1. Identify an discuss three (3) manual handling hazards faced by paramedics and ways these hazards can be minimised.

1. What cardiac rhythms may cause cardiac arrest.
2. Which of these rhythms can be defibrillated?
3. Define each rhythm identified above?
4. Summarise ILCOR’s (International Liaison Committee on Resuscitation) basic life support cardiac arrest guideline pertaining to the adult patient.
5. For each step identified above, provide a rationale.

Airway Management and Ventilation

6. What is clinical significance of sighting the vocal cords during laryngoscopy?

Clinical observations and vital signs

7. Why is the colour and moisture of the skin a clinical observation when assessing the cardiovascular and respiratory of a patient?
8. Why does a patient with poor perfusion present with diaphoresis?
9. Why is blood pressure an important clinical observation when assessing a patient’s respiratory condition?
10. What are you observing when assessing a patient’s respiratory rhythm?
11. What is the Glasgow Coma Scale used for and in what setting is it best applied?
12. Why are pupillary observations important in assessing patient’s neurological condition?
13. List 9 causes of an altered conscious state. 3 causes of respiratory, 3 cardiovascular, 3 endocrinological .

1. For each patient presentations listed below, list ten questions you would ask whilst gaining a detailed history and provide a Rationale for each question listed. (Questions such as description, onset, location, other signs and symptoms and relieving factors constitute one question.

–70 years old male complaining of chest pain.

–25 years old female complaining of lower abdominal pain

–56 years old female complaining of epigastric discomfort.

–15 years old male complaining of pain in right wrist, post skateboarding accident.

–42 years old male complaining of a sudden onset of severe headache.

–18 years old male involved in a motor vehicle accident.

–80 years old female who has fallen in the bath from a standing height.

2. You are dispatched to an 18 year old female who has crashed her car into a tree and is supposedly trapped. On arrival you notice the impact appears quite low speed and there is minimal damage to the car. The patient appears very anxious, is tearful and too emotionally overwhelmed to follow direction. She is sitting in the driver seat and will not get out of the car. At first glance, she appears to have no injuries.

–What form of entrapment does this constitute?

–What equipment (if any) may you require to effectively extricate this patient?

–What techniques might one adopt / apply to gain the patients cooperation, confidence and alleviate her anxiety?

–Outline your clinical approach to this patient.

Time Criticality

3. What is time criticality?
4. What is the difference between medical time criticality and trauma time criticality?
5. You are dispatched to an 80 year old female who has fallen in the bath from a standing height. You note a minor laceration to her forehead with no haemorrhage.

–With the information presented, is this patient time critical?

–On further examination you note she has no other complaints or injuries. Outline your management of this patient.

–Does this patient require transport? If so, to what level of care will you transport this patient and will you classify her as not time critical, potential, emergent or actual time critical? Provide a rationale for your answer.

6. You are dispatched to a 30 year old male involved in a motor vehicle accident at 75km/h. On arrival you note the male standing out of the car seemingly well. The car has moderate damage to it.

–Does this patient require transport? If so, to what level of care will you transport this patient and will you classify him as not time critical, potential, emergent or actual time critical? Provide a rationale for your answer.

7. Now consider this, you were dispatched to a 30 year old male, but on arrival you find that there has been a miscommunication and it is a 3 year old male. All other circumstances remain unchanged.

–Does this patient require transport? If so, to what level of care will you transport this patient and will you classify him as not time critical, potential, emergent or actual time critical? Provide a rationale for your answer.

–Learning that your patient is a 3 year old male, what is something that you may want to investigate further? Not necessarily to do with the patient, but the circumstances surrounding the incident.

8. Whilst you are dealing with this 3 year old male, you are greeted by a 70 year old female who states she is the child’s grandmother and she was driving the car. She has no complaint but is concerned for the child’s welfare.

–Does the 70 year old female require an additional ambulance? If you are going to call for an additional resource provide rationale. If so, to what level of care do you expect this patient will be transported and will you classify her as not time critical, potential, emergent or actual time critical? Provide a rationale for your answer.

9. Now, consider the 30 year old male once more. Detail your clinical approach and management of this patient.

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