Case Review 2023

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University of Colorado, Boulder *

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3.05

Subject

Medicine

Date

Feb 20, 2024

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docx

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1

Uploaded by PresidentReindeer4217

“Ski With the Grandkids Day” the sign said as you enter the resort. Your shift runs from 09:30 – 16:00 and if you are honest with yourself, you just love this day. Grandparents bringing their grandchildren out to ski. Usually, there are whole families out enjoying the festivities: children, parents, and grandparents. After an uneventful morning you get a call at 13:30 about an individual down on ‘Hollerman’s Hollow: a blue run on the front side of the mountain. Arriving on the scene you see Deb, a 9-year-old female sitting next to her 64-year-old grandfather, Bill. Deb states that her grandfather started to act “funny” on the chairlift, said he had a bad headache, skied a few feet and slumped to the ground. When addressing Bill, you feel something is “off” about him as well. Upon further inquiry you start suspecting a stroke and you use the assessment protocol “FAST-ED”. The results are as follows: F : Face is drooping at the corner of the mouth. A : Right Arm drifts down further than the left arm. S : His speech is garbled. T : Is it Time to call for help? When is the last time the patient was reported to respond normally? E : Eyes move normally. D : You determine that the patient is in Denial of a problem. After you call for help you begin to take a “SAMPLE” history, which reveals that Bill is on Plavix, a blood thinner, Lisinopril for high blood pressure, and Atorvastatin for high Cholesterol. First Scenario : Make your radio call. What equipment, transportation and personnel will you ask for? By the time your help arrives, Bill’s condition has improved dramatically. Using “FAST-ED” again, everything appears normal. Bill insists he is okay and wants to continue to ski with his granddaughter. After consultation with other Patrollers on the scene you feel strongly that Bill should be transported to a hospital ER with a stroke center. Explain in detail your arguments for Bill to be treated at the ER with a stroke center. Outline your on-hill treatments, and transportation decisions, both off the hill and to the hospital. Deb states that she is a beginning to intermediate skier and can make it down the run. Do you have concerns regarding her well-being? What are your protocols for dealing with a minor, in this situation? Does your area have any specific protocols for dealing with this situation? If “yes”, what are they? Second Scenario : Make your radio call. What equipment, transportation and personnel will you ask for? By the time your help arrives, Bill’s condition has NOT changed. Is this a “load and go” situation? What treatment do you provide on the hill? If you are requesting emergency transportation, what is your area’s best option for this patron? You feel this individual needs to be seen at a hospital with a stroke center. What hospitals in your area specialize in stroke care? Deb states that she is a beginning to intermediate skier and can make it down the run. You have some concerns regarding her well-being. Because of her grandfather’s condition she now becomes an unaccompanied minor. In this situation what are your local protocols for dealing with an uninjured, unaccompanied minor? 2023 REFRESHER CASE REVIEW
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