury (MOI) based on the above information.

  • Pathophysiology

Shock is an imbalance of oxygen supply and demand, lactic acidosis, anaerobic metabolism, metabolic anomalies, cellular and organ dysfunction, and, if left untreated, it can also lead to irreparable injury and death.

·       Mechanism of Injury (MOI)

Trent’s is having traumatic shock in which the defense mechanism or reaction of body reacts to overwhelming emotions following a traumatic event. The mind and body freeze or disassociate to protect the psyche because the brain is unable to completely understand or respond to the traumatic incident.

4.           Explain the pre-planning you would need to consider based on the information dispatch provided.

  1. Neck brace to stabilize the neck and spinal cord
    • Temporary cast to prevent any further bone injury
    • Hemostatic kit to control bleeding
    • Fluids to prevent him from going hypovolemic shock
5.           Which injury would you prioritise based on the information above and how would you treat it?

Bleeding control is the injury that would be prioritized because uncontrolled bleeding can cause major organ injury and eventually leading to the patient death. Trent’s bleeding can be stopped by applying direct pressure on the bleeding area with cloth or thick pad of bandage. Also bleeding limbs should to raise to stop bleeding.

6.           A helicopter crew has been called due to time criticality. Provide a patient handover IMIST- AMBO format as if you were communicating with the helicopter rescue crew.

IMIST-AMBO stands for identification, mechanism of injury, injury information, sign and symptoms with vital signs, treatment given, allergies, medication, background information of the patient, and other information such as social and family information.

I- Trent Turner M- Bleeding

I- Head wound

S- Pale, low blood pressure, clammy skin, rapid breathing and high pulse rate

T- Bleeding pad and direct pressure A- Nor allergy

M- No medication B- 65 years old man

O- No other information

7.           Outline the reporting and documentation requirements for this patient.

1.

Text Box: Case Study 2: Infant Croup

Dispatch informs you at 1800 hours of a mother who has called requesting urgent help for her 8-month-old infant Bella, who is having trouble breathing and is starting to go blue.
On arrival at the scene, you undertake a preliminary scene assessment and evaluate the mechanism of injury. The mother, Emily, is panicked and hands you the infant begging ‘please help my baby, I think she’s dying!’. Emily is clearly distraught and frantic.
Your initial observation identifies the infant is coughing copiously and appears to be unable to ‘catch her breath’, she is cyanosed. You manage to gain information from Emily who states that Bella has been unwell for two (2) days and was reviewed by their local GP in the late afternoon the day before.
On assessment, your observations indicate that the baby is in respiratory distress, and you suspect she is suffering from croup-like symptoms.

Answer the following questions. You must answer all questions correctly to receive a satisfactory outcome for this task.

Note: Question numbering continued from previous task

8.           What is the most likely cause for Bella’s decline?

The most potential cause Bella’s decline is viral infection in her upper airways that results in the breathing obstruction and resulting in barking cough and respiratory distress.

9.           Identify three (3) potential complications of Bella’s condition.

The three potential complication in this condition can be the following:

  1. Blue skin around mouth, nose, and fingernails
    • Difficult and fats breathing
    • Pulmonary edema
10.       Identify the pathophysiology and Mechanism of Injury (MOI) based on the above information.
  • Pathophysiology

Croup is a viral infection of the upper respiratory tract that results mucosal irritation between the nose and the trachea. The parainfluenza virus is the most frequent pathogen. In the subglottic part, obstruction occurs because of the inflammatory exudates and edoema and becomes more apparent.

·       Mechanism of Injury (MOI)

Infiltration of white blood cells causes expansion of the larynx, trachea, and big bronchi in croup. Swelling causes partial airway blockage, which results in drastically increased labour of breathing and the distinctive turbulent, noisy airflow known as stridor when it is severe.

11.       Explain the pre-planning you would need to consider based on the information dispatch provided.

Provide pharmacologic therapy Give nebulizer

Education patient mother to cover the child nose and mouth while coughing and sneezing

12.        Explain how you could support Emily in this situation to calm her down.

Emily is the mother of the child; she is panicked by observing her child condition and begging for help. In this condition nurse should calm Emily by introducing themselves and understanding her about the procedure that they are going to perform. Nurse should explain Emily how the procedure is helpful and how it will make the child more clam and control.

