It is appreciated that the given case study contains other factors such as psychological trauma and the impact of blood loss. However this essay is going to explore the efficacy of pre hospital immobilisation utilising cervical collars and extrication/ orthopaedic stretchers, reflecting on an account from the paramedic’s practice. A modified framework of Gibbs Reflective cycle (1988) will be used. Including Description, Feelings, Evaluation, Conclusion and Action Plan. This essay is supported throughout using relevant evidence and seminal work.
When working on an ambulance for a large ambulance service a case was given of a 27-year-old male who had been assaulted. On arrival at scene the crew were met at the entrance to a block of flats by a police officer. The crew where informed that the patient was in a second floor flat and the assailants where no longer on scene. On entering the given address there was blood in the corridor of the unkempt flat. A Primary survey was conducted to ascertain scene safety regarding threats to the crew or patient and to identify any immediate life threatening conditions. Fisher J.D, Brown S.N & Cooke M.W (2006) reinforces this by stating the importance of evaluating Time Critical, Potentially Time Critical or Non Critical features when undertaking the Primary survey. The patient was sat up in the kitchen accompanied by a police officer; he informed the crew that he had been assaulted with a baseball bat.
A secondary survey was undertaken encompassing a patient history and head to toe assessment to identify the extent of the patient’s injuries as stated by I. Greaves, K.Porter, T.Hodgetts and M.Woodard (2006). He was found to have a 2-inch haematoma to the back of the head and a 1inch laceration ...
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...y W.A & Hostler D.P (2006). Comparison of the Ferno Scoop Stretcher with the long backboard for spinal immobilisation. Prehospital Emergency Care.10 (1): 46-51
Mobbs R.J, Stoodley M.A & Fuller J (2002) Effect of cervical collar on intracranial pressure. The Royal Australasian College of Surgeons.72 (6); 389-391
National Institute for Clinical excellence (2007) 56- Head injury (p15).
Stiell I.G, Clement M, McKnight R.D, Brison R, Schull M.J, Rowe B.H, Worthington J.R et al (2003). The Canadian C-Spine Rule versus the NEXUS low-risk criteria in patients with trauma. The New England Journal of Medicine, 349(26): 2510-2518
Stiell I.G, Wells G.A, Vandemheen K.L, Clement C.M, Lesluk H, De Maio JD et al (2001) The Canadian C-spine Rule for radiography in alert and stable trauma patients. The journal of the American Medicine Association, 286(15); 1841 -1848
This assignment will explore a case study on an episode of care where a patient with chronic pain was hoisted. This will be written from the perspective of the author, a student nurse. The purpose of this assignment is to underline the ethical, legal and professional issues surrounding the episode of care during nursing practice and how these issues influence the role of the nurse and their professional judgement in delivering holistic, person-centred care for the patient. The author will cover the complications on delivering care when healthcare professionals should consider and respect the patient’s decisions and personal preferences whether it may benefit the patient or not. Therefore, the author will argue the principles of the patient’s autonomy against the concerns for the patient’s health and well-being, considering what form of care is appropriate and what must be done and how the nurse can maintain their professional role in being an advocate. Moreover, this will consider the nurses’ approach in providing the best care possible by means of ethical, legal and professional values. Furthermore, this assignment will briefly show an awareness of the roles of other professionals involved in the care.
In any major accident, it is important that everyone involved in the co-ordinated planned response liaise with all Health services, Traffic control, Police, Fire services, ambulance and hospital. The action at an accident starts as: assessing the situation, in the management of an incident one of the most important steps is evaluating the scene accurately.
Tien, Homer. “The Canadian Forces trauma care system.” Canadian Journal of Surgery 54 (2011): 112-117.
Interaction with their patient on a regular basis is also a crucial aspect of a neurosurgeon’s career. Supporting the patient in medical decisions and informing the patient of all possible risks, effects, delays, results, and outcomes of his or hers surgery is conceivably the most imperative obligation a neurosurgeon can carry out. The physician must be able to clearly and precisely discuss they patient’s course of action with whom they are comfortable with to ensure the best recovery.
