ADVANCED MEDICAL STUDIES
CASE STUDY DETAILS
Due:
Word count: 3000 (+/- 20%) excluding references and cover page. In brackets and in red throughout the case study I have suggested how many words to allocate to each section. THESE ARE SUGGESTIONS ONLY.
Referencing: APA style.
Presentation: One document, retain formatting.
Marks allocated: 50% of unit mark (NB: look at the marking guide for details of mark allocation).
General layout: As this is a case study, there is some leeway in terms of how you wish to present your paper. You may include tables, diagrams, graphics etc if they support your paper, but do not rely on them to tell the story. Make sure you credit any external sources.
You are welcome to use headings and subheadings to make your paper clearer. It would be advisable to have numbers/subheadings for the individual questions asked in the case study details below.
Point form may be used to emphasise certain aspects, but please do not present the entire case study as one long list.
As everyone approaches case studies in a different way, I will be flexible with the layout; just make sure you address all the points in the marking guide, even if they’re not structured in exactly the same way as the marking guide.
Introduction: Can be brief. Use the introduction to present the patient’s condition. (100 words)
Evidence: You need to incorporate some evidence into the paper; you cannot just state what you would do. For example, if you choose to perform ETI, you need to support your decision with reference to a trial, or ARC guidelines. ARC, ILCOR and AHA are good sources. Reference to evidence should not be the bulk of your case study (as it was in the assignment), but there should be references to support your choices.
If you’ve kept up with your weekly study guides, you should have most of the evidence you need. The case study touches upon the text readings and articles from weeks 1, 2, 3, 6 and 10.
Conclusion: If you have incorporated your evidence into the body of the paper, the conclusion can just be a brief recap. If there is evidence you have strongly relied upon in the paper, you may wish to reiterate it here. (200)
Queries: I cannot look over drafts of papers, but I’m happy to answer any questions at all via the discussion board.
There are no ‘tricks’ with the case study. If there is information omitted, assume it is not relevant. I expect intensive care paramedic level assessment, intervention, management and clinical decision making, based on best practice evidence.
Case Study Details:
Your role and location: You are working as an intensive care paramedic (ICP) in a remote mining location in rural Australia. The mining company also provides medical care to the local Aboriginal community. You have support in the way of basic life support (BLS) officers, but you are the senior officer. You are trained and authorised to perform interventions and administer medications in line with the Australian Resuscitation Council (ARC). You are also authorised to administer primary care, in the way of antibiotics.
Extrication: You have direct access to a well-equipped medical centre. The closest medical officer and hospital are two hours away by 4WD ambulance.
Call out: A patient is brought to the medical clinic in a private vehicle. The patient is ‘Elly’, a 50 year old woman who identifies herself as Aboriginal. She is able to walk 10 metres into the clinic, heavily supported by family members.
History of presenting complaint: Elly’s family state she has been ‘generally unwell’ with a moist cough for approximately two weeks. She is normally self-caring. Today, she has been unable to walk unaided and has been confused. They believe there is no trauma involved, but are unable to provide further details. She denies chest or other pain.
Past Medical History (PMHx): Family and patient unable to provide any details. Medications: Nil.
Allergies: Unknown.
On examination:
Airway: Patent
Breathing: Appears short of breath. 40 resps/minute. Audible wheeze. Bilateral crackles on late inspiration. SpO2 88% on room air.
Circulation: Radial pulse is hard to palpate due to oedematous tissue. 130 beats/minute. BP 80/65mmHg.
Disability: Patient is confused to time and place. GCS 12 (eyes 3, verbal 4, motor 5). BSL 12.5 mmol/L.
Exposure: Patient is febrile to touch. Tympanic thermometer reads 39.4oC. Nil rash. ECG: Sinus tachycardia.
1. Outline your assessment, intervention and management. Provide evidence to justify any medication choice.(1000)
2. What is your provisional diagnosis? Explain your response.(200)
3. What ABG trends (you are not being asked for exact values) would you expect for
pH, PaCO2, PaO2 and HCO3- given the patient’s condition? Explain your
answers.(600)
4. What is your fluid regimen for this patient over the next two hour transport? Justify
your response. (500)
