RECENT ASSIGNMENT

SCENARIO AND INSTRUCTIONS:
Diabetic Ketoacidosis (DKA)
ASSESSMENT 2 - SCENARIO
Patient: You are called to a 23 year old. approximately 60 kg female patient who is feeling generally unwell with frequent vomiting over the last 12 hours.
On arrival: You find the patient sitting upright on the side of her bed She appears lethargic and at times confused. Arrival time at scene is 0630
On examination: The patient is complaining of central abdominal pain, nausea, lethargy. She states she has vomited probably 10 times ' over the previous 12 hours and has been unable to keep any sustenance down. She describes the vomitus as mostly liquid and denies the presence of blood in the vomit She reports diarrhoea intermittently since last night She also states that she had an increased thirst in recent times and frequency of urination. She states that she feels insatiably hungry however unable to keep anything down
Past Medical History: hypothyroidism
Medications: oral contraceptive pill and thyroxine. Patient states she is always compliant with her medications
Allergies: No known allergies
Primary survey:
D-Nil
R - AVPU (respond to verbal commands)
C - Radial pulse present, fast and weak
A - Clear
B - Fast and irregular
Vita! Sign Survey:
. GCS - 13 (E3. V4. M6)
• Speech - Normal
• Pupils - PEARL
• Respiratory rate - 24 breaths per minute Irregular rhythm with a sweet odour on her breath.
• SpO; - 98% on room air
• Lung sounds - Air entry clear, right = left
• Pulse 106 beats per minute, regular, radial and weak
• Blood pressure - 85/60mmHg
• Temperature - 37ec (tympanic)
• Blood glucose level - 28 mmol/L
• Skin - dry. warm poor skin turgor and dry mucous membranes
• Head to toe: Pain in abdomen 6/10. No other abnormalities detected
Additional information: The patient tells you she last ate a small meal at dinner time yesterday (at 1830).
SCENARIO AND INSTRUCTIONS:
WHAT YOU NEED TO DO:
Students are required to use the case study provided below to create a pre-hospital case management plan for this patient. Students are required to;
a. Provide a brief overview of the patient’s condition, including pathophysiology. (What is your diagnosis? Explain what is happening to the patient).
b. Demonstrate an understanding of the patient s presentation in relation to their signs and symptoms (state the signs and symptoms and explain how their underlying condition is causing these. Go into detail here).
c. Develop a paramedic management plan based on current literature. Be sure to include full details of treatment (e g dose, route, repeats, total maximum dose. etc. for all medications)
Note - it is NOT necessary to summarize the details of the scenario in your presentation. You can assume the reader has read the case and is familiar with it. Save your word count for more essential information.
Message to writer:
• Roughly 900 words
• You will need to give a brief description of the ECG in part B as well (saying what it is and why do you think it's happening).
• The condition is Diabetic Ketoacidosis (DKA)
SCENARIO AND INSTRUCTIONS:
• The management plan needs to be in pre-hospital settings and should include something more than fluid administration.