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Working Impression - Case Study Example

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As a doctor, one should first identify the possible causes of the symptoms, based on the initial information provided. From this set, a primary working impression, which is the most probable cause among the list, is chosen. …
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Working Impression
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Download file to see previous pages If the working impression holds after confirmatory test/s, then it will hold to be the diagnosis, and the future steps will be dedicated onto eradicating the sources and treating the symptoms accordingly. However, if the PWI turns out not to be the diagnosis, then the differentials will then be tested, so that the primary root of the chief complaint be identified. Treatment will thus be planned based on the definitive diagnosis. Working Impression In coming up with our primary impression, we should look into the information we have for any pertinent data. In summary, we have four female employees of a food distribution warehouse facility who complain of dizziness. They conduct blister packing in an area with a 40°F temperature, and two railroad car lines and gas-powered forklifts nearby. The facility also has a special seal that insulates in the cold temperature needed for storage. There was no noticeable odor, nor there mention of a ventilating system for the area. Because multiple cases (four) have been reported in the facility, we consider this as an occupational health issue. Because of the nature of their work, the only possible factors that might have caused dizziness are inhalation of toxic fumes, exposure to chemicals from the food products, and the cold temperature (40°F). Because there are no reports of food poisoning caused by the products of the facility, then we can rule out the second factor. In considering the presence of toxic fumes, we must take note that the suspected inhalant must be odorless and colorless. In addition, the special insulating system in the warehouse might have been contributing in keeping the toxic fumes in the facility. A possible source of such fumes must be established, and the symptoms observed in our case should be explained by its presence. With these qualifications, we take carbon monoxide (CO) poisoning as our primary working impression. CO is an odorless, colorless gas that may come from the incomplete burning of organic substances such as gasoline, kerosene, oil, propane coal or wood (Canadian Centre for Occupational Health and Safety, 2008; WorkSafe Victoria, 2008). In our case, CO may have been emitted by the car and forklift exhaust and possibly, a kerosene-powered heater, although the presence of such equipment must first be verified. CO gas interferes with the oxygenation of red blood cells and subsequently of tissues such as the brain, causing dizziness. Other symptoms include chest pains, headache, fatigue, dizziness, drowsiness or nausea. Prolonged exposure may result to weakness, vomiting, confusion, loss of consciousness, coma, and death (Canadian Centre for Occupational Health and Safety, 2008). Differential Diagnoses It is important to consider other causes of the incidents, as the PWI might not be the root cause, or there are environmental conditions that may cause harm to the employees. Low oxygen levels In preserving food products, it is important to have a room wherein oxygen levels can be kept at a low level (1% to 2%) to prevent the growth of aerobic microorganisms that compromise the quality of food products. This room is referred to as a controlled atmosphere (CA) room. Inhalation of this highly deoxygenated atmosphere from CA room has detrimental consequences to employees, who need oxygen levels of 19.5% to 23.5% to survive. In fact, inhaling a single breath of this highly deoxygenated atmosphere will result to instantaneous loss of consciousness, with consequent brain and health injuries. Employees who work near a CA room are thus susceptible to health risks (WorkSafe Victoria, 2008). If a CA room is present in the warehouse, then this diagnosis is highly likely. Ammonia The cooling condition exposes the employees to many factors. One of ...Download file to see next pagesRead More
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