Diagnosis day student Assignments & Information
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- Bu səhifədəki naviqasiya:
- TIME/DATE
- Temperature
- Cardiac Tracing
- Head Trauma
- Diagnosis
- Scenarios for Diagnosis Day 2014
- Charlie
DIAGNOSIS DAY Student Assignments & Information Spring 2015 Student Name _________________________ School _________________________ D.D. Date ________________
DIAGNOSIS DAY 2015 Welcome to the Diagnosis Day adventure. In order to maximize your experience and your learning, please complete the assignments below, read the information about TRAUMA and read the SCENARIO pages. You’ll be asked questions during Diagnosis Day about this information. Bring this booklet with you. Diagnosis Day Learning Objectives: At the conclusion of Diagnosis Day, students will
TIME/DATE: Diagnosis Days generally begin by 8:30am and finish no later than 3:00 p.m. ASSIGNMENT #1: Personal research about careers in Health Care. Here, you have a choice. You can complete the quick survey at www.healthjobsstarthere.com (accessed directly via the link or through our website at http://www.cascadeseast.org/). On this website, you answer a few simple questions and are provided with a list of possible careers which might be a good match for your interest. Or use the website EXPLORE HEALTH CAREERS. From this site you can investigate many careers, get information on education requirements and find basic salary ranges.
_____________________ _____________________ _________________________ _____________________ _____________________ _________________________ ASSIGNMENT #2: Medical Vocabulary During Diagnosis Day, you will be part of the process as patients are evaluated based on their symptoms. You need to know these terms and be ready to offer them as an explanation or course of action for the patient. You will be divided into 3 teams. Each team needs to make sure that each of the vocabulary terms is researched by a team member. Write down the information you find below. There are many easily accessible internet sources- including Webmd and Medterms.com.
Pulmonary Embolism (PE) _________________________________________________________________ Pneumothorax ________________________________________________________________________ Tension pneumothorax _________________________________________________________________ Decubitus _______________________________________________________________________________ Fat embolism _______________________________________________________________________________ Cardiac tamponade ________________________________________________________________________
Bag Valve Mask ventilation (BVM) ________________________________________________ Cricothyrotomy (needle and surgical)________________________________________________ Complete Blood Count (CBC) ______________________________________________________ Blood Chemistry (chem 7, chem 14) ________________________________________________ Arterial Blood gas ______________________________________________________ Blood types (A, B, AB, O +, -) ______________________________________________________ Subarachnoid hemorrhage _____________________________________________________ Subdural hemorrhage ___________________________________________________________ Glasgow Coma Scale (GCS) _____________________________________________________ Dermatomes ___________________________________________________________
Femur _________________________________________________________________ Humerus _________________________________________________________________ Pelvis (number of parts) _____________________________________________________ Spine: cervical, thoracic, lumbar, sacral _________________________________________
Subdural hematoma ____________________________________________________________ Epidural hematoma _____________________________________________________________ Concussion ____________________________________________________________________ TRAUMA First, a note about the use of simulation manikins. We will be using high-fidelity simulation manikins. These manikins breathe, cough, and have heart, lung and bowel sounds that can be heard by stethoscope. You may have the opportunity to give IV medications, apply oxygen, and check pulses among other things. We will try to make the scenarios as realistic as possible but, as this is an extremely expensive piece of equipment, the actions will need to be closely monitored. We will be running 3 scenarios with each group getting to perform some unique actions for the patient. The other groups will observe. For the scenarios to work and to get the action done in a reasonable amount of time we will be “time warping” the scenario. Paying close attention to the controller is key to giving you the best experience possible. For the balance of this document the term Caregiver should be seen as any of the multiple healthcare workers directly involved in treating the patient. This can include physicians, nurses, respiratory therapists, EMT/paramedics and Basic Life Support providers. Trauma Trauma is the leading cause of injury and death among Americans between age 1 and 50. This trauma can be from accidents, assault or self-inflicted injury. In our scenario, we will treat three simulated trauma patients and help them- from the time of their accident through acute treatment and possibly through rehabilitation. Trauma can take many forms. Among teenagers, auto accidents are the leading cause of trauma, followed by bike accidents, falls, other sports accidents, drowning, and gunshot wounds. The initial approach to trauma follows the ABCs. A is for airway and cervical spine control. With trauma, the patient may well be unconscious. Unconscious patients are at risk for blockage of their airway called airway obstruction. They may also have suffered damage to or a fracture of the neck. Moving the neck can damage the spinal cord. Thus, the goal is to open the airway while being sure not to damage the spinal cord. The signs of airway obstruction may be a snoring sound or no sound at all. To open the airway, the caregiver will try to keep the head straight and will try to move the jaw upward so as to move the tongue out of the airway. The EMTs will then try to stabilize the neck with