Long term conditions physco social aspect
The account which is being reflected took part when working as part of a double staffed ambulance (DSA) as a student paramedic alongside a paramedic. The emergency call to an older aged lady came through; her friend had called it through as shortness of breath to a private address. The womans friend was waiting outside the property to greet the ambulance staff, she gave a very brief history of findings. On going into the property we found the patient sat on the sofa in a tripod position, sitting upright, leaning forward placing her hands on her knees, displaying signs of extreme respiratory distress.
The patient was not able to communicate in full sentences with the crew due to the sheer distress she was in, the crew communicated to the patient that instead of attempting to talk and cause more distress a simple thumbs up and down for vital questions were deemed enough to be able to keep the patient involved in her treatment.
Building up a rapport with patients, empathizing with their fears and concerns, showing an understanding of their values when feeling vulnerable and endangered will have a positive impact on their care experience (Reisfield,2004).
From obtaining a primary survey, baseline observations and a respiratory assessment on the patient it was deemed that the patient was time critical and drug therapy would be in the patients best interest. The patient had given clear communication in the method we had collaborated together that she did not think she suffered from an illness called chronic obstructive pulmonary disease (COPD) which is a narrowing of the airways making it much harder for air to move, your lungs arent able to take in as much oxygen and find it harder to dispose of carbon dioxide due to lung tissue damage, therefore making it harder to breathe.
(British Lung Foundation, 2016) or in fact, have any other medical history that would be of any assistance to us.
Therefore, drug therapy was administered via a nebulizer, cannulation obtained and further monitoring. Looking around the environment it was clear the patient was a heavy smoker and stated had been for over thirty-five years, My colleague decided as the drug therapy via a nebulizer wasnt having the desired effect for the patient, that hydrocortisone, in fact, would be a good option; due to the unclear history and the thought that the patient may actually have COPD that has been undiagnosed.
Joint Royal Colleges Ambulance Liaison Committee handbook does not indicate that Hydrocortisone was needed (Aace.org.uk, 2016). Therefore, we decided to call the patients Doctor and explain our findings. The Doctor stated we could administer hydrocortisone as it sounded very much like the patient did have an undiagnosed COPD due to smoking, in addition, the drug therapy, we had administered hadnt had any effect on the patient and she was still in a critical distressed state. Once this was given the patient was taken to the ambulance and transported to the nearest accident and emergency facility. On route, the patient improved and became slightly more communicative and expressed how scared she had felt having her basic functions taken away from her; such as breathing and the freedom to express herself via communication.
During hospitalization the patient was diagnosed with COPD, this has encouraged me to look at how we can communicate with patients that have breathing difficulties, the environment that surrounds a patient and how that may provide us with vital information and in comparison, how the patients life will now change.