Paramedics on the field

You are working as an Extended Care Paramedic (ECP) in a Metropolitan Ambulance
Service. A patient is referred to you by a Paramedic crew.
The patient is a 48 year old woman with a 2 week history of a productive cough with
green sputum, and is complaining of general malaise and fever.
On examination:
AIRWAY – patent
BREATHING – 18 resps/min, SpO2 = 97% room air
CIRCULATION – pulse = 87, BP = 130/80mmHg
DISABILITY – GCS = 15, BSL = 5.1 mmol/L, PERL, nil neuro deficits
EXPOSURE – temperature 38º, nil rash
Past medical history: depression, exercise induced asthma
Medications: Zoloft
Allergies: Penicillin
! Explain your systematic respiratory assessment.
! Explain the Pneumonia Severity Index (PSI) Class 1.
! Outline the exclusion criteria that would prevent you from managing this patient at
home. Include in this a discussion of ECP Scope of Practice and the
Inclusion/Exclusion Criteria for such services as Silver Chain or Doctor in the Home.
! Outline your treatment regime.
! What other advice might you give the patient?

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