Critical account of a cardiac incident from clinical practice

Assessment Information:

  • 1500 word critical account of a cardiac incident from clinical practice
  • Must include references from evidence based sources/guidelines in relation to clinical practice in the UK
  • Appendix no more than 5 included
    Assessment Criteria:
    Evidence knowledge of contemporary issues, through data collection and literature searching.
    Effectively demonstrates patient examination techniques along with use of cardiac diagnostic to
    determine a cardiac condition or differential diagnosis in order to provide suitable out-of-hospital
    cardiac treatment.
    Correctly interprets ECG rhythms and arrhythmias in relation to clinical significance.
    Responds to ethical and psychological implications when managing a cardiac condition and
    demonstrates professional articulation of information within an inter-professional team and with the
    patient
    Learning Outcomes
    LO1
    Review the literature concerning the epidemiology of Coronary Heart disease and other cardiac conditions to identify
    best practice for out-of-hospital and in-hospital interventions.
  • Facts and figures around CHD and/or case.
  • Discuss pre-hospital and in-hospital treatment of case
    LO2
    Proficiently undertake a clinical assessment of a patient with a cardiac condition and be able to identify typical and
    atypical presentations.
  • Discuss the assessment of case, including the signs and symptoms
    LO3
    Demonstrate competency in the use of cardiac diagnostic and therapeutic equipment, including the use of
    electrocardiograph acquisition and telemetry.
  • Heart sounds, ECG placement, Telemetry (clinical support at ED?)
  • Therapeutic equipment- What do you use? What can be used? Oxygen yes/no?
    LO4
    Interpret electrocardiogram rhythms and arrhythmias, in relation to their clinical context and provide appropriate
    interventions.
  • Discuss ECG interpretation- what are the characteristics?
  • What does this mean from a pathophysiological perspective?
  • What intervention? What do we do? What does the Emergency Department do? Could we do more?
    LO5
    Deliver pre-hospital cardiac therapy, with appropriate regard to ethical considerations and psychological impact on
    the patient, their families and carers.
  • Ethics, professionalism, law, consent.
    LO6
    Communicate effectively with the patient and inter-professional teams.
  • ATMIST pre alert
  • Handover- SBAR, ATMIST, IMIST-AMBO?
  • Telephone, face to face.
  • Referral?
  • Discuss inter-professional working, specialist practice maybe.
    Case Study Advice
    Introduction
  • Once upon a time, there was a patient who was presenting with Rationale for choosing Case. 300 of this, 60% of
    that.
  • This, that and the other will be discussed in this essay (signposting).
    Main Body
  • On arrival, introductions were made and consent sought. The family involved and a history was taken using the
    acronym…
  • Discuss the signs and symptoms and possible differential diagnoses. Baseline obs etc.
  • Discuss cardiac assessment- foot of the bed, heart sounds, heaves, thrills, apex palpation etc.
  • ECG- Include a relevant ECG image and discuss characteristics and pathophysiology.
  • Discuss telemetry if appropriate- ED, not CCU (unless STEMI)
  • Discuss Tx of patient- eg. Modified Valsalva, anything else that might be out there – prehospital troponin?
  • Transport to ED with ATMIST- Handover on arrival- IMIST AMBO?
  • What can ED do that we can’t? Should we be able to do more?
    Conclusion
  • Conclude the evidence, not your performance (evaluation)
  • Make recommendations for future practice