Describing a Medical Case
ambulance bay
приёмный бокс скорой помощи / зона приёма скорой
Medical Reports
Emergency Department Report (Trauma / Cardiac Arrest)
The patient was brought to the emergency department via ambulance and received in the ambulance bay. On arrival, the patient was unconscious and not breathing adequately. Initial assessment revealed cardiac arrest with an unknown downtime prior to EMS arrival.
Cardiopulmonary resuscitation was initiated immediately. Adrenaline was administered intravenously, and defibrillation was performed with one shock delivered. Return of spontaneous circulation was achieved after resuscitation efforts. The airway was secured due to compromised breathing and risk of hypoxia.
The patient presented with significantly elevated heart rate following resuscitation. Given the mechanism of injury, a car accident was suspected. Clinical findings raised concern for severe traumatic injuries and possible internal bleeding. The patient was assessed by the emergency nurse and trauma team. Further imaging and monitoring were initiated due to the risk of global organ damage secondary to hypoxia and trauma.
Compose Emergency Department Chart:
Arrival:
Chief Complaint:
Initial Assessment (Primary Survey)
Airway:
Breathing:
Circulation:
Disability:
Exposure:
Vital Signs (Post-ROSC)
Heart rate:
Blood pressure:
Oxygen saturation:
History (Limited, per EMS)
Physical Examination
HEENT:
Cardiovascular:
Respiratory:
Abdomen:
Neurological:
Interventions / Treatment
Obstetric Evaluation
Plan
Medical Reports
Emergency Report (Anaphylactic Reaction)
The patient presented to the emergency department in an agitated state following multiple bee stings. The patient reported a known history of allergic reactions, and this was not the first episode.
Shortly after exposure, the patient developed symptoms of an allergic reaction, including nausea, abdominal pain, and tingling around the lips. The condition rapidly progressed to a systemic reaction. Examination revealed swelling of the tongue, lips, and throat, resulting in severe respiratory distress. The patient was unable to breathe adequately.
A diagnosis of severe anaphylactic reaction was made. An immediate injection of adrenaline was administered. Due to persistence of symptoms, a higher dose than usual was required. The reaction continued for a period of time, and the patient was closely monitored for serious side effects. The condition was considered dangerous and potentially fatal without prompt treatment.
Obstetric Assessment Report (Emergency Context)
The patient, who was pregnant, was evaluated due to concerns that the acute medical condition could induce labour. Vital signs were initially unstable, with some parameters falling below acceptable levels.
Given the risk of premature childbirth, fetal assessment was performed. Ultrasound was used to evaluate the baby’s heartbeat. A strong and regular heartbeat was detected, and the fetal heart rate was within normal ranges. No immediate signs of fetal distress were observed at the time of examination.
Continuous maternal and fetal monitoring was recommended due to the severity of the maternal condition and the potential risk of preterm labor.
Compose Emergency Department Chart on the following situations:
1. Слишком сильно чихнул.
2. Пошел ночью в туалет, наступил на кота.
3. Экспериментировал с едой.
4. Потянулся за пультом, свалился с дивана.
5. Испугалась собственного отражения в темном окне.
6. Уронила телефон на глаз, лежа в кровати.
7. Играл с сыном в "войнушку".
8. Поспорил с другом.
9. Слишком активно возмущалась поведению соседки.
10. Решили прихлопнуть муху.
EMS history: age, male/female, condition found
Arrival:
Chief Complaint:
Initial Assessment (Primary Survey)
Airway:
Breathing:
Circulation:
Disability:
Exposure:
Vital Signs (Post-ROSC)
Heart rate:
Blood pressure:
Oxygen saturation:
Physical Examination
HEENT:
Cardiovascular:
Respiratory:
Abdomen:
Neurological:
Переформулируйте для отчета:
Пациенту было очень плохо, он почти не дышал.
Был без сознания, вообще никакой.
Его трясло, и он ничего не понимал.
Хватал воздух ртом.
Резко «накрыло».
Еле откачали.
Увидел кровь, повело.
Нога посинела.
Схватился за сердце.
Лежал, не реагировал.
Нес чепуху.
Размахивал руками, пытался что-то сказать.
Побледнел прямо на глазах.
