Reflection
Using the Gibb’s Reflective Model I will reflect on the fifth Lab
session we had for this semester.
Description: In this week, I was given a scenario of a 45 male complaining of
shortness of breath. Correct management of COPD patient was required in the scenario.
I checked for ABC assessment. However, it wasn’t
in the correct sequences. Then I asked the
patient the history using PQRST and SAMPLE, this followed by asking the partner
to take the vital signs. Oxygen saturation was low, high flow oxygen was given
to the patient 15l/min, using non- rebreather mask. Also, salbutamol along with
ipratropium bromide was given to the patient and transport was initiated.
Feelings: I felt my management was correct. However, I didn’t follow the
correct sequence of the assessment. Also, I felt very interested in COPD case
since I was able to relief the shortness of breath and giving the patient
oxygen.
Evaluation: What I did right
was the management of patient, using the salbutamol and ipratropium bromide
helped the patient to improve his condition. What I didn’t do right was I
forget to ask the patient history if he smokes or not. Also, I did follow the
correct sequence of the OSCE sheet. In addition, I did not looked to the
patient surrounding area because he was using a lot of tissues.
Analysis: I could have been more in the patient center interview. For
example, when I did asked about medication that he is uses, l could ask more
for how long he is uses and if he used the medications before we arrive. This
information would have better outcomes if acquired.
Conclusion: It’s important to conduct the patient center interview as soon as
possible. Because patient condition may become difficult to manage if the right
information didn’t obtained, especially the information that help to diagnose
the patient condition and differentiation form
other conditions.
Action plan: In future, I will follow clinical approach sequence. Also, I will
make sure that I am following the correct sequence of the OSCE sheet. This is
in order to don’t miss anything. Moreover, I will make sure that I have obtain
all information that related to the patient and help me to diagnosis the
patient condition.
Domain knowledge
Enquiry and Research
In this week, I have further read the
article below, which is about acute respiratory distress syndrome. Actually, in
the lecture there was no much information about ARDS that’s why I have chosen
this topic in understand more information and after I read it I found a lot of useful
information. In my further, I found acute lung injury and acute respiratory
distress syndrome are defined by refractory hypoxaemia (using the PaO2 to FiO2 ratio)
in associationwith bilateral lung infiltrates on chest radiography, in the
absence of left atrial hypertension. Moreover, Patients present either with
acute lung injury or full blown acute respiratory distress syndrome, which may have
prognostic significance. Some 55% of patients with acute lung injury seem to
develop acute respiratory distress syndrome within three days of admission to
an intensive care unit. In terms of treatment, treatment of patients with acute
lung injury is essentially supportive, coupled with aggressive management of
the precipitating condition. Complications, which include the exacerbation of
lung injury, multiple organ system failure, nosocomial pneumonia, deep vein
thrombosis, and gastrointestinal bleeding must be minimised. Admission to an
intensive care unit with experience in dealing with such cases is mandatory and
may improve outcome.
References
Leaver, K., &
Evans, W. (2007). Acute respiratory distress syndrome. British Medical Journal,
335(1), 389-94. doi:10.1136/bmj.39293.624699. Retrieved from https://scholar.google.ae/scholar?q=Acute+Respiratory+Distress+Syndrome&hl=ar&as_sdt=0&as_vis=1&oi=scholart&sa=X&ved=0ahUKEwiqsrHhiKvMAhXCK8AKHZnnDcAQgQMIGTAA
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