Instructions 1- After reading the case study, answer the questions. All thoughts, ideas, and content application need to be supported with evidence from the readings, class discussions, or the case study. You may not add information to the case study. What is provided is what you have to work with. Do not be afraid to share your real thoughts, actions, and impressions. Just make sure you back them up. Keep all treatments and assessments within your scope of practice. 2- Your submissions should be a minimum of 5 pages in length. You may format your submission as a questions and answer. Excessive spacing will be removed when looking at length. Use complete sentences and watch your spelling and grammar. 3- Whenever the case study refers to “you”, it is referring to each individual student. You may input your training background and certification level. 4- A pdf version of the case study is available if you would like to download the case study and questions to work on them. 5 -For each of the listed patient scenarios below, answer all five (5) questions. Provide support for your statements and decisions from the class lectures, discussions, assignments, and readings. *Remember you are answering the questions as an EMS provider. More detail and explanation is always better than less. Questions 1. Identify the diverse group dicussed in class that this patient belongs to. Be as specific as possible. If there is a sub-group, identify the sub-group, . name the specific religion or special need. 2. Identify from the case study, what lead you to put them into that specific group or sub-group. Include any co-morbidities the patient may have. 3. If there is an alternative or complimentary medicine being used, identify it and explain how it would impact your patient interactions and care. 4. Explain how you would adjust or change your assessment/treatment for this individual and/or situation; include why you would need to make the adjustment or change. 5. How could you advocate for this patient? Patient Scenario #1 You are dispatched to the comic book store for a seizure. You find a male in his early 40’s that is postictal. He is sitting up and rocking slightly with his ears covered and eyes closed. The owner of the comic book store tells you that the patient is a regular and spends a few hours a day in the shop. He lives near by and walks over. He also tells you that the man’s bother is on his way over. When you reach out to make contact and introduce yourself, the patient pulls away and does not open his eyes. You tell him your name and he repeats it over and over. You ask why he has his ears covered and eyes shut. He points toward the front window where the Fire truck and Ambulance are parked with the lights flashing. You start asking him questions and he does not respond. He just continues rocking and saying your name. When you go to place the blood pressure cuff on his arm he rips it off and yells no. The brother arrives and tells you that the patient takes Lexapro and uses lavender and chamomile to help him relax. In talking to the brother you decide the patient needs to be transported. Patient Scenario #2 You are dispatched to the local bar for an assault. You find a male in his early twenties sitting up against a wall outside the bar. He has multiple abrasions and simple lacerations on his face and he is complaining of abdominal pain. A witness states that the patient was kicked in the abdomen. The patient seems reluctant to answer your questions. You ask them their name and they mumble Alexia. You notice witnesses calling him Alex. The patient states that they are taking testosterone and uses Butterbur and feverfew herbs for migraines. You ask for permission to do an exam of his abdomen and trunk. The patient becomes hesitant and nervous but allows you to perform the exam. You find that he is wearing a sports bra. He states that his hips and pelvis are fine and refuses to allow you to check them. You begin discussing transport options with him and he becomes agitated and will not consent to transport. From your exam you are concerned about internal injuries and explain this to them. He reluctantly consents to be transported. Patient Scenario #3 You are dispatched to a home for a woman having a seizure. You arrive to find a 16-year old female lying next to a wheel chair. You notice that her limbs are all flexed and her mouth is open. The patient is trying to turn her head to look at you but is struggling to support it and coordinate the movement. The patient’s mother states that the patient was in her wheel chair when the seizure began. The patient then fell out of the chair. They called because the family was nervous about a head injury from the fall. You begin assessing and notice little marks on the patient’s shoulders and back that look like injection sites. The mother says that they are from aligning the patient’s energy to help her maintain her strengthen better. You determine that she needs to be transported. Patient Scenario #4 You are dispatched to a motor vehicle collision. You find only one patient, a 60 year-old male complaining of chest pain. He struck his chest against the steering wheel. The patient very politely requests that a male EMT assess and treat him. As you are asking him history questions you find out that he is a vegetarian and currently participating in Ramadan. The patient keeps trying to look at their phone and watch. He is becoming anxious and requests to pray. As you are doing a physical exam you notice several perfectly round, slightly raised bruises on his back. They seem to be in a purposeful pattern. You ask the patient about them and he explains that he had recently cleansed his blood. You determine that he needs to be transported. Patient Scenario #5 You are dispatched to a residence for a fall. When you arrive a mid 70 year-old female meets you on the front porch. She tells you that her 77 year-old husband has fallen and she cannot lift him to get him up off the floor. You enter the home and find a clean, well taken care of room with older obviously loved furniture. You also see baskets of magazines and newspapers. Every surface seems to have a figurine or plant. The floors are hardwood with area rugs everywhere. You find the patient lying on their side in the hallway. You introduce yourself and the patient asks you who the older woman with you is. You explain that it is his wife. He then asks what happened. After explaining that he fell the patient becomes emotional. You calm them down and begin a physical exam. The patient continues to ask what happened every few minutes. They also keep reaching for your stethoscope and rubbing your EMS patch. Suddenly, in a panicked voice they ask for their wife. You get her and it calms the patient down. You ask about medications and the wife begins to list prescriptions. She seems nervous and keeps looking around. She asks if the police are there. You respond that they are not present. She then whispers that they smoke some stuff that their grandson gets for them, several times a day. It helps them relax and helps the patient be more present. You determine that the patient’s injuries are significant enough to transport them.
