Making clinical decisions with chronic/complex patients (In paramedics area) - Essay Example

Making clinical decisions with chronic/complex patients (In paramedics area) Introduction: Not all patients are able to go to hospitals for medical treatment. Various practical and personal reasons could make a patient decide not to seek medical help. This is where pre-hospital patient care becomes crucial. When applied appropriately, it can dramatically change the course of a person’s illness, especially those that are life-threatening and complicated, even before he or she receives hospital care.

Currently, there’s a growing interest in research discussing the many aspects of this practice, while most of the studies are directed on hospital management. These guidelines are even globally recognized by the CPG and WHO.Description:Pre-hospital patient care is very important especially in difficult cases wherein the patient is hesitant to receive hospital-based medical care. In the case presented, the patient has generalized right leg pain especially in the knee and calf area. The patient also complains of chest pain, headache and other signs and symptoms which suggest the diagnosis of deep vein thrombosis complicated with pulmonary embolism.

The patient is reluctant to be hospitalized. Hence, the application of pre-hospital care is essential to ensure the wellness of the patient. Based on the available options, the best intervention would be provision of warm compress.Benefits/Disadvantages:Prehospital care is defined as any initial medical care given an ill or injured patient by a paramedic or other person before the patient has access to hospital-based care. In the case presented, it is essential to have a prehospital care to the patient since she is reluctant to have access to the hospital.

Although there are no direct studies showing the advantage of having prehospital care, it is shown in many studies that the mortality rate of patients undergoing prehospital care is decreased. Also, having prehospital care increases the chance for survival in trauma and injured patients.The application of warm compress for patients with deep vein thrombosis is one of the initial treatments, along with leg elevation and medication with aspirin. This is done to prevent the clot formation from severing other parts of the body.

Although there are also no studies regarding the effectivity of application of warm compress for the treatment of deep vein thrombosis, this method is part of the guidelines for the management of the disease. This has been included in the prehospital care guidelines by the WHO (World Health Organization) and CPG (Clinical Practice Guidelines).Conclusion:The execution of pre-hospital care is crucial in such cases because this does not occur in a hospital setting. It is hence very important to have an accurate diagnosis based on the clinical picture alone, without the aid of laboratory exams and radiographic findings.

In this case, we see a patient that presents with sign and symptoms which most probably suggest DVT complicated with pulmonary embolism. Since the patient is reluctant to be hospitalized, it is very important to effectively execute pre-hospital care to preserve the wellness of the patient. An option would be to apply warm compress.Bibliography:Ali J et al. 1997. Effect of the prehospital trauma life support program (PHTLS) on prehospital trauma care. Journal of Trauma. 42:786–90.Dalen JE, Alpert JS. 1975. Natural history of pulmonary embolism.

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