Pain Management Treatment - Essay Example

?Question According to Mick Sanders p. 491), history taking refers to details gathered during the interview with a patient. It provides information such as medical and social aspects of a patient’s life. It also has information on environmental factors which may have impacts on his condition. This procedure is crucial in the establishment of priorities when it comes to patient care. Graham Harris (n.d., pp. 7-8), in his General principles of Assessment stated that history, vital signs and physical assessment helps a paramedic in detecting signs and symptoms of underlying medical condition of a patient. He further stated that if a paramedic has a good questioning skill, further history may become available. In the case of Mr. Markantonakis, the paramedic on duty did not fully exercise proper history taking. Thorough questioning of the patient’s wife and daughter should have been done in order to be fully informed about the patient’s behaviour prior to their coming. If the patient’s wife and daughter would be believed, the paramedics did not come across as caring and professional, not introducing themselves and making sure to do anything to gain the patient’s trust. Obtaining facts about when the pain started, the severity, the medications taken and the patient’s medical history was done unprofessionally. The paramedic only learned of some of them because the patient’s family volunteered the information. With regards to assessment, like what she did in history taking, the paramedic was unprofessional. Questions such as “What provokes or relieves the pain?” Is it constant, colicky, sharp or heavy?”; “Any radiation from site?” (Harris, p. 10) and other such questions were not asked and thus, her overall impression is not credible. The paramedic based her decisions and advice only on what she has seen, and not on pertinent information that she should have obtained in the first place. From asking the proper questions to writing them down, the paramedic has failed in her duty as an attending paramedic. Question 2 Potential diagnoses, according to Richard Hogston (n.d.) are those which could arise as a result or consequence of the actual diagnoses (p. 11). In the case of Mr. Markantonakis, it was said that he was suffering from lower back pain for several days before being brought to the hospital. If I were the attending paramedic, the possible potential diagnosis that I would list down would be the following: potential risk of further muscle strain due to constant violent movement in response to severe pain being experienced by the patient The paramedics were told that the patient was also vomiting and the potential diagnosis would be: potential risk of dehydration from vomiting, and potential risk of suffering from abdominal muscle pain due to vomiting According to Beebee and Myers (p. 314), when a paramedic is faced with a situation in which there are several plausible explanations for a pain or disorder, and he cannot narrow the causes down to one disorder. Considering this, the patient should be treated aggressively and it should be assumed that the disorder can harm the patient severely. Possible clinical decisions: identification of possible neurologic symptoms with the knowledge that the patient has already taken medication and still suffers from the pain, hospitalization will be recommended take into consideration all possible scenarios and causes of the pain blood chemistry testing electro cardiogram (ECG) test continuous monitoring of patient’s vital signs such as blood pressure, respiration, heart rate and pulse Question 3 Chrisuola stated that the paramedic was “rude” (Finding of Inquest, 3.6). This shows that the paramedic was unprofessional with regards to communicating with a patient and his family. My strategies and communication methods would be: Establish a professional demeanour greet patient by name and shake hands be sensitive and courteous ensure patient safety and comfort inquire about feelings watch for signs of uneasiness ask direct, open-ended questions using understandable language use therapeutic communication techniques Knowing that the family of the patient is undergoing stress because of the patient’s condition, paramedics must show empathy and establish trust between them and the patient and his family. Behaving otherwise will only result to difficulty in obtaining relevant information. Question 4 During the handover, the paramedic should have given the triage staff all relevant information that she should have gathered during their conversation with the patient and his family. Handover is one of the most important activities in patient care. It can also be dangerous if not done properly. (Talbot and Bleetman, 2007, par. 5) If the triage nurse was told of the patient’s treatment and the suprapubic and epigastric pain he developed on the way to the hospital and the angina and heart history, the triage nurse would probably have treated the case differently and have given the patient immediate attention. The paramedic thought the patient was not in severe pain and that it was just a case of “poor me”. This and considering her irritated mood at having to go back to the patient’s house did not have the qualities a paramedic should have in terms of behaviour, patience and professionalism. Question 5 The assessment and the decisions made in the case of Mr. Markantonakis were insufficient due to the inefficiency and unprofessionalism of the attending paramedic in gathering relevant information with regards to history making and proper assessment. According to Gordon, et al. (2005), “high-quality pain management includes appropriate assessment, including screening for the presence of pain, completion of a comprehensive initial assessment when pain is present and frequent reassessments of patient responses to treatment; interdisciplinary, collaborative care planning, including patient and family input; appropriate treatment that is efficacious, cost conscious, culturally and developmentally appropriate, and safe; and access to specialty care as needed” (par. 9). Pain management treatment plan for Mr. Markantonakis: completing a thorough medical history of the patient finding the symptoms of pain in order to identify its cause pain assessment propose and give immediate pain relief medication and observation and monitoring for result in case medication is ineffective and pain persists, discussion of alternative plans for the patient must be done with the family, such as hospitalization for a more thorough assessment make sure that the patient is comfortable en route to the hospital, by giving the patient hot or cold pack Bibliography Beebe, R. and Myers, J. (2010).Professional Paramedic: Foundations of Paramedic Care. [Internet]. Clifton park, NY, Delmar Cengage Learning. Gordon, et. al. (2005). American Pain Society Recommendations for Improving the Quality of Acute and Cancer Pain Management American Pain Society Quality of Care Task Force. JAMA Internal Medicine [Internet]. 2005, 165(14), pp. 1574-1580. Graham, H. (n.d.) General Principles of Assessment. [Internet]. Available at: [Accessed 24 March 2013]. Hogston, R. (1999). Managing Nursing Care. In: Hogston, R. and Simpson, P. eds. Foundations of Nursing Practice: Making the Difference. Basingstoke, UK, Palgrave, Macmillan, pp. 2-20. Johns, M.F. (2006). Finding of Inquest. Adelaide, South Australia. PDF Sanders, M. (2011). Mosby’s Paramedic Textbook. 4th Ed. Wall Street, Burlington, MA, Jones & Bartlett Learning. Talbot, R. and Bleetman, A. (2007). Retention of information by emergency department staff at ambulance handover: do standardise approaches work? Emergency Medicine Journal [Internet]. 2007 August, 24(8). pp. 539–542. Read More