Minor Injuries & Illnesses for Urgent and Pre-Hospital Clinicians

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HEAPA 2000
Minor Injuries & Illnesses for Urgent
and Pre-hospital clinicians

CONTENTS;

* Page 2 – contents

* Page 3 - One Patient report forms prior to course with additional comments

* Page 3 - Reflection One with patient report form

* Page 4 - Refection Two with patient report form

* Page 5 - Reflection Three with patient report form

* Page 6 - Reflection Four with patient report form

* Pages 7 – 11 – Additional patient report forms

* Page 12 - References

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REFLECTIVE NUMBER: ONE
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TYPE OF INCIDENT: Shoulder Injury - trauma
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DESCRIPTION
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999 call to male shoulder injury, en route I was considering all my potential pain relief -------------------------------------------------
options, on arrival presented by young male, GCS fifteen, standing upright at the -------------------------------------------------
door stating he had “dislocated his shoulder again”. He said he felt the joint “pop” -------------------------------------------------
when he turned the door handle. This had previously happened fifteen times in the -------------------------------------------------
last eighteen months and had most recent occurred twelve hours ago and that he -------------------------------------------------
had only returned from AED a few hours ago.
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It was obvious from initial assessment that there was evidence of lack of -------------------------------------------------
symmetry in the right shoulder. Prior to arrival, no pain relief had been taken but -------------------------------------------------
stated pain score of 8/10, GCS 15, BM 7.1, temp 37.0, pulse 98, resps 18 and BP -------------------------------------------------
121-78, sp02 on air 98%.
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It was obvious from onset that the man was in pain and I limited any movement of -------------------------------------------------
the shoulder to aggravate it. At this point I provided immediate pain relief in entonox -------------------------------------------------
(ISCI Six edition [2008]) to enable a thorough assessment of the shoulder region but -------------------------------------------------
also the elbow region, clavicle and shoulder girdle. Looking for any soft tissue -------------------------------------------------
injuries, circulation issues and nerve damage and providing a thorough assessment -------------------------------------------------
of the shoulder. (Shoulder and elbow D Limb, J Rankine, J Sloan, S Aldous et al ). -------------------------------------------------
On completion of the assessment it became obvious that additional pain relief was -------------------------------------------------
required and set about providing Morphine sulphate 5mg and metoclopramide -------------------------------------------------

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10 mg via a18 gauge cannula sited in the uninjured left forearm (JRCALC -------------------------------------------------
Guidelines 2006).
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The administration of pain relief is necessary although Shoulder and elbow D Limb, -------------------------------------------------
J Rankine, J Sloan, S Aldous et al states that shoulder dislocations can be pain free...
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