The following are Case based learning projects.They are worth 50% of your unit mark and therefore are important in
terms of the learning process associated with the unit.
The questions following the cases are designed to stimulate Clinical and
Situational awareness in the aeromedical retrieval environments and are
based on an expectation of a high-level clinical knowledge foundation.
Stimulating and enhancing your clinical understanding and developing
your clinical thinking and application are an underlying goal.
The Case Studies will comprise:
• Pre-Hospital Retrieval: 3 Cases
• Co-ordination: 1 Case
• Inter-Facility: 1 Case
• Total: 5 Cases
The assignment should be presented as per ECU guidelines and use an
acceptable academic referencing system where necessary.
Use of bullets is acceptable to summarize pertinent points and
information to save on word count.
The total word count for all submissions should not exceed 3500 words
plus or minus 20%
Line spacing should be 1.5
Font may be Arial or Times New Roman
You can find a copy of the marking key and criteria in this part of the
blackboard website
Case Studies: PST 4106
2
Paramedical Science
Pre-Hospital Cases:
Case 1:
A van has collided at high speed with a car. The tasking agency reports
that there are three severely injured patients including children. All are
still in the vehicle and could be trapped.
In addition there is one potential fatality at the scene.
Relevant information:
Retrieval means: Rotary Aircraft
Ground resources: 3 ambulances, police and fire and rescue
Retrieval options: Major trauma center 20 minutes by air, general
hospital 30 minutes via road.
Environmental: Approaching rain.
Questions:
1.1 Describe your Pre hospital plan and immediate actions on
arrival at scene
On arrival you note 4 patients from 2 vehicles and all have been
extricated:
a. Patient 1 is pulseless and apneic with a large opened
skull fracture with extra-cranial brain tissue visible
b. Patient 2 is a middle aged female with a rigid abdomen
and bruising over the pelvis. She has decreased air entry
over the left lung field according to on scene paramedic.
Her BP is 90 systolic and GCS 6
Case Studies: PST 4106
3
Paramedical Science
c. Patient 3 is a male 11 years old with a closed bilateral
femoral fracture that is crying inconsolably. His pulse is
120 beats per minutes
d. Patient 4 is from a 3rd vehicle and is C/O ankle pain.
1.2: Outline your treatment for these patients and provide rationale
for which you would select for the air retrieval. What could
potentially go wrong with this scenario and how can you prepare?
Case 2:
A 50-year-old female motorcyclist has collided with a car and is said to
be ‘not responding’
Relevant Information:
Aircraft option: Rotary Wing landing site less than 200m away.
Ground resources: One Ambulance and local Police Service
Retrieval options: Major Trauma Centre 30 min by road or 10 min by air
Environmental factors: Tuesday Morning 08:00, clear conditions
Questions:
2.1: Using the information so far available, outline your pre-hospital
plan prior to arrival on scene.
Clinical Information:
• P: 120/min
• BP: 150/90 mmHg
Case Studies: PST 4106
4
Paramedical Science
• GCS 6 (E1 V2 M3)
2.2: Briefly describe Patient selection criteria for RSI, paying
particular attention to the airway examination component and
predictors of a difficult intubation.
2.3: Describe the key steps required in the performance of a Pre-
Hospital RSI.
2.4 What are the risks and benefits associated with RSI in the trauma
patient? Provide a critical assessment of your decision to RSI or not?
Case 3:
An 18-year-old male has been riding his dirt bike along a dirt track and
he is struck across the anterior neck by an unseen guide wire.
He is complaining of dyspnea and has also sustained a compound fracture
to his Right Tibia and Fibula.
He is also anxious and tachypnoeic with a RR of 30.
All other vital signs remain within normal parameters.
Relevant Information
Aircraft option: Rotary wing
Ground resources: 2 Ambulances, Fire & Rescue Services
Retrieval Options: General Hospital 20 min by road, Major Trauma
center 30 min by air
Other: Fire & Rescue declare scene safe
Case Studies: PST 4106
5
Paramedical Science
Questions:
3.1: What is your initial pre-hospital plan prior to arrival on scene
On arrival you find the patient anxious but lucid
He complains of severe anterior neck pain and is spitting out bloody
saliva.
His voice is hoarse and remains tachypnoeic at a rate of 30 breaths/min
Examination reveals an acutely tender anterior neck.
There is slight crepitus over the laryngeal structures and a compound
fracture of the Right tibia and fibula with good distal perfusion.
No other injuries detected.
3.2: What is your initial management and which hospital will you
transfer to? Why might you choose to transport this patient or to
leave this patient with the paramedics who would transport to the
local general hospital with surgical capacity?
3.3: Describe how you will notify the receiving hospital of your
planned arrival and how they might prepare for your arrival.
Co-ordination Case:
Case 4:
The following assessment is related to the tasking and coordination of
physician led retrieval.
Case Studies: PST 4106
6
Paramedical Science
Tasking and clinical coordination are vital aspects of retrieval medicine.
Triage resource allocation and high level clinical oversight are key
elements to this process.
The following incidents need to be considered as being independent of
each other.
In each case the decision to mobilize, coordinate and support of the
retrieval team rests solely with you.
You have the maps and communication equipment available to you to
make each decision.
Incident 1:
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