Explain to the Patient:
cardiac arrest
defiblilator
adrenaline
anaphylactic reaction
initial assessment
unconscious
downtime
cardiopulmonary resuscitation
intravenously
blood circulation
secure airway
hypoxia
elevated heart rate
internal bleeding
global organ damage
allergic reaction
respiratory distress
side effect
fetal distress
preterm labor
Offer Interventions/Actions for Symptoms:
Tongue swelling
Cardiac arrest
Respiratory distress
Unconsciousness
Absent breathing
Tachycardia
Chest pain
Seizure activity
Vomiting with aspiration risk
Anaphylactic shock
Altered mental status
Cyanosis
High fever
Fainting
Severe anxiety with hyperventilation
Bradycardia
True/False:
1. Adrenaline is given orally in cardiac arrest.
2. Defibrillation may restore spontaneous circulation.
3. Hypoxia can cause global organ damage.
4. CPR should be started immediately if a patient is unresponsive and not breathing.
5. Anaphylactic reactions can be fatal without prompt treatment.
6. Tongue swelling is a symptom of severe allergic reaction.
7. Oxygen therapy is not necessary if SpO₂ is 85%.
8. Cardiac arrest can occur after trauma.
9. Adrenaline is only used for pain relief.
10. Continuous maternal and fetal monitoring is recommended if the mother is critically ill.
11. Shortness of breath is never a sign of hypoxia.
12. Intravenous fluids can be used to treat hypotension in trauma patients.
13. Airway should always be secured in patients with compromised breathing.
14. Defibrillation can be performed without checking if the patient has a pulse.
15. A patient who lost consciousness may need neurological assessment.
16. Elevated heart rate always indicates heart failure.
17. An EMS report should include age, sex, and condition found.
18. Adrenaline can be administered intramuscularly in severe anaphylaxis.
19. Cardiac monitoring is unnecessary in post-ROSC patients.
20. Severe bleeding should be controlled with direct pressure.
Give a Medical Report on Each Case:
EMS history: age, male/female, condition found
Arrival:
Chief Complaint:
Initial Assessment (Primary Survey)
Airway:
Breathing:
Circulation:
Disability:
Exposure:
Vital Signs
Heart rate:
Blood pressure:
Oxygen saturation:
Physical Examination
HEENT:
Cardiovascular:
Respiratory:
Abdomen:
Neurological:
Describing a Medical Case: Anaphylactic Shock
acute myocardial infarction
острый инфаркт миокарда
Study the Medical Case:
The patient is being treated at the cardiology center for acute myocardial infarction.
An interventional procedure was performed: coronary angiography with stent implantation into a coronary artery.
The patient stayed in the Intensive Care Unit (ICU) for two days.
On day two, the patient was transferred to the cardiology ward due to stabilization of the clinical condition.
Day 4 of Treatment
An emergency call (Code Blue) was initiated in the cardiology ward.
After an injection of medication, the patient lost consciousness and collapsed to the floor.
There was no pulse in the major arteries, and the patient had agonal breathing.
The defibrillator monitor showed pulseless electrical activity (PEA).
Resuscitation Measures
Resuscitation was started immediately:
Chest compressions at a rate of 120 per minute
Bag-valve-mask ventilation with humidified oxygen
Intravenous adrenaline injection (1.0 ml)
After two minutes, the carotid pulse was restored.
The patient regained consciousness and was emergently transferred to the ICU.
ICU Assessment
The patient complained of:
Shortness of breath at rest
Chest pain in the area of chest compressions, aggravated by palpation
The overall condition was severe due to:
Coronary insufficiency
Acute myocardial infarction
Post-resuscitation state
Acute left ventricular failure
Physical Examination
Conscious, Glasgow Coma Scale: 15
Reduced insight into own condition
No focal or generalized neurological deficits
Skin: normal color, moderately moist
No peripheral edema
Lungs:
Harsh breath sounds bilaterally
Diffuse fine moist crackles
Respiratory rate: 25–30/min
SpO₂: 86%
The patient was placed on non-invasive ventilation (NIV) in CPAP/PSV mode
After NIV, SpO₂ improved to 100%.
Cardiovascular System
Heart sounds clear
Rhythm irregular
Coarse systolic murmur
Blood pressure: 116/79 mmHg
Heart rate: 150–180/min
Monitor showed atrial fibrillation
Abdomen and Other Findings
Abdomen soft, non-tender, non-distended
Liver palpable at the costal margin
No defication reported today
Urinary output via urethral catheter
ECG Findings
Atrial fibrillation with ventricular rate 175–200 bpm
Left axis deviation
Poor R-wave progression in leads V1–V6
ST-segment elevation in leads V1–V6 up to 6 mm
Treatment Provided
Amiodarone (Santodaron):
150 mg IV bolus
600 mg via infusion pump at 60 mg/hour
Furosemide:
20 mg IV bolus
100 mg via infusion pump at 5 mg/hour
Urethral catheter placed
Morphine 5 mg IV for analgesia
Plan
Treatment is continued in full accordance with the prescribed treatment plan.
