Unit 4 Case 1

Question 1

What is Unit 4 Case 1 about?

Answer 1

A couple has 2 children and runs a family dairy farm business who both work full time. While working in a field, the wife gets trampled on by a charging cow. She has severe chest pain. A guy nearby rang 999 and an air ambulance came, taking her to a trauma center. After a CT scan, a chest drain was inserted and she was mechanically ventilated. 4 days later she was sent home, and she had nightmares about the event and worried she could not work on the farm again

Question 2

What is the effect of prolonged CO2 levels in the blood?

Answer 2

Tissues in the body are not getting enough oxygen to carry out metabolic functions. Can lead to many symptoms such as dizziness, fatigue, or dsypnea

Question 3

What is the term for an excess build-up of CO2 in the body?

Answer 3

Hypercapnia

Question 4

How can increased levels of CO2 change the pH concentration in the blood?

Answer 4

As CO2 combines with water it forms carbonic acid, decreasing pH levels in the blood. Causes acidosis. Acidic conditions effect the function of metabolic enzymes

Question 5

What is acidosis?

Answer 5

Acidosis is the condition where the pH of the blood becomes less than 7.35

Question 6

What is a bruise?

Answer 6

Also known as a contusion, is a region of injured tissue or skin in which blood capillaries have been ruptured

Question 7

What is the progression of a bruise?

Answer 7

Starts red- fresh, oxygen rich blood has newly pooled under the skin
The blood begins to loose oxygen and change colour to blue/purple/black
In about 5-10 days it turns yellow/green
-These colours come from compounds the body produces when it breaks down haemoglobin

Question 8

What is bovine tuberculosis (BT)?

Answer 8

It is an infectious disease in cattle which primarily effects the lungs. It can jump the species barrier and cause tuberculosis like infections in humans and other animals

Question 9

How is pain scaled for a patient?

Answer 9

Using a numeric rating scale 
- Patient describes their pain from 1-10
0 is no pain
1-3 is mild pain
4-6 is moderate pain
7-10 is severe pain

Question 10

How does the accessibility of the emergency services differ in rural vs urban areas?

Answer 10

In more rural areas, there is often less accessibility as there are many areas no accessible by ambulance. Therefore an emergency helicopter is often sent out for rural emergencies
-Whereas in urban areas most/all places accessible by ambulance - quicker

Question 11

Is there any risk of pesticides to farmers?

Answer 11

Pesticides have been proven to cause reproductive and developmental effects, cancer, kidney and liver damage, endocrine disruption etc.
-linked to diseases like Alzheimer’s aswell

Question 12

What is turbulent flow in breathing?

Answer 12

Turbulent flow refers to when air is not flowing in paralllel layers and direction.
-Pressure needed to maintain air flow therefore needs tobe increased, causing resistance in the airway

Question 13

What is a primary trauma survey?

Answer 13

Is the initial assessment and management of a trauma patient. It is conducted to detect and treat actual or imminent life threats and prevents complications from these injuries

Question 14

When would an air ambulance be called out?

Answer 14

When the pateint is in a position that is not accessible by other emergancy services like an ambulance
-but also when the patient is in quite critical condition and needs immediate medical attention

Question 15

What is the role of a flight paramedic?

Answer 15

A flight paramedic are responsible for working to recover or stabilize the patient while in transport to a qualified medical facility.

Question 16

What are the basics of first aid?

Answer 16

Call an ambulance
If the patient is unconscious and breathing put them in the recovery position until help arrives
If the patient is inconscious and not breathing call 999 and start CPR
(Danger, Response, Airways, Breathing, Circulation)

Question 17

What is the difference between a trauma centre and the ER?

Answer 17

A trauma centre is equipped to handle the most serious of conditions. Have access to quick CT scans and MRIs, trauma surgeons, lots of life support and easy access such as helicopter landing pads

Question 18

What is paradoxical breathing movement?

Answer 18

Where the diaphragm moves out down inspiration (abdominal wall moves in) and in up expiration (abdominal wall moves out) (oppisite of expected)
-Prevents you from inhaling O2 and exhaling CO2

Question 19

What is lung resonance?

Answer 19

Low pitched hollow sounds that can be heard over normal lung tissue.
This sound gets replaced by a dull sound when fluid or solid tissues replaces air-containing lung tissues (e.g with pneumonia)

Question 20

How does a mechanical ventilator work?

Answer 20

Endotracheal tube goes through pateints mouth and into windpipe. And a nasogastric tube goes through patients nose and into the stomach
-works by bringing oxygen to the lungs via one tube and taking carbon dioxide out via another

Question 21

What is an arterial blood gas (ABG)?

Answer 21

An ABG is a blood test that measures the pH, levels of O2, and levels of CO2 from an artery. The test is used to check the function of a patients lungs and their ability to move oxygen in the blood and remove carbon dioxide

Question 22

What is a pneumothorax?

Answer 22

A pneumothorax is a ‘collasped lung’. Air leakes into the spaces between your lung and the chest wall. This pushes on the outside of your lung and makes it collapse

Question 23

What is a flail chest?

Answer 23

A flail chest is a chest injury in which 2 or more ribs fracture and become detached from the rest of the rib cage

Question 24

How can a flail chest cause pneumothorax?

Answer 24

When the ribs fracture and become detached from the rib cage they can be sharp and puncture the pleura of the lung. This can allow air to move into the space between the lung and chest wall, causing the lung to collapse

Question 25

What is tracheal deviation?

Answer 25

Tracheal deviation is when your trachea is pushed to one side of your neck by abnormal pressure in your chest cavity or neck

Question 26

What is a CT scan?

Answer 26

Medical imaging
A Computerised Tomography uses x-rays at different angles and a computer to create detailed images of the inside of the body
(sometimes referred to as a CAT scan)

Question 27

How is a CT scan used?

Answer 27

Produces detialed images of many structures inside the body, including the internal organs, blood vessels and bones. So used to diagnose conditions- such as bone damage, internal organ problems, problems with blood flow etc.

Question 28

What is a chest drain?

Answer 28

A chest drain is a procedure used to drain blood, fluid, or air from around the lungs, heart, or oesophagus

Question 29

How is a chest drain done?

Answer 29

Using a chest tube. This is a flexible plastic tube that is inserted through the chest wall and into the pleural space or mediastinum, and used to remove the air, fluid or pus from the intrathoracic space

Question 30

Why would a provider withhold pain medication to get informed consent?

Answer 30

As pain’s influnce on cognition can significantly impact the cognitive domains required to obtain valid informed consent

Question 31

What is the effect of trauma on mental health?

Answer 31

People who have experinced trauma can develop PTSD, with common symptoms including re-living the trauma in flashbacks or nightmares, depression or high levels of anxiety

Question 32

What are the physical and mental health risks of being a farmer?

Answer 32

Work long irregular hours
Income dependant on season
Risk of injury with machinery
Health danger with exposure to pesticides
Isolation
Stress- uncontrollable factors like weather

Question 33

What is the effect of isolation on mental health?

Answer 33

Social isolation has been linked to many health consequences.
Some of these include depression, poor sleep quality, lonliness, and accelerated cognitive decline

Question 34

What are rhonchi

Answer 34

Low pitch sounds

Question 35

What is stridor

Answer 35

These are harsh vibrations

Question 36

What does arteriole blood gas measure

Answer 36

Ph
Oxygen level
Carbon dioxide level
Bicarbonate ions