Hronic Medical Conditions and Health Surveillance

The aim of this assessment is to demonstrate knowledge and understanding of key concepts in the module, showing their application to professional practice and care delivery.The essay should be no more than 2,500 words.

You are working as a Paramedic Practitioner and have been dispatched at 1400 hrs to a 76 yrs female who has suffered a fall.
On arrival you are met by Mr Smith, who explains that he observed his wife get up out of her chair before collapsing to the floor. You introduce yourself to Mrs Smith and gain consent to undertake an assessment. Mrs Smith explains that she has just returned from a cruise holiday, during which she suffered a nosebleed. Knowing that she has a history of hypertension, she consulted the ship s doctor, who advised that her blood pressure was high and started her on a medicine called Atenolol for five days with instructions to see her own GP on her return. She remembers feeling  giddy when she stood up and her  legs giving way but denies any loss of consciousness, pain or palpitations.
As requested by the  999 call taker, Mr Smith has gathered his wife s regular medication.
Medication Amlodipine 10mg od Aspirin 75mg od
Atenolol 400mg bd Calcichew

” Critically analyse these findings and discuss any additional history you would obtain providing a rationale and evidence base for your actions.

Respiratory rate 16/minute Temperature 36.7c
Heart rate 62/minute BM 5.2
Capillary refill Less than 2 seconds Lead II ECG Sinus Rhythm
SpO2 97% GCS 15/15
Blood Pressure 119/70

o Discuss any further physical examination you would perform providing a rationale for your actions.

” With reference to relevant pathophysiology and pharmacology critically analyse the significance of these findings and suggest potential differential diagnoses for this patient.

Mrs Smith is able to mobilise independantly and refuses to attend hospital. Whilst you complete paperwork she prepares afternoon tea in the kitchen and asks if you would like a piece of cake

” Compare and contrast the range of referral options available in this scenario. Provide details of any aftercare advice you would provide

For the purposes of this case study you may assume that you have the full range of medication and diagnostic equipment available to Emergency care/ Paramedic Practitioners within your Trust.
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McCance, K. L. & Huether, S. E. (2006). Pathophysiology. This biological basis for disease in adults and children. (5th ed.). St. Louis: Elsevier.

Naidoo, J. & Wills, J. (2000). Health promotion: Foundations for practice. (2nd ed.) Bailliere Tindall.

Raftery, A.T., Kian, E. & Lim, S. (2001). Churchill s pocketbook of differential diagnosis. Churchill Livingstone.

Snyder, D. R. & Christmas, C. (2003). Geriatric education for emergency medical services. London: Jones and Bartlett Publishers International.

United Kingdom. Department of Health. (2001). National Service Framework for Older People. London: Department of Health.

United Kingdom. Department of Health. (2003). National Service Framework for Older People: A Report of Progress. London: Department of Health.

United Kingdom. Department of Health. (2005). Independence, Well-Being and Choice: Our Vision for the Future of Social Care for Adults in England. London: The Stationery Office.

United Kingdom. Department of Health. (2007). Generic Choice Model for Long-Term Conditions. London: The Stationery Office.

United Kingdom. Department of Health. (2008). Health and Care Services for older People: Overview report on research to support the National Service Framework for Older People. London: COI.

United Kingdom. Healthcare Commission, Audit Commission and Commission for Social Care Inspection. (2006). Living Well in Later Life: A Review of Progress against the National Service Framework for Older People. London: Healthcare Commission.



WEBSITES

British Thoracic Society: uk

Department of Health: uk

Evidence Based Guidance: uk

Health Professions Council: asthma.org.uk

National Institute for Clinical Excellence: uk

National Osteoporosis Society: uk

Occupational asthma record forms: sign.ac.uk