PARA1000 Clinical Simulation Practice Scenarios (1-8) PDF

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PARA1000: Introduction to Paramedic Practice

CLINICAL SIMULATION PRACTICE SCENARIO 1 Job Information: (To be read to student outside of classroom and student to repeat aloud) Flinders 81: Priority 1 to a residential address for a 26 year old female patient who is unresponsive and not breathing. Received at (current time), Dispatched at (current time). Introduction: Ms Samantha Lawrence – DOB: 7/5/89. Situation: Hx – Pt is a university student in second year. She hasn’t eaten all day. Been c/o nausea and lower abdominal pain for past 4hours. Been at home studying all day with boyfriend. Whilst sitting in chair in lounge, resting, she suddenly collapsed unresponsive and fell to the floor. Boyfriend called for paramedics immediately. No CPR initiated. Boyfriend can provide ‘background’. Background: PMHx – asthma, appendectomy 6months ago (January this year) Medn – ventolin puffer, Microgynon 30 (contraceptive pill) SHx – smoker (1/2 pack day), regularly sexually active, binge drinking most weekends, nil illicit drug use, mild stress with exams, good family supports FHx – breast ca (mother and aunty), MI (father) Allergies – nil Communicable diseases – nil Assessment: HR Pulse

O/A 0 bpm Nil

2 mins later 0 bpm Nil

Rhythm BP Cap Refill RR Breathing SpO2 Skin BGL Temp GCS Pupils Pain 2 survey

PEA PEA Nil Nil Nil Nil Nil Nil Nil Nil Nil Nil grey, cold, sweaty 5.0 mmol/L 5.0 mmol/L 37.0˚C 37.0˚C 111=3 111=3 44Nil Nil Nil obvious injuries

2 mins later 0 bpm Nil

2 mins later 0 bpm Nil

2 mins later 0 bpm Nil

PEA Nil Nil Nil Nil Nil

PEA Nil Nil Nil Nil Nil

PEA Nil Nil Nil Nil Nil

2 mins later 54 bpm Weak at all sites bradycardia 80/50 >2secs 0 Nil Nil

5.0 mmol/L 37.0˚C 111=3 4Nil

5.0 mmol/L 37.0˚C 111=3 4Nil

5.0 mmol/L 37.0˚C 111=3 4Nil

5.0 mmol/L 37.0˚C 111=3 4Nil

Anthea Cayetano - 2015

PARA1000: Introduction to Paramedic Practice

CLINICAL SIMULATION PRACTICE SCENARIO 2 Job Information: (To be read to student outside of classroom and student to repeat aloud) Flinders 81: Priority 1 to the sick-room of Marion Primary School, for a 56 year old male patient who is unresponsive and not breathing. Received at (current time), Dispatched at (current time). Introduction: Mr Leroy Brown – DOB: 5/2/59. Situation: Hx – Pt is a grade 3 teacher. He ate breakfast at 8am / lunch at 12pm. C/O chest pain for past hour. Pain started whilst teaching. He attempted to rest but nil relief. Went to sick-room to see if nurse had GTN spray as he forgot his. Whilst sitting in chair in sick-room, he suddenly collapsed unresponsive to the floor. Nurse called for paramedics immediately. No CPR initiated. Nurse has notes on ‘background’. Background: PMHx – High cholesterol, hypertension, MI last year (2013), Medn – Lipitor, Metoprolol, GTN spray SHx – ex-smoker (1 pack day) quit after MI, social drinking most weekends, nil illicit drug use, mild stress with family life FHx – lung CA (mother), CCF (father) Allergies – nil Communicable diseases – nil Assessment: HR Pulse

O/A 0 bpm Nil

2 mins later 0 bpm Nil

Rhythm BP Cap Refill RR Breathing SpO2 Skin BGL Temp GCS Pupils Pain 2 survey

VT VT Nil Nil Nil Nil Nil Nil Nil Nil Nil Nil grey, cold, sweaty 5.0 mmol/L 5.0 mmol/L 37.0˚C 37.0˚C 111=3 111=3 44Nil Nil Nil obvious injuries

