PARA 2000 Written Assignment for 2018
It is the intention of this assignment to highlight social, environmental and genetic factors of acute coronary syndrome (ACS) and cardiac failure. Furthermore, paramedics need to understand the complexity of patient assessment, and appreciate the value of looking into risk factors and genetic markers for potential ACS. Treatment pathways for these patients will vary depending on the region in which you work, many paramedics will be placed in regional and remote communities where access to cardiothoracic surgeons is not possible.
Case Study: A 56-year-old Australian Indigenous male has called an ambulance for localised left bicep pain that started two days ago. You have difficulty in gaining further history due to language barrier, but you gather from a bystander that the pain is worse when he moves his arm. The patient declines all further assessments with the ambulance crew, and just wants to go to hospital, so you take him. From a basic visual assessment, the patient does not look unwell, and it is only a slightly elevated respiratory rate of 22/min that is outside normal limits.
At the emergency department they confirm the patient is suffering an acute myocardial infarction (STEMI).
From the above Case Study present your essay to include discussions on: 1. Consider at least FIVE social determinates of health-factors for this patient, describe the clinical course of such patients’ developing ACS at an earlier age and subsequently lead to potential cardiac failure
2. Outline the clinical assessments that you would perform on this patient, if he did consent, and argue your rationale given that all this patient is complaining of was a sore bicep on movement
3. How would your management of this patient differ if he was located in Port Pirie rather than Port Adelaide, if in fact he was suffering an acute myocardial infarction (STEMI). Include both prehospital and in-hospital treatments available for this patient.
Assessment Requirements: It is expected that you site current research articles as well as textbooks to demonstrate your understanding of these issues. At least FIVE (5) journal articles are expected to be part of your literature search (none less than 10 years old).
You will also need to review the clinical practice guidelines of at least TWO (2) Australian ambulance services. The goal is to provide up to date evidence-based practice for the management of the patient’s condition.
Higher grades will be awarded for the extensive use of relevant evidence-based literature, and the quality of your rationale behind your clinical assessment of this particular patient.
Word Limit: 2,500 (excludes references)

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