DIALOGIA

3 Examining the patient's state

3.1. ABCDE

A middle-aged man has been found lying unconscious by the roadside. A passerby calls an ambulance to the scene. The passer-by tells that the man is lying on his back, and that he may have been hit by a car. An EMS unit arrives and starts examining the patient. The man doesn’t respond.

Pm1: Airways are open. I’ll unzip your jacket and unbutton your shirt. Chest movements are symmetrical. Breath sounds are clear. I’ll attach a pulse oximeter on your fingertip. The saturation is 95 %. I’ll take your blood pressure. The blood pressure is 120/60 mm/Hg. Now I’ll squeeze your finger. Capillary refill is 2 seconds. I’ll attach electrodes to your chest now.

P: What?

Pm2: Emergency care here. The ECG shows sinus rhythm. The pulse is 65/min.

P: What are you doing?

Pm1: I’m examining you. You had lost consciousness. What’s your name?

P: I’m Väpä. I just came from over there.

Pm1: Do you remember when your birthday is?

P: Thursday. Last year.

Pm1: Will you open your eyes. Opens his eyes when talked to, 3p. Pupils react normally to light. Verbal response, confused, 4p. Now squeeze my hand. Grip strength weak. Motor response, obeys commands, 6p. Total score 13p.

Pm1: I’ll take a closer look at you. There is a bump on the head and a slightly bleeding wound. The chest is stable,
abdomen is normal.

P: Stop groping me.

Pm1: Take it easy. Pelvis is normal. Nothing special on the back.

P: Leave me alone. I’ll go over there now.

Pm1: The examination is not finished. We need to make sure that you’re fine. The limbs are moving. No signs of fractures. Will be transferred to emergency room for suturing.

Pm2: Let’s take a breathalyzer test and blood glucose before the transfer. Breathalyzer 1,28. Blood sugar 7.6. We’ll help you into the ambulance now.

P: Will you join me to Pirre’s?

Exercises

SVENSKA-ENGLISH

Discuss in pairs / groups
Diskutera med ditt par / din grupp
    1. How did Väpä end up in this situation? Did he possibly have a conflict with Pirre?
    2. What background and what kind of problems does Väpä have?
    3. Has emergency care taken good care of Väpä (a drunk patient)? Väpä was a bit aggressive.
    4. Has emergency care conducted the right examinations?
    5. What readings did Väpä have? Good, bad, or completely okay?
    6. Why is Väpä taken to the hospital?
    7. Väpä is an alcoholic. Can he recover?
    8. Have you encountered intoxicated patients during your practice?

SUOMI-ENGLISH

Discuss in pairs / groups
Keskustele parisi / ryhmäsi kanssa
    1. How did Väpä end up in this situation? Did he possibly have a conflict with Pirre?
    2. What background and what kind of problems does Väpä have?
    3. Has emergency care taken good care of Väpä (a drunk patient)? Väpä was a bit aggressive.
    4. Has emergency care conducted the right examinations?
    5. What readings did Väpä have? Good, bad, or completely okay?
    6. Why is Väpä taken to the hospital?
    7. Väpä is an alcoholic. Can he recover?
    8. Have you encountered intoxicated patients during your practice?
2.2 Patient Interview at an outpatient clinic
3.2 Examining pain

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