rationales for your diagnosis and interventions
Select one of the cases below.
The case study will provide you with an opportunity to discuss:
• Key clinical signs of the case
• Differential diagnoses and their rationales
• The pathophysiology of those diagnoses
• Current management practices
• A critique on the evidence supporting the management practices
You are required to demonstrate a thorough understanding of the pathophysiology and provide rationales for your diagnosis and interventions (for more tips and information, visit assignment tips).
It is expected that you research the condition from both text books and current literature. At least SEVEN journal articles are expected to be part of your literature search. The goal is to provide up to date evidence based practice for the management of the patient’s condition.
Higher grades will be awarded for evidence of extensive use of literature and a critical evaluation of the care provided for the patient.
Do NOT discuss mental illness diagnoses; the same case studies might be used in Mental Health Emergencies where this discussion is expected.
3000 word limit
PLEASE NOTE: Extension for assessment will only be approved for extenuating circumstances supported by official documentation
Case Scenario 1
You are called to the scene of a motor vehicle accident at 11:00 pm. The driver is a 25 year old female. She has been removed from the car by the witnesses before your arrival and she is lying down on the side of the road. Witnesses state she has not lost consciousness during their presence. You approach the patient and she responds and appears alert, but confused with memory loss of the accident.
While assessing the patient, her partner and family arrive on scene and express that she has been out every night over the last fortnight and has become increasingly withdraw.
After 10 minutes of family arrival she starts losing her consciousness, becomes unresponsiveness and in a minute she stops breathing.
Case Scenario 2
You have been called to a shopping centre at 10:30 am for a 62 year old male who has collapsed. Upon you arrival, he is sitting on the ground, he is awake but drowsy and disoriented. He has difficulty talking, however he can remember that he collapsed after feeling extremely dizzy.
He is with his daughter. She tells you that her father is living alone in a double story building. He has had a falling episode from stairs 8 months ago without any major injury.
He is insisting on going home regardless of your offering help to take him to the hospital.
His eyes suddenly move upward and in a few seconds he starts a seizure.
Assignment tips for PARA2000
[these are your notes which will be converted into prose for this assignment]
Potential diagnosis
Pathophysiology
Underlying Diagnosis
Paramedic clinical practice interventions
Critique of interventions from literature
Potential Cardiac arrest from lethal arrhythmia due to low potassium K+
The heart relies on its internal pacemaker (SA node) and superconductive pathway to generate and disseminate cardiac action potentials. These action potentials cause the contraction of cardiac muscle tissues and the effective propulsion of blood throughout the body. Abnormal conduction of the action potential may cause ineffectual cardiac muscle function and thus catastrophic heat failure. The sodium potassium exchange across the cardiac cell membrane required to get an action potential and contraction of the cardiac muscle.
(Reference)
Cardiac monitoring
? Attach defibrillation monitor & encourage early defibrillation should defibable arrhythmia occur
? Continuous Monitoring of patients cardiac rhythm,
? 1/24 vital signs eg BP. P RR SaO2 checks
? Regular checks and management of electrolyte balances
? 12 lead ECG
? CPR & Medication management of arrhythmia
? (Referenced)
Critique each of the clinical practice intervention, defending is validity or not from the current literature linking this to the underlying pathophysiology of the potential diagnosis identified. (Referenced)
* Attachment and monitoring of the defibrillator of the cardiac patient during transport allows for the early defibrillation. Early defibrillation has increased success at reverting lethal arrhythmias and preventing death in a cardiac arrest (Ref1, Ref 2, Ref 3,.……)………
Paramedic
Introduction (the introduction may be brief but should cover major concepts)
[all in prose, sort of like an essay introduction]
Introduce the patient…. [it is okay if this part isn’t much different from others’ introduction of the patient, consider SBAR format]
The issues that will be discussed are……….
They have been chosen because…….
Differential diagnosis [2 potential diagnoses]
[XXXXXXXXXXX] You will be not be graded on achieving my expected final diagnosis but on your ability to relate the signs and symptoms to a disease process and then on your suggested management and critique of the management that is defended from literature.
[make sure that you include the pathophysiology behind the diagnosis]
XXXXXX (Reference).
Paramedic Intervention and Rationale
[What paramedic interventions/treatment are you doing and why are you doing them]
The interventions that will address the issue of potential arrhythmias are as follows.
————————————————————————————————————————–
Working example of transferring bullet points into sentences
1. Attach defibrillation monitor & encourage early defibrillation should defibable arrhythmia occur
2. Continuous Monitoring of patients cardiac rhythm,
3. 1/24 vital signs eg BP. P RR SaO2 checks
4. Regular checks and management of electrolyte balances
5. 12 lead ECG
6. CPR & Medication management of arrhythmia
(Referenced)
————————————————————————————————————————–
[Intervention 1 in prose format, you will need to be more comprehensive in your assignment]
Attachment and monitoring of the defibrillator of the cardiac patient during transport allows for the early defibrillation and reverting of cardiac arrhythmias. Early defibrillation has been shown to have increased success at reverting lethal arrhythmias and preventing death in a cardiac arrest (Ref1, Ref 2, Ref 3,.……)………
The interventions need to be critiqued from literature as to how they will be treating, monitoring or managing the diagnosis they have chosen. This will include their paramedic guidelines. The assignment is designed to help them understand their practice and be able to critique what they do in a constructive format. They are allowed to discuss management into the hospital for the 1st 24 hours to assist them with the assignment and understanding the disease process.
Conclusion (sort of like an essay conclusion)
We’ve discussed ….
We’ve identified potential diagnoses such as….
These potential diagnoses should be addressed by the paramedic interventions as described.
[This is purely optional: acknowledge that it is not comprehensive if you like, BRIEFLY mentioning some examples of what you might have looked at.]
Good writing is concise yet still easy to read and cover all of the content required.
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