Summary OSPE Practice Scenarios and their Management
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Course
Paramedic Science (PSY04)
Institution
St Georges
Its a detailed version of everything you should go through in your OSPE exam, given the things we’ve learnt in sim sessions! They are really easy to understand and have been broken down ready to use as a revision guide for the ACCP module!
This document covers everything from DR.cABC primary s...
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.
- 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
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