2 mins later 0 bpm Nil

2 mins later 0 bpm Nil

2 mins later 0 bpm Nil

VT Nil Nil Nil Nil Nil

VT Nil Nil Nil Nil Nil

VT Nil Nil Nil Nil Nil

2 mins later 54 bpm Weak at all sites bradycardia 80/50 >2secs 0 Nil Nil

5.0 mmol/L 37.0˚C 111=3 4Nil

5.0 mmol/L 37.0˚C 111=3 4Nil

5.0 mmol/L 37.0˚C 111=3 4Nil

5.0 mmol/L 37.0˚C 111=3 4Nil

Anthea Cayetano - 2015

PARA1000: Introduction to Paramedic Practice

CLINICAL SIMULATION PRACTICE SCENARIO 3 Job Information: (To be read to student outside of classroom and student to repeat aloud) Flinders 81: Priority 1 to a residential address for a 61 year old female patient who is unconscious and not breathing. Received at (current time), Dispatched at (current time). Introduction: Mrs Isabelle Morris – DOB: 8/6/54. Situation: Hx – Pt lives at home with husband. She has been sitting on the couch for the past 30mins watching the news when she experience sudden onset of crushing chest pain. She took 3 x sprays of GTN 5mins apart. Nil relief so she asked her husband to call for paramedics. Whilst on the phone, her husband witnessed her collapse unresponsive to the ground. No CPR inititated. Husband can provide ‘background’. Background: PMHx – Angina (past 2/12 on excessive exercise), depression, osteoporosis Medn – GTN spray, Lexapro, Panadol-osteo SHx – non-smoker, non-drinker, nil illicit drug use, nil stress, good family supports FHx – cervical ca (mother and aunty), stroke (father) Allergies – penicillin (rash) Communicable diseases – nil Assessment: HR Pulse

O/A 0 bpm Nil

2 mins later 0 bpm Nil

Rhythm BP Cap Refill RR Breathing SpO2 Skin BGL Temp GCS Pupils Pain 2 survey

PEA PEA Nil Nil Nil Nil Nil Nil Nil Nil Nil Nil grey, cold, sweaty 5.0 mmol/L 5.0 mmol/L 37.0˚C 37.0˚C 111=3 111=3 44Nil Nil Nil obvious injuries

2 mins later 0 bpm Nil

2 mins later 0 bpm Nil

2 mins later 0 bpm Nil

PEA Nil Nil Nil Nil Nil

PEA Nil Nil Nil Nil Nil

PEA Nil Nil Nil Nil Nil

2 mins later 54 bpm Weak at all sites bradycardia 80/50 >2secs 0 Nil Nil

5.0 mmol/L 37.0˚C 111=3 4Nil

5.0 mmol/L 37.0˚C 111=3 4Nil

5.0 mmol/L 37.0˚C 111=3 4Nil

5.0 mmol/L 37.0˚C 111=3 4Nil

Anthea Cayetano - 2015

PARA1000: Introduction to Paramedic Practice

CLINICAL SIMULATION PRACTICE SCENARIO 4 Job Information: (To be read to student outside of classroom and student to repeat aloud) Flinders 81: Priority 1 to Cedars Nursing Home for a 76 year old female patient who is unresponsive and not breathing. Received at (current time), Dispatched at (current time). Introduction: Mrs Betty Watts – DOB: 3/4/39. Situation: Hx – Pt lives at high level care nursing home. Carers attempted to wake patient for a meal. Patient was found unresponsive and not breathing. Nursing staff called paramedics immediately. No CPR initiated. Patient has been unwell for the past 5/7 ?pneumonia. Locum commenced patient on AB 2/7 ago. Nurse has notes on ‘background’. Background: PMHx – dementia, CHF, pressure sores on right leg Medn – Aricept, Lasix, Perindopril SHx – non-smoker, non-drinker, nil illicit drug use, good family supports, assistance required with all ADL FHx – nil known Allergies – nil Communicable diseases – MRSA in wound on leg Assessment: HR Pulse

O/A 0 bpm Nil

2 mins later 0 bpm Nil

Rhythm BP Cap Refill RR Breathing SpO2 Skin BGL Temp GCS Pupils Pain 2 survey

PEA PEA Nil Nil Nil Nil Nil Nil Nil Nil Nil Nil grey, cold, sweaty 5.0 mmol/L 5.0 mmol/L 37.0˚C 37.0˚C 111=3 111=3 44Nil Nil Nil obvious injuries

