General medical 1 CSE KETTERING Scenario
General Medical - 1
You are a 24 year old registered respiratory therapist. You are single, love to travel and work for a
company called Mobile Medical Corps. It is winter and you are fulfilling a six-month temporary work
contract at a major medical ...
You are a 24 year old registered respiratory therapist. You are single, love to travel and work for a
company called Mobile Medical Corps. It is winter and you are fulfilling a six-month temporary work
contract at a major medical center in south Florida on the Atlantic coast. There has been a deep-sea
diving accident and some of the victims are being brought to the hospital's Emergency Department. You
have been called in to assist.When you arrive in the ED you are asked to evaluate the cardiopulmonary
status of the 22 year old Navy diver in Cubicle 6. Which of the following would you evaluate at this
time?(SELECT AS MANY as you consider indicated in this Section.)
General appearancePatient is breathing shallow, he is pale, but has no signs of trauma.
Vital signsPulse 130/min, respirations 28/min, and BP 90/58 mmHg.
Chest auscultationDecreased sounds in the bases.
Level of consciousnessPatient is obtunded.
Recent history-While conducting underwater salvage, the patient ascended rapidly.
Arterial blood gases
At an FIO2 of 1.0, PaO2 350 torr, pH 7.41, PaCO2 38 torr, HCO3- 23 mEq/liter, SaO2 99%.
Pupillary response
Pupils constrict more slowly than normal.
Babinski reflex- Normal response
Rectal temperature-35.8oC (96.4oF)
ECG monitor-Sinus tachycardia with an occasional PVC
NFORMATION GATHERING
Analysis:In this simulation you are a therapist who works for a traveling service. You become involved in
two different situations, one of which includes the use of hyperbaric therapy.You must first deal with a
patient who exhibits symptoms of air embolism. Later you are asked to assist in the care of a patient
with carbon monoxide poisoning.It is always important to quickly assess critically ill patients. A solid
understanding of the principles of hyperbaric medicine is very important here. It is also important for
you to recognize the limitations and dangers of hyperbaric therapy when other therapy is more
appropriate.You are working in a hospital on the southern Atlantic coast. An ocean accident has
occurred and there are "victims" being brought to the Emergency Department.You should be prepared
for any number of problems. There could be more victims than the ED can handle without triage.
Problems could range from multiple trauma, to burn injury, to near drowning, to decompression related
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