MALE Teaching Case #1 Mr. Kruski 45 Y/O 180 lbs.

InterviewExam Tools Scene Pt. Interventions Dispatch 8550: “Dispatch, 8550 is on the air” Disp: “8550, a fall, code 3 at the Minneapolis/St. Paul airport Building B. Northwest Airlines.” 8550: “Received, responding Building B” Disp: “Incident 48754, time out 1030 hours,45 year old male, Conscious and Alert. Patient is pinned under construction equipment.” 8550: “Received, thank you” 8550: “Dispatch, 8550 is on the air” Disp: “8550, a fall, code 3 at the Minneapolis/St. Paul airport Building B. Northwest Airlines.” 8550: “Received, responding Building B” Disp: “Incident 48754, time out 1030 hours,45 year old male, Conscious and Alert. Patient is pinned under construction equipment.” 8550: “Received, thank you”

InterviewExam Tools Scene Pt. Interventions Scene/MOI You arrive on scene to find: a man laying supine. His coworkers state he was struck by a falling barrel that weighs approximately 800lbs. The barrel fell from a height of approx. 10 feet. They removed the barrel before you arrived. You arrive on scene to find: a man laying supine. His coworkers state he was struck by a falling barrel that weighs approximately 800lbs. The barrel fell from a height of approx. 10 feet. They removed the barrel before you arrived. Scene

InterviewExam Tools Scene Pt. Interventions Interview Introduce yourself What question would you like to ask? Do you have any allergies to medications?Do you have any allergies to medications? Do you take medications? What is your past medical history? When did you eat your last meal? What events led to you to call us? More HPI questions (OPQRST)? Introduce yourself What question would you like to ask? Do you have any allergies to medications?Do you have any allergies to medications? Do you take medications? What is your past medical history? When did you eat your last meal? What events led to you to call us? More HPI questions (OPQRST)? Interview

Exam Tools Scene Pt. Interventions Introduction EMS: Hello, my name is Jane EMT and I will be taking care of you today Mr. Kruski. What happened? PATIENT: Thank you for introducing yourself… aah my hips hurt. EMS: Mr. Kruski, did you loose consciousness? PATIENT: No and please call me Bernie… EMS: Hello, my name is Jane EMT and I will be taking care of you today Mr. Kruski. What happened? PATIENT: Thank you for introducing yourself… aah my hips hurt. EMS: Mr. Kruski, did you loose consciousness? PATIENT: No and please call me Bernie… Courtesy goes a long way, doesn’t it?

InterviewExam Tools Scene Pt. Interventions HPI What question would you like to ask? When did your symptoms start? What were you doing when this began? Is it a sharp or dull pain? Does it radiate or go anywhere? What have you done to make yourself feel better?What have you done to make yourself feel better? What question would you like to ask? When did your symptoms start? What were you doing when this began? Is it a sharp or dull pain? Does it radiate or go anywhere? What have you done to make yourself feel better?What have you done to make yourself feel better?

InterviewExam Tools Scene Pt. Interventions OPQRST: Onset Injuries occurred after a barrel fell on top of the patient. The patient denies Loss of Consciousness.

InterviewExam Tools Scene Pt. Interventions OPQRST: Provocation “Like my co-worker said: A barrel fell on top of me, you don’t listen very good do you?”

InterviewExam Tools Scene Pt. Interventions OPQRST: Quality Constant and sharp.

InterviewExam Tools Scene Pt. Interventions OPQRST: Radiation Mr. Kruski: “No it is just in my hips. Please help me.”

InterviewExam Tools Scene Pt. Interventions OPQRST: Severity 10 over 10. Mr. Kruski answers questions very slowly and in a low tone of voice. He is starting to feel groggy. 1510

InterviewExam Tools Scene Pt. Interventions OPQRST: Time Injury occurred only a minute or two before EMS was called.

InterviewExam Tools Scene Pt. Interventions Allergies Mr. Kruski: “I get terrible hayfever, I think it’s the pollen and ragweed”

InterviewExam Tools Scene Pt. Interventions Medications I don’t take drugs of any kind. My doctor Katheryn Richards doesn’t believe in that stuff.

InterviewExam Tools Scene Pt. Interventions PMH None

InterviewExam Tools Scene Pt. Interventions Last Meal Pt. Can’t remember. His coworkers say he always has breakfast with them but he didn’t show up this morning because he has an errand to run at Target. Pt. Can’t remember. His coworkers say he always has breakfast with them but he didn’t show up this morning because he has an errand to run at Target.

InterviewExam Tools Scene Pt. Interventions Events Leading to Present Illness Pt.’s coworker: “ We were moving some barrels on the shelves. We should have been using a forklift but we were in too much of a hurry. Do you think he’s going to be OK? I’m very sorry… REALLY sorry.”

InterviewExam Tools Scene Pt. Interventions Physical Exam Exam

InterviewExam Tools Scene Pt. Interventions PE: HEENT No sternal notch retractions trachea midline Clear of fluids No JVD PERL Skin is pale, clammy, cool No sternal notch retractions trachea midline Clear of fluids No JVD PERL Skin is pale, clammy, cool

InterviewExam Tools Scene Pt. Interventions PE: CHEST No tenderness or abnormality on palpation Chest Rise is equal No use of accessory muscles Clear, Equal Bilat. Lung Sounds No tenderness or abnormality on palpation Chest Rise is equal No use of accessory muscles Clear, Equal Bilat. Lung Sounds

InterviewExam Tools Scene Pt. Interventions PE: EKG Monitor shows:

InterviewExam Tools Scene Pt. Interventions PE: Neck/Back No deformities, discoloration, tenderness.

InterviewExam Tools Scene Pt. Interventions PE: Abd./Pelvis Soft No masses Non-Tender Pelvis is unstable. No crepitus. Extreme pain on palpation. Soft No masses Non-Tender Pelvis is unstable. No crepitus. Extreme pain on palpation.

InterviewExam Tools Scene Pt. Interventions PE: Extremities No sensation or movement bilaterally below the level of the waist. Pedal pulses are thready but present. Capillary refill is delayed in finger. Handgrips strong and equal. No Pedal Edema No sensation or movement bilaterally below the level of the waist. Pedal pulses are thready but present. Capillary refill is delayed in finger. Handgrips strong and equal. No Pedal Edema

InterviewExam Tools Scene Pt. Interventions PE: Vital Signs Current Vitals are:

InterviewExam Tools Scene Pt. Interventions PE: Diagnostics Glucometer: Not Obtained End Tidal CO 2 : Not performed Glucometer: Not Obtained End Tidal CO 2 : Not performed Diagnostics

InterviewExam Tools Scene Pt. Interventions Mr. Kruski’s coworkers have been holding his head and trying to keep him still. The 800 pound barrel has been removed. Mr. Kruski’s coworkers have been holding his head and trying to keep him still. The 800 pound barrel has been removed. Pt. Interv.