Obst Long Case Practice Breech PDF

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Bachelorof ParamedicalScience   

AssessorPack   

SpecialPopulationsinParamedicPractice PMSC12003  

LONGCASE Scenario–Imminentbreechbirth              Page1of5 

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CandidateInformation   TimeLimit:20mins   Youwillbenotifiedatthe15minutemark.   Instructions:  Youareworkingatastationwhenyouaredispatchedcodeonetoa24A00 Pregnancy/Birth:Imminentbirth.  Ptisa28yofemale.   Task:  Toassess,diagnoseandtreatthepatientaccordingtocurrentQASClinical Guidelines   AdditionalInformation  3minstoscene  15minstohospital  Timeofdayis2300hrs  Nobackuphasbeendispatched.Ifbackupisrequired,itmustbeaskedfor duringtheassessment  Thesceneisaneatandtidyhighsethouse           Page2of5 

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SimulatedPatientInformation   Instructions:  Crewmetbyptparent,directedtobedroom  Ptlocatedinbedroom,extremelyanxious,inobviouslabour  History: o 38weeksgestationwithsecondbaby(G2P1) o Statesyoubeganlabouratapprox.1300hrs,withcontractionsnow1min apart o Waterbrokeapproximatelyonehourpriortocallingtheambulance o Youareexperiencinglowerbackpain&havejuststartedfeelingtheurge topush o Lastpregnancywasnormalvaginaldelivery o Havenotattendedanyantenatalappointmentsforthepastfewmonthsas “Thelastdeliverywasnormalandfeeltheyareawasteoftime”   PmHx:Asthma Allergies:Pollen Meds:Ventolin&Seretide LastMeal:Dinnerat0600(pickedatashepherd’spie)              Page3of5 

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AssessorSurveys&Observations  ONARRIVAL:Metbypartneratdoor,directstobedroom  GENERALAPPEARANCE:Ptextremelyanxious,inobviouslabour.  Danger‐Nil Response‐Alert A‐Clear  B‐Normal  C‐Normal  VITALSIGNS Initialassessment 2ndpostdelivery GCS 15 15 CNS Pupils PEARLsize3 PEARLsize4 Motor/Sensory GoodandEven GoodandEven Rate 18 14 Rhythm Normal Normal RSA Effort Normal Normal Auscultation L=R L=R Speech ClearandContinuous ClearandContinuous Pulserate 100R 80R Bloodpressure 120/80 125/90 ECG NSR NSR CVS BSL 6.8 ‐ SPO2 98%RA 98%RA Temperature 37.1 ‐ Skin WellPerfused WellPerfused Other Pain 10/10 2/10   OPQRST‐ContractionPain,cramping,urgetopush HEAD NECK CHEST ABDOMEN PELVIS BACK ARMS LEGS H2T Nil Nil Nil Nil Nil Nil Nil Nil      Page4of5 

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BABY‐POSTDELIVERY   Danger‐Nil Response‐Alert A‐Meconium B‐Normal  C‐Normal  VITALSIGNS Initialassessment 2ndpostdelivery APGAR 9 (blueextremities) 10 CNS Pupils ‐ ‐ Motor/Sensory ‐ ‐ Rate 32 32 Rhythm Normal Normal RSA Effort Normal Normal Auscultation L=R L=R Speech ‐ ‐ Pulserate 130R 125R Bloodpressure ‐ ‐ ECG ‐ ‐ CVS BSL 6 ‐ SPO2 98%RA 98%RA Temperature 36.1 ‐ Skin WellPerfused WellPerfused Other Pain ‐ ‐   OPQRST‐ HEAD NECK CHEST ABDOMEN PELVIS BACK ARMS LEGS H2T Nil Nil Nil Nil Nil Nil Nil Nil       

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