2 mins later 0 bpm Nil

2 mins later 0 bpm Nil

2 mins later 0 bpm Nil

PEA Nil Nil Nil Nil Nil

PEA Nil Nil Nil Nil Nil

PEA Nil Nil Nil Nil Nil

2 mins later 54 bpm Weak at all sites bradycardia 80/50 >2secs 0 Nil Nil

5.0 mmol/L 37.0˚C 111=3 4Nil

5.0 mmol/L 37.0˚C 111=3 4Nil

5.0 mmol/L 37.0˚C 111=3 4Nil

5.0 mmol/L 37.0˚C 111=3 4Nil

Anthea Cayetano - 2015

PARA1000: Introduction to Paramedic Practice

CLINICAL SIMULATION PRACTICE SCENARIO 5 Job Information: (To be read to student outside of classroom and student to repeat aloud) Flinders 81: Priority 1 to a sports centre for a 21 year old male patient who is unresponsive and not breathing. Received at (current time), Dispatched at (current time). Introduction: Mr James Cogdon – DOB: 11/3/94. Situation: Hx – Pt has been playing basketball all day in a tournament. He was playing his fourth game when he started to feel dizzy and SOB. He clutched his chest and collapsed to the ground unresponsive. The coach called paramedics. No CPR was initiated. Dad watching the game can provide ‘background’. Background: PMHx – WPW Medn – verapamil SHx – non-smoker, sexually active, binge drinking most weekends, nil illicit drug use, stress-free, good family supports FHx – MI (males), high cholesterol (mother) Allergies – Elastoplast (rash) Communicable diseases – nil Assessment: HR Pulse

O/A 0 bpm Nil

2 mins later 0 bpm Nil

Rhythm BP Cap Refill RR Breathing SpO2 Skin BGL Temp GCS Pupils Pain 2 survey

VF VF Nil Nil Nil Nil Nil Nil Nil Nil Nil Nil grey, cold, sweaty 5.0 mmol/L 5.0 mmol/L 37.0˚C 37.0˚C 111=3 111=3 44Nil Nil Nil obvious injuries

2 mins later 0 bpm Nil

2 mins later 0 bpm Nil

2 mins later 0 bpm Nil

VF Nil Nil Nil Nil Nil

VF Nil Nil Nil Nil Nil

VF Nil Nil Nil Nil Nil

2 mins later 112 bpm Weak at all sites tachycardia 110/75 >2secs 0 Nil Nil

5.0 mmol/L 37.0˚C 111=3 4Nil

5.0 mmol/L 37.0˚C 111=3 4Nil

5.0 mmol/L 37.0˚C 111=3 4Nil

5.0 mmol/L 37.0˚C 111=3 4Nil

Anthea Cayetano - 2015

PARA1000: Introduction to Paramedic Practice

CLINICAL SIMULATION PRACTICE SCENARIO 6 Job Information: (To be read to student outside of classroom and student to repeat aloud) Flinders 81: Priority 1 to a shopping centre for a 54 year old female patient who is unresponsive and not breathing. Received at (current time), Dispatched at (current time). Introduction: Mrs Joanne Manson – DOB: 18/9/60. Situation: Hx – Pt has been out at the shops today with a friend to buy a birthday present. She has been stuck at home with a sore leg recently, but decided to get out of the house today. Whilst walking around, pt became very SOB and collapsed to the ground. Her friend called paramedics straight away, and just prior to their arrival the pt became unresponsive and stopped breathing. No CPR initiated. Friend can provide ‘background’. Background: PMHx – DVT, HT Medn – aspirin, coversyl SHx – social smoker, social drinker, nil illicit drug use, stress from illnesses, minimal family supports FHx – CVA (mother), HT (father) Allergies – nil Communicable diseases – nil Assessment: HR Pulse

O/A 0 bpm Nil

2 mins later 0 bpm Nil

Rhythm BP Cap Refill RR Breathing SpO2 Skin BGL Temp GCS Pupils Pain 2 survey

VT VT Nil Nil Nil Nil Nil Nil Nil Nil Nil Nil grey, cold, sweaty 5.0 mmol/L 5.0 mmol/L 37.0˚C 37.0˚C 111=3 111=3 44Nil Nil Nil obvious injuries

