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You have been called to the home of a 87 year old woman, Chantelle, who has experienced an episode of syncope and chest pain.

For this assignment you may choose a case from your clinical practice (in
negotiation with your topic coordinator) or evaluate the case below and choose
one (1) potential differential diagnosis that relate to PARA2000 topic content.
Please de-identify the case – no place or name identifiers. If you have not
attended a case or a case you feel comfortable discussing then two cases will be
provided for you to choose from.
(You may NOT choose acute coronary syndromes (ACS) as they have been
discussed in your previous assignment).
The case study will provide you with an opportunity to discuss:
 Key clinical signs of the case
 The pathophysiology of your diagnosis
o Related signs and symptoms, assessment and management
 Vital sign interpretation
 Current management practices
o Paramedic Management
o Hospital emergency management (first 24hours only)
 A critique on the evidence supporting the management practices
You are required to demonstrate a thorough understanding of the
pathophysiology and provide rationales for your diagnosis and interventions.
It is expected that you research the condition from both text books and current
literature. At least five journal articles are expected to be part of your literature
search (Less than 10 years old). You will also review the clinical practice
guidelines of at least two (2) Australian state clinical practice guidelines. The
goal is to provide up to date evidence based practice for the management of the
patient’s condition.
Higher grades will be awarded for evidence of extensive use of literature and a
critical evaluation of the care provided for the patient.
1500 word limit
PARA2000 Pathophysiology 1 – Cardiovascular 2016
Case Scenario 1
Situation: You have been called to the home of a 87 year old woman,
Chantelle, who has experienced an episode of syncope and chest pain.
Background: The patient has a history of has been complaining of feeling
increasingly unwell for the last 24 hours with pain in her chest.
PMHx: HT, Angina diagnosed 28 years ago, angioplasty (successful), MI
x2, CABG x 2, Asthma, GORD, OA
Med’n: Atenolol, ramipril, GTN spray, transiderm-nitro patch,
atorvastatin, salbutamol inhaler, symbicort inhaler, pantoprazole, aspirin,
Plavix, paracetamol PRN,
Allergies: Morphine
Comm. Diseases – Nil Known, up to date with vaccinations
Social Hx: Lives with partner
Family Hx: Father died of CVA, mother died in fatal MVC
Alcohol: Social
Smoking: Stopped 20 years ago (30/day)
Assessment: When you arrive you find the patient looking distressed.
Vital signs: BP 90/60, PR 105, RR 28, SpO2 96%, T35.1°C,
Appearance: Pale, cool, clammy, distressed
Case Scenario 2
Situation: You have been called to a military parade where a soldier has had an
unconscious collapse.
PMHx: Unknown
Med’n: Paracetamol PRN,
Allergies: NKDA
Comm. Diseases – Nil Known, up to date with vaccinations
Social Hx: Lives with partner
Family Hx: Parents living, paternal grandfather died suddenly aged 38 –
no autopsy, grandmothers both living.
Alcohol: Social
Smoking: Non smoker
Assessment: When you arrive you find the patient supported by colleagues in
the left lateral position.
Vital signs: BP 63/38, PR 135, RR 28, SpO2 91%, T36.9°C,
Appearance: Fit looking young man, pale, cool, clammy, fluctuating
conscious state
You are expected to:
 outline your potential diagnosis and defend your diagnosis from
 provide an ECG appropriate to your diagnosis and explain why.
PARA2000 Pathophysiology 1 – Cardiovascular 2016
 outline the paramedic management of your patient, including the vital
signs and defend how these align for your potential diagnosis against the
A&P. Please see example for further clarification. (You may outline
treatment up to the first 24 hours in hospital)

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