Examination paper must be submitted via the subject 1MS (CANVAS), via the assessment link, and in Word.doc format only jNo Dues (Apple) or Of) All submissions are subject to Turn-it-in Similarity percentage. It is the student’s responsibility to ensure similarity % is at a satisfactory level (ideally less than 20% match). Turn-it-in reports will be reviewed, and high similarity matches will be escalated to the subject coordinator. At the submission of the written examination, students are declaring that the work submitted is original, have not worked with another student (collusion) and have acted within the University’s Policy on Academic Integrity httos://oolicv.unimelb.edu.au/MPF1310
2 of S CCHS Written Examination 2022
Natalie Hill (pronouns she/her) is a 42-year-old female admitted to University Hospital by ambulance at 0420am following a motor vehicle accident (MVA) at 80km/hr. The car had impact with the metal lane barrier. Natalie was the driver, with no other persons in the car at the time of the crash.
Natalie’s primary survey upon immediate arrival to the Emergency Department (ED) of University Hospital (UH) demonstrated the following:
A: Airway cleared, Yankeur suctioning required to remove vomitus. Blood noted in mouth, 3 front teeth loose. Speaking inappropriate words, drowsy. C-spine collar in situ B: Respiratory rate (RR) 26 per minute, laboured. Decreased breath sounds to right lower lobe, and left lung. Equal chest symmetry. Sp02 84% at scene, 99%10 L oxygen via Hudson mask (HM).
C: Heart rate (HR) 121 beats per minute, pulse thready and regular. Blood pressure 90/58 mmHg. Skin is cool, pale, clammy. Capillary refill (CR) > 3 seconds. 2L 0.9% Normal Saline IVT administered by paramedics. 2 x IV cannula inserted left and right antecubital fossa. Positive focused assessment with sonography in trauma (FAST) scan. Hb 94g/L. D: Glasgow coma score (GCS) 10 (E2V3h.45). PEARL size 3+. Blood glucose level 11.1mmol/L mmol/L.
E: Temperature 35.5 degrees Celsius, Bair Hugger warming blanket applied. Multiple lacerations and contusions evident on all limbs, abdomen and face. Significant bruising and swelling to right lower leg, toes mottled and cool.
Question 1. (approx. 250 words) The above data outlines what is involved in the primary assessment of Natalie. From this information, rationalise one actual/priority problems and two potential problems. Underpin your responses with possible underlying pathophysiological causes to justify your decision making. Link to other signs and symptoms as applicable.