Ryan, E. "A Case of Shell Shock." Canadian Medical Association Journal. 6.12 (1916): 1095-9. Print.
...l. "[The Use Of Physical Restraints In An Acute Care Hospital]." Assistenza Infermieristica E Ricerca: AIR 23.2 (2004): 68-75. MEDLINE. Web. 22 Oct. 2013.
Williams, B, Brown, T & Onsman, A 2012, ‘From stretcher-bearer to paramedic: The Australian paramedics’ move towards professionalisation’, Australian Journal of Paramedicine, vol. 7, no. 4, pp. 8, viewed 12 May 2014, < http://ro.ecu.edu.au/jephc/vol7/iss4/8/>
..., Ducker, T.B., ….. Young, W. (1997). International Standards for Neurological and Functional Classification of Spinal Cord Injury: International Medical Society of Paraplegia, 35, 266 – 274.
22 November 2004. Clear and Present Danger? Test. The. 2004.
Modern society has developed an understanding and recognised the morals regarding consent as individuals have a right and interest over their body (5). Consent enables protection against unauthorised invasion of an individual’s body and can be applied to numerous scenarios, including medical care (5). A paramedic must obtain consent before treating a patient, as consent has legal and ethical aspects that must be regarded (2). It is imperative for a paramedic to maintain ethical and legal competency to assess whether a patient is competent to deny or consent to treatment as presented in the case study (3). Paramedics attended Betty, a 78-year-old female, after her son called the ambulance service. Betty is provided
“Summary Report for: 29-2041.00 - Emergency Medical Technicians and Paramedic.” O*Net. 2008. Web. 18 Feb. 2010.
The current patient may be experiencing a range of traumatic injuries after his accident, the injuries that the paramedic will focus on are those that are most life threatening. These injuries include: a possible tension pneumothroax or a haemothorax, hypovolemic shock, a mild or stable pelvic fracture and tibia fibula fracture.
Neurological procedures can lead to significant postoperative deficits. It is important for physicians to assess nervous system function intraoperatively so that any deficits can be corrected before they become permanent. The oldest method of assessing spinal cord function is with the Stagnara wake up test where patients are awoken in the middle of surgery in order to assess motor function(1). Once the neurological status of the patient is evaluated, the patient would be reanesthetized and the surgery would resume. The wake up test is limited in that it only provides a brief assessment of motor function. It fails to detect ischemia and sensory function(2). Now, intraoperative neurophysiological monitoring with motor evoked potentials (MEPs), somatosensory evoked potentials (SEPs), electromyography (EMG), electrocorticography (ECoG), and cortical mapping has become the new standard of care. It allows physicians to examine the nervous system function without waking the patient. It has become an essential intraoperative tool to improve safety in surgical procedures and helping minimize postoperative deficits. It has allowed surgeons to accept high-risk patients who might have been otherwise denied for a surgical procedure. There are many intraoperative monitoring modalities used to assess different part of brain, spinal cord, and the peripheral nervous system. The strength of each modality is able to offset the limitations of other monitoring modalities, and when combined together, they provide a comprehensive picture on the complex spinal cord function.
First responders play a crucial role in the establishment of a crime scene. Upon arriving at the scene, the first responders have checked for living victims and have rendered aid. It’s important to create a perimeter around the crime scene (this can be altered if additional evidence is found outside the initial crime scene). Only emergency personnel should enter and exit from the central entry point to control contamination, by creating an exit point; it helps avoid any excessive traffic through the crime scene. By secure the scene to ensure that no evidence is misplaced or damaged, or otherwise compromised. Do a cursory check of the crime scene to obtain any transient evidence and secure any weapons found at the scene (in this case it was already at the scene with the suspect). Crime scene analysts and investigators communicate with first responders and are quickly briefed on the situation, and now a more thorough search can be conducted.
Stocchetti, N., Pagan, F., Calappi, E., Canavesi, K., Beretta, L., Citerio, G., … Colombo, A., (2004). Inaccurate early assessment of neurological severity in head injury. Journal of Neurotrauma, 21(9), 1131-1140. doi:10.1089/neu.2004.21.1131