their hands and will later stabilize the neck using a cervical collar or a back board. B is for breathing. With trauma or head injury, the patient may be so deeply unconscious that he/she is no longer breathing. The caregivers will carefully listen for air movement and will look for the chest to rise as a sign of adequate breathing. If the breathing is not adequate, they may use a breathing bag and mask to assist the breathing. If the patient does not quickly respond to “bagging”, they may try to insert a breathing tube into the lungs to further assist the breathing. Even if the breathing is normal, the caregiver may give additional oxygen. Typical breathing rate for adult patients is 14-20 breaths per minute. C is for circulation. The caregiver will check for a pulse. A normal pulse will be strong, regular and at a rate of 70 to 100 beats per minute. A weak pulse can mean low blood pressure and shock. An irregular heart rate may suggest an electrical problem or arrhythmia. A very fast pulse suggests early shock. A slow pulse may be associated with increased pressure on the brain. The caregiver may further check for circulation by checking the blood pressure, monitor the heart using an electrocardiogram and insert an IV to give the patient fluids, if necessary. In the instance where the patient is coming from the field after the caregivers have assessed and addressed the ABCs, they will contact the Emergency Department (ED) so that it will be ready for the patient. In the hospital, the trauma team will be assembled and assignments will be determined based on the anticipated needs of the patient. On the trip to the hospital, the field caregivers will continue to gather more information and will continue to monitor the vital signs. In the ED the field caregivers will give a very concise but more extensive than the earlier radio report to the ED staff about the patient. The ED crew will then take over the case. When treating a trauma patient, the trauma team will generally consist of a doctor, several nurses, a respiratory therapist, a lab technician, a radiology technician(s) and the chaplain. Additional members are called in depending on the level of the trauma and the facility’s policies. The trauma team will re-assess the ABCs. If those are stable, the team will then do a full head to toe assessment, looking for other injuries. They may do certain tests, including:
The physical assessment will look for injuries that may have been sustained in the accident. The doctor will feel the head to look for swelling, lacerations (a jagged wound or cut), or signs of a skull fracture. He will look at the ears to be sure that the eardrums are clear. With a severe head injury or particular skull fracture, there may be blood coming from the ears. The ED doctor will look at the eyes. When normal, the pupils will be equal and will constrict equally to light. With head injury or pressure on the brain, the pupils may be unequal or may not react to light. The doctor will carefully check
The doctor will then do a neurologic exam, looking for the level of consciousness, muscle tone, and reflexes. Almost any part of the body can be injured in trauma. The most important injuries include:
From the Emergency Department, the patient will go to the operating room (OR), if necessary. Many trauma patients are then monitored in the intensive care unit (ICU) until stable. With severe head trauma or orthopedic trauma, the patient may not be able to return to normal activities and may need rehabilitation to regain all of their pre-trauma functions. Please answer the following questions, as they will be important to help you properly diagnose a patient on Diagnosis Day.
Scenarios for Diagnosis Day 2014 Car vs Bike plus Tree Anne, Bill and Charlie- the accident victims- are all high school students in a rural community. Bill is driving with Charlie, headed to school on a rainy, sleety morning. Charlie realizes he left his phone in his bag and really wants Bill to see the latest “cute kitten” post on Instagram. Charlie unbuckles to reach the bag in the back seat and looks for the posting. He neglects to re-buckle his seat belt. While Bill is looking at yet another kitten posting, he veers to the right, hits a slick spot in the road. This sends the car spinning off the road. While spinning they feel and hear two distinct impacts. The last one stops the car. Another driver witnesses the accident and sees the car first hit a cyclist, then hit a tree. The driver calls 911. EMS arrives on the scene and finds Bill behind the steering wheel, Charlie lying face up on the floor of the back seat and Anne thrown from her bike. Community members are frantic and trying to talk to the injured youth. The EMS responders in the initial contact will triage the patients based on injury and needs using multiple assessment tools that can be performed quickly. In this case they quickly find: Bill appears alert and oriented to person, place, time and situation, is having some trouble breathing, hand on chest, and his left leg is angled oddly midway between the knee and ankle. His color is pale, but has strong pulses with a heart rate of 108 and is breathing at 22 breaths per minute. He is making eye contact, and responds appropriately to questions. Keeps asking where Charlie is. Bill complains of pain in his chest, left wrist and leg as well as hip. Charlie is positioned face up on the floor of the back seat and is currently unconscious. He is breathing at a rate of 16 and has a strong pulse of 85. Anne was riding her bike when she was struck from behind by the vehicle and is lying face up in the dirt about 15 feet from the side of the road. She is conscious but is having trouble holding eye contact or answering questions. She knows her name but that is all. She is not wearing a helmet and bystanders state they did not see one. She is breathing rapidly and has strong pulses at 120 beats per minute. She is complaining of pain in her head, back, and neck and hips. Please answer the following questions based on the very limited information you have received so far. There are several possibilities and we do not expect you to catch every possibility. Based on this quick look:
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