Communication with the patient and their family members or close ones has an essential role in patient care. In order to create a feeling of safety, it is important that the patient can speak their native language.
A middle-aged man has called the emergency number. He has been outdoors mowing the lawn and now he has shortness of breath. He has been diagnosed with asthma before. An EMS unit has arrived and they are examining the man’s condition.
Pm: How are you?
P: It’s difficult to breathe, and the medicines won’t help. I have asthma.
Pm: For how long have you had the attack now?
P: I was outdoors cutting grass and started coughing. Now my breathing is laborious and I keep coughing a lot.
Pm: Have you taken your asthma medication?
P: I’ve taken two doses of asthma medication, but it hasn’t helped at all.
Pm: I’ll give you an oxygen mask to help your breathing. I’ll also help you sit more comfortably. Let’s put a couple of cushions behind your back. Now I’ll take your vital signs. Do you feel better?
P: No. How are my readings?
Pm: The oxygen saturation of your blood is a bit low and your heart beats fast. I’ll give you more medicine.
P: Do I have to go to the emergency clinic?
Pm: Yes. The doctor has to check up on you. Do you have a contact person, whom we should inform?
The patient is a young man who is suffering from a shortness of breath. His girlfriend has called the emergency response centre. The patient himself suspects influenza and tells that girlfriend had it a while ago.
The emergency care nurses notice that the patient’s breathing is fast and rattling, and they want to examine the patient more thoroughly.
Pm: Have you been ill for a long time?
P: For about a week or so.
Pm: Do you have any other illnesses?
P: No, I’m totally healthy.
Pm: I’ll take the stethoscope and listen to your breathing sounds. After that I’ll measure your oxygen saturation.
P: Please, go ahead.
Pm: There is more rattling on the left. The saturation is 95 %, it’s a bit low.
P: I’ve also done sports recently, despite the flu. Can that have something to do with my condition?
Pm: Yes, it’s possible. It can be inflammation of the heart muscle, but we need to do more examinations. Now I’ll take your blood pressure.
Pm: Your blood pressure is 130/75, pulse is 100. The readings are fine.
P: Good to hear.
Pm: I’ll do a few more examinations. I’ll take ECG next.
Pm: I’m going to attach the adhesive electrodes to your chest, so could you expose your chest, please.
P: Ok, I’ll remove my shirt.
Pm: I will have to shave your chest a little so that I can attach the electrodes properly. Now the electrodes are in place. Stay still please.
P: How does it look? Am I alright?
Pm: The ECG shows changes typical of the inflammation of the heart muscle. Do you have any other symptoms?
P: My chest hurts at times, but I guess it’s just the common cold. I also get out of breath easily, but I think it’s also because of the cold.
Pm: I’ll take your temperature, and then I’ll call the doctor.
P: Can I stay home?
Pm: I can’t promise anything yet. The temperature from your ear is 37,9°C. Now I’ll call the doctor.
The paramedic calls the doctor.
EMS physician: EMS physician Mäki.
Pm: This is paramedic Jan. I’d like to consult you about a patient with breathing difficulties. The ECG shows findings indicative of myocarditis. His oxygen saturation is 95 %, blood pressure is 130/75 and pulse is 100. The tympanic temperature is 37,9°C. Breathing sounds rattling on the left. The patient says that he has had a cold for a week, and he has done sports during that time. No other illnesses. Now he has breathing difficulties, chest pain and breathlessness. I suggest that we’ll take the patient to hospital, not to health centre.
EMS physician: The symptoms may be caused by the inflammation of the heart muscle (myocarditis), so I’d like to have him here. We’ll take blood tests here to be able to make a more exact diagnosis.
Pm: The doctor suggested that you come to hospital with us for more examinations.
P: For how long do I have to stay there?
Pm: I can’t tell. What personal items would you like to take with you? Do you want to call anyone?
P: Can you pass me my phone and keys from the table? I’ll call my girlfriend.
Pm: Here are your phone and keys. Get up slowly and walk with me to the ambulance, please. It takes 10 minutes to get to the hospital from here.
Sisällöt on lisensoitu CC BY-SA 4.0.
© Tampereen ammattikorkeakoulu
© Copyright 2020. All Rights Reserved.