OPSE SCENARIOS — ACCP
EXACERBATION OF COPD:
Introduction:
- Check for DANGER
- Hello my name is Hirak, I am a Student Paramedic.
- What’s your name?
- May I have a feel of your wrist while we talk?
- What happened today?
- AIRWAY? Clear + patent
- BREATHING? Resp rate, slightly higher
- CIRCULATION? Radial present
- Can i have a full set of observations please: Sp02, reps rate, BP, BM, Temperature
- Do you have any pain anywhere?
- Has anything like this happened before at all?
- IPPA
- Inspect chest
- Palpate
- Percuss
- AUSCULTATION: Listen to the chest: check for equal chest rises, expiratory wheeze etc
SAMPLE ASSESSMENT
- Signs + symptoms: SIB, DOB, Pallor/ skin color, cyanosis, High reps rate, Cough.
- Allergies?
- Medications?
- Past Medical History? COPD, Respiratory distress, Asthma
- Last oral Intake
- Social Hx - Smoker, how much do you smoke?
- Events leading up.
OBSERVATIONS:
- Sp02 (COPD pts: 88-92%) (94% and above)
- Respiratory Rate: 16-20 normal
- Auscultation the lungs
Treatment:
OXYGEN + SALBUTAMOL
- 6-8 liters of oxygen via NEBULISER MASK
- 6 minutes on and 6 minutes off
IPRATROPIUM BROMIDE:
- COPD Exacerbation
- 6 minutes on + 6 minutes off
- Nebulised at 6-8 liters per minute
HYDROCORTISONE:
- Acute exacerbationof COPD
- IV slow injection over 2 minutes/ IM injection
- Reassess all observations after medication/ treatments given
- Get a 12-lead ECG to rule off any cardiac abnormalities.
, OPSE SCENARIOS — ACCP
EXACERBATION OF ASTHMA:
Introduction:
- Check for DANGER
- Hello my name is Hirak, I am a Student Paramedic.
- What’s your name?
- May I have a feel of your wrist while we talk?
- AIRWAY? Clear + patent
- BREATHING? Resp rate, slightly higher
- CIRCULATION? Radial present
- What happened today?
- Can i have a full set of observations please: Sp02, reps rate, BP, BM, Temperature
- Do you have any pain anywhere?
- Has anything like this happened before at all?
- AUSCULTATION: Listen to the chest: check for equal chest rises, expiratory wheeze etc
SAMPLE ASSESSMENT
- Signs + symptoms: SIB, DOB, Pallor/ skin color, cyanosis, High reps rate, Cough.
- Allergies? ANy dust or anything unusual in your routine?
- Medications?
- Past Medical History? COPD, Respiratory distress, Asthma
- Last oral Intake
- Social Hx - Smoker, how much do you smoke?
- Events leading up.
Observations:
- Sp02, Resp rate, Blood pressure, temp, BM.
Treatments:CHECK JRCALC
- Administer oxygen is Sp02 below 94%
- Peak Floe before nebulised treatment: <33%
- Nebulised Salbutamol (continuous Nebulisation of 6-8 litres of oxygen)
- Reassess all observations
- No improvement: Ipratropium Bromide
- Hydrocortisone (steroids)
- If blood pressure too low, set up IV Fluids.
Reassess all observations + auscultation the chest