Describe the Medical Case:
True / False
1. The patient was admitted with acute myocardial infarction.
2. A coronary angiography with stent implantation was performed.
3. The patient stayed in the ICU for five days before transfer.
4. The patient was transferred to the cardiology ward due to stabilization.
5. The emergency event occurred on the first day of hospitalization.
6. A Code Blue was initiated on day four of treatment.
7. The patient lost consciousness after an injection of medication.
8. The patient collapsed to the floor and had no pulse in major arteries.
9. The patient had normal breathing at the time of collapse.
10. The monitor showed pulseless electrical activity (PEA).
11. Chest compressions were started immediately.
12. Chest compressions were performed at a rate of 120 per minute.
13. The patient was ventilated using bag-valve-mask ventilation with oxygen.
14. Adrenaline was administered intravenously during resuscitation.
15. Carotid pulse was restored within two minutes after adrenaline injection.
16. The patient remained unconscious after return of circulation.
17. The patient was emergently transferred back to the ICU.
18. In the ICU, the patient complained of chest pain and shortness of breath at rest.
19. The patient’s condition was mild after resuscitation.
20. Glasgow Coma Scale score was 15.
21. No focal or generalized neurological deficits were observed.
22. Oxygen saturation was normal before starting non-invasive ventilation.
23. SpO₂ improved to 100% after NIV was started.
24. Cardiac monitoring showed atrial fibrillation with rapid ventricular rate.
25. Treatment was continued in full accordance with the prescribed treatment plan.
Translate, Using Medical Terms for the Report:
«Сердце прихватило по-серьёзному»
«Поставили железку в сердце»
«Два дня под капельницами и проводами»
«Полегчало — перевели в обычную палату»
«Вдруг всё пошло не по плану»
«Все забегали и закричали»
«Вырубился прямо на месте»
«Грохнулся как подкошенный"
«Пульса вообще не было»
«Дышал как будто в последний раз»
«Аппарат показал какую-то ерунду»
«Начали его качать»
«Дышали за него мешком»
«Вкололи адреналин — по классике»
«Сердце снова заработало»
«Очнулся, начал моргать»
«Срочно увезли обратно в реанимацию»
«Задыхался даже лёжа»
«Грудь болела после откачки»
«Состояние — совсем тяжёлое»
«В голове вроде всё нормально»
«Соображает плохо, не понимает серьёзность»
«В лёгких всё булькает"
«Без кислорода совсем не тянул»
«Под маской сразу задышал нормально»
Study the Dialogue:
Nurse:
Doctor, we have an emergency in the cardiology ward. The patient suddenly collapsed.
Doctor:
What happened exactly?
Nurse:
After the injection, the patient lost consciousness and collapsed to the floor.
There was no pulse in the major arteries, and the breathing was agonal.
Doctor:
Was a Code Blue initiated?
Nurse:
Yes, Code Blue was called immediately.
Doctor:
What did the monitor show?
Nurse:
The defibrillator monitor showed pulseless electrical activity.
Doctor:
Alright. Start chest compressions at 120 per minute.
Prepare bag-valve-mask ventilation with oxygen.
Nurse:
Chest compressions are ongoing.
Bag-valve-mask ventilation with humidified oxygen is in progress.
Doctor:
Give intravenous adrenaline, one milliliter.
Nurse:
Adrenaline given intravenously.
Doctor:
Check the carotid pulse.
Nurse:
Carotid pulse is back. We have return of spontaneous circulation.
Doctor:
Good. Is the patient conscious?
Nurse:
Yes, he is regaining consciousness.
Doctor:
Transfer him to the ICU immediately.
In the ICU
Nurse:
Doctor, the patient complains of shortness of breath at rest and chest pain in the area of compressions.
Doctor:
What is his oxygen saturation?
Nurse:
SpO₂ is 86 percent on room air.
Doctor:
Place him on non-invasive ventilation in CPAP/PSV mode.
Nurse:
NIV started. SpO₂ has improved to 100 percent.
Doctor:
Good. What about heart rhythm?
Nurse:
The monitor shows atrial fibrillation. Heart rate is around 160.
Doctor:
Start amiodarone — bolus, then infusion.
Also give furosemide.
Nurse:
Amiodarone bolus administered. Infusion is running.
Furosemide given as ordered.
Doctor:
Any neurological deficits?
Nurse:
No. Glasgow Coma Scale is 15.
The patient is conscious, but his insight into his condition is reduced.
Doctor:
Alright. Continue close monitoring and follow the treatment plan.
Nurse:
Understood, doctor.
What\'s the Device and What was it Used for According to the Medical Case?