13.       Identify the time criticality for getting treatment to Bella. Would you require any backup or other resources in this situation?

Epinephrine is an effective treatment for croup it will help in minimizing the inflammation in severe symptoms. The backup during providing this treatment to the child respiratory support is also required for decreasing the oedema in airways.

14.       Outline the reporting and documentation requirements for this patient.

Bella should be reporting to the pulmonologist because these are those medical professionals who specializes in the finding and treating issues related to respiratory system and tissues or organs that helps the person in breath. Documentation perform for this child should includes the following things: utilization of accessory muscles during breathing, breath sounds, character and presence of any secretion, hoarse voice, seal-like cough, and high pitch sound while breathing.

Text Box: Case Study 3: Childbirth

You are responding to an emergency scene at a nearby shopping mall, where dispatch has informed you of a pregnant woman who has fallen and gone into premature labour. Her name is Angie. She is 26 years old and is 38-weeks’ gestation.

On arrival, she is bearing down and it appears she is ready to birth the baby. There is no time to waste, your partner calls for immediate back up and you must assist with the delivery of the baby.

After 15 minutes Angie delivers the baby. Angie appears to be in a stable condition; however, the infant is not crying as lustily as you would expect a newborn to cry.
The newborn quickly stops breathing independently and goes limp in your arms. You immediately assess the newborn’s tone, breathing and heart rate.
Answer the following questions. You must answer all questions correctly to receive a satisfactory outcome for this task.

Note: Question numbering continued from previous task

15.       Identify the most likely cause for the infant’s decline.

The main cause for this condition of the new born baby is premature labour. It has been observed that most of the premature infants born with immature respiratory system that refers that infant might not breathing properly and does not have the hearty cry as full time infant.

16.       Identify four (4) potential complications of the infant’s condition.

Premature infants are more likely to suffer from chronic health complications, some of which might need hospital care. Following are the potential complications that might occur in this premature baby:

  • Breathing complications
  • Infections or neonatal sepsis
  • Intraventricular hemorrhage
  • Cardiac issues
17.       Identify the pathophysiology and Mechanism of Injury (MOI) based on the above information.
  • Pathophysiology

Respiratory distress syndrome (RDS), is a type of disease in premature newborns, is a prevalent condition. The primary cause of this condition is a lack of pulmonary surfactant in a developing lung. In preterm newborns, RDS is a leading cause of morbidity and mortality. The premature newborn is diagnosed with infant respiratory distress syndrome, which is defined by decreased oxygen intake. The alveolar (air cell) ducts of the lungs have a transparent membrane that is associated with lower levels of lung wetting agents or emulsifiers.

·       Mechanism of Injury (MOI)

Fluid forms up in the tiny, elastic air sacs (alveoli) in lungs, triggering acute respiratory distress syndrome (ARDS). Because the fluid stops lungs from fully filling with air, less oxygen spreads circulation. Organs will be destitute of the oxygen they necessitate to function.

18.       Outline the pre-planning you would need to consider based on the information dispatch provided.

The child is having respiratory distress syndrome, thus, provide mechanical ventilation, nutritional support, prophylaxis for stress ulcers and venous thromboembolism.

19.       Identify the emergency care procedures you would need to apply in this situation as per your clinical practice guidelines.
  1. Chest compression
    1. Epinephrine
    1. 3.  Airways management
    1. Bronchodilators
20.       Identify the time critical treatment for the infant.

Provide extra amount of oxygen to the infant. Using a mechanical breathing machine who helps in pushing the continuous air flow to the tiny air passages can also be serves as the time critical treatment for this infant.

21.       Outline the reporting and documentation requirements for this patient.

The new born infant does not cry and stopped breathing thus should be reporting to paediatrician. Documentation part of this infant should involve the heart rate, respiratory rate, pulse, and response on touching.

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