2 mins later 0 bpm Nil

2 mins later 0 bpm Nil

2 mins later 0 bpm Nil

VT Nil Nil Nil Nil Nil

VT Nil Nil Nil Nil Nil

PEA Nil Nil Nil Nil Nil

2 mins later 54 bpm Weak at all sites bradycardia 80/50 >2secs 0 Nil Nil

5.0 mmol/L 37.0˚C 111=3 4Nil

5.0 mmol/L 37.0˚C 111=3 4Nil

5.0 mmol/L 37.0˚C 111=3 4Nil

5.0 mmol/L 37.0˚C 111=3 4Nil

Anthea Cayetano - 2015

PARA1000: Introduction to Paramedic Practice

CLINICAL SIMULATION PRACTICE SCENARIO 7 Job Information: (To be read to student outside of classroom and student to repeat aloud) Flinders 81: Priority 1 to a residential address for a 31 year old female patient who is unconscious and not breathing. Received at (current time), Dispatched at (current time). Introduction: Miss Gabbie Willis – DOB: 21/10/83. Situation: Hx – Pt lives at home with friends and has been feeling unwell for the past couple of days with ?gastroenteritis. She has barely eaten over the past day or so, but has made sure she has taken her medication as normal. Today she was found to be lying on the kitchen floor by her housemate who heard a loud noise from her bedroom. The housemate called paramedics and didn’t know what to do, so no CPR was initiated. Housemate can provide ‘background’. Background: PMHx – Type I DM, migraines Medn – actrapid, protophane, paracetamol SHx – non-smoker, social drinker, nil illicit drug use, nil stress, good family supports FHx – Type II DM (mother and aunty), schizophrenia (father) Allergies – morphine Communicable diseases – ?gastroenteritis Assessment: HR Pulse

O/A 0 bpm Nil

2 mins later 0 bpm Nil

Rhythm BP Cap Refill RR Breathing SpO2 Skin BGL Temp GCS Pupils Pain 2 survey

PEA PEA Nil Nil Nil Nil Nil Nil Nil Nil Nil Nil grey, cold, sweaty LO LO 37.0˚C 37.0˚C 111=3 111=3 44Nil Nil Nil obvious injuries

2 mins later 0 bpm Nil

2 mins later 0 bpm Nil

2 mins later 0 bpm Nil

PEA Nil Nil Nil Nil Nil

PEA Nil Nil Nil Nil Nil

PEA Nil Nil Nil Nil Nil

2 mins later 54 bpm Weak at all sites bradycardia 80/50 >2secs 0 Nil Nil

LO 37.0˚C 111=3 4Nil

LO 37.0˚C 111=3 4Nil

LO 37.0˚C 111=3 4Nil

LO 37.0˚C 111=3 4Nil

Anthea Cayetano - 2015

PARA1000: Introduction to Paramedic Practice

CLINICAL SIMULATION PRACTICE SCENARIO 8 Job Information: (To be read to student outside of classroom and student to repeat aloud) Flinders 81: Priority 1 to a home address for a 43 year old male patient who is unresponsive and not breathing. Received at (current time), Dispatched at (current time). Introduction: Mr Michael Jones – DOB: 30/1/72. Situation: Hx – Pt lives at home with partner and has been really stressed lately after losing his jobs. Patient has not been able to pay his bills and has become depressed. Partner came home from bingo and found the patient to be unresponsive and not breathing. There was a ‘goodbye’ note next to the patient. Partner called paramedics in a panic and would not start CPR as directed. She is able to provide ‘background’ for paramedics. Background: PMHx – Type II DM, high cholesterol, depression Medn – metformin, Lipitor, valium SHx – ex-smoker, binge drinker, past illicit drug use, stress from unemployment, poor family supports FHx – nil known Allergies – unknown Communicable diseases – hepatitis C Assessment: HR Pulse

O/A 0 bpm Nil

2 mins later 0 bpm Nil

Rhythm BP Cap Refill RR Breathing SpO2 Skin BGL Temp GCS Pupils Pain 2 survey

PEA PEA Nil Nil Nil Nil Nil Nil Nil Nil Nil Nil grey, cold, sweaty 9.0 mmol/L 9.0 mmol/L 37.0˚C 37.0˚C 111=3 111=3 44Nil Nil Nil obvious injuries

2 mins later 0 bpm Nil

2 mins later 0 bpm Nil

2 mins later 0 bpm Nil

PEA Nil Nil Nil Nil Nil

PEA Nil Nil Nil Nil Nil

PEA Nil Nil Nil Nil Nil

2 mins later 110 bpm Weak at all sites tachycardia 100/50 >2secs 0 Nil Nil

9.0 mmol/L 37.0˚C 111=3 4Nil

9.0 mmol/L 37.0˚C 111=3 4Nil

9.0 mmol/L 37.0˚C 111=3 4Nil

9.0 mmol/L 37.0˚C 111=3 4Nil

Anthea Cayetano - 2015...