Reflection
.
Using the Gibb’s reflective I will reflect on the seventh lab
session we had for this semester. It took place on the 28th of
February.
Description: I was given a scenario of a 32 male complaining
of shortness of breath. Demonstrating a correct management and
logical sequence of history taking was required from me. My management of this
was correct however, I did tried to give the epinephrine IV since the patient
have sever asthma and he used he’s puffs this morning however, he’s condition
remind the same. Also, the general impression of this patient was anxious and
he was speaking in words. However, my teacher
remind me to give the epinephrine IM not an IV. Moreover, I didn’t follow the
OSCE sheet in the order. But I was able to take the vital signs quickly. Also,
I was able to take the history from the patient using OPQRTS and AMPLE .However,
I delayed the treatment because I spent a while to take the history
.
.
Feelings: I felt more confident while assessing this patient. Moreover, I
felt I am not aware about the route of epinephrine because I want to give it IV
but my teacher told me to give it IM. Also, I felt I was very concerns about
the patient condition. Furthermore, I felt guilty because I didn’t give the
medication quickly which worse the patient condition
.
.
Evaluation: what I did well was evaluating the patient, I did the assessment
quickly, I had my vital signs survey, RSA including the SpO2 and the
temperature done quickly and had asked the PQRST and AMPLE. Also, I transported
the patient to the hospital as soon as possible. However, what I know did badly
was I delayed given the epinephrine. Also, I confused to give it IV or IM. In
addition, I didn’t follow the OSCE sheet in order
.
.
Analysis: I think
my approach to this patient was not systematic because this patient was in
severe asthma, I kept the patient question without providing the epinephrine
quickly. However, I think my approach for this patient was correct as per the
JRCALC, this patient took his two puffs of each the salbutamol and hydrocortisone
with any improvement of his condition. This made me to give the patient the
epinephrine. Moreover, it was a good case to evaluate my decision clinical
making capacity
.
.
Conclusion: It is very important to conduct the treatment to the patient
along with taking the history. Also, to make sure
the route of the medication. Moreover, it is important to follow a systematic
approach, the OSCE sheet and document all the acquired information to avoid
forgetting when handover the patient case
Action plan: Next time I will follow the OSCE sheet sequence. Also, I will
keep practicing the approach of server asthmatic patient. Moreover, I will make
sure that any patient who have severe asthma, have received the epinephrine, if
the other medication didn’t work. Furthermore, I will make sure that the
medication is administer in the right route.
Domain knowledge
Enquiry and Research
In this week, I felt that I am not fully aware about the injury
that caused by the smoke inhalation. That why I planned to read useful article
that may help to understand this concept. I read the “lung injury from smoke
inhalation article written by
In my reading, I found that the Lung
injury from smoke inhalation can be caused by chemical and thermal insults. As
smoke is inhaled, most of the heat is dissipated by the upper airways by the
time the inhaled material reaches the carina. Therefore, direct thermal injury
primarily affects the supraglottic airways. Thermal injury of the intrathoracic
airways occurs during prolonged exposure to high ambient temperatures or with
inhalation of steam, since steam has a greater thermal capacity than dry air (Lee & Mellins, 2006).
Moreover, in terms of treatment, initially the treatment should
focus on reversing carbon Monoxide poisoning, if present, by the administration
of high concentrations of humidified oxygen. If severe carbon monoxide
poisoning is suspected, it is helpful to administer oxygen via a
non-rebreathing mask at flow rates higher than the victim’s minute ventilation
in or der to achieve concentrations close to 100%. Moreover, with significant
airway oedema, tracheal intubation may be necessary to maintain airway patency
and adequate oxygenation and ventilation. (Lee
& Mellins, 2006).
After
reading this article, I was able to understand that Carbon monoxide is the
predominant cause of death among fire victims and high concentrations of
humidified oxygen should be focus on reversing carbon Monoxide poisoning, if
present.
References:
Lee, A. & Mellins, R. (2006). Lung injury from smoke
inhalation. Paediatric Respiratory Reviews, 7(2), 123-128. doi:
10.1016/j.prrv.2006.03.003
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