- 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
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
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
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
Proficiently undertake a clinical assessment of a patient with a cardiac condition and be able to identify typical and
- Discuss the assessment of case, including the signs and symptoms
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?
Interpret electrocardiogram rhythms and arrhythmias, in relation to their clinical context and provide appropriate
- 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?
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.
Communicate effectively with the patient and inter-professional teams.
- ATMIST pre alert
- Handover- SBAR, ATMIST, IMIST-AMBO?
- Telephone, face to face.
- Discuss inter-professional working, specialist practice maybe.
Case Study Advice
- Once upon a time, there was a patient who was presenting with Rationale for choosing Case. 300 of this, 60% of
- This, that and the other will be discussed in this essay (signposting).
- On arrival, introductions were made and consent sought. The family involved and a history was taken using the
- 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?
- Conclude the evidence, not your performance (evaluation)
- Make recommendations for future practice