Week 11

Week 11
Reflection:
Using the Gibb's Reflective Model, i will be reflecting on the practical session we had on the 11th of April, 2016.
Description: This week we practiced for our OSCE that was coming up. I did two scenarios. The first was a moderate asthma attack. I have the patient high flow oxygen, 5mg of salbutamol and 500mcg of ipratropium bromide. The second scenario was a FBAO that lead to cardiac arrest. I asked for assistance from an EMT, which started compressions. I took over the ventilation and inserted an LMA, delivering 1 breath every 5-6 seconds. We did ten cycles and I provided 2 shocks since the rhythm was VF. After 10 cycles, I was able to observe the foreign body in the airway. I asked the EMT to stop compressions and removed the obstruction using Magill’s forceps. The patient continued being apneic, so I continued providing ventilations at a rate of 1 breath every 5-6 seconds. The patient then regained his consciousness and breathing. He still had some difficulty breathing, and he had history of asthma and did not take his Salbutamol inhaler dose that day. For these reasons I provided the patient with 5mg of Salbutamol and rapidly transported him to hospital. I passed both scenarios.
Feelings: I was confident in the first scenario, since I have practiced similar scenarios previously. However, in the second scenario I was a little nervous and did not feel fully sure of what I had to do. I followed what I know and when I knew I passed it felt really good. I felt proud of myself.
Evaluation: I passed both OSCEs so I believe I did a good job in both scenarios. Nonetheless, I felt nervous in the second one because I never practiced a similar scenario previously. Therefore, passing it made me feel really good because it was my first time and I passed it!
Analysis: It’s a little stressful but fun to be thrown in a scenario I never practiced before. This is the nature of paramedic work, you never know what case you might get. Therefore, I really enjoyed doing the second scenario, and passing was the cherry on top. I passed the first scenario because I followed the guidelines for moderate asthma in the JRCALC (2013). I passed the second one because I followed the AHA guidelines for a choking patient and cardiac and respiratory arrest. Those are the guidelines required from me and I executed them well. This allowed me to pass.
Conclusion: In conclusion, having a surprise scenario that I’ve never done before is really good for me as a future paramedic. This reminds me of the nature of my future job and helps test my skills to act in any situation/ scenario. I really enjoyed this lab session and am really happy that I passed both scenarios.

Action Plan: I plan to continue practicing until I am perfect in my approach and treatment. I would like to work hard to do really well and not just pass. Also, I want to ask my teacher to give me more surprise scenarios so I can continue developing and testing my skills on the spot, as it would be in real life.

Learned Concepts:
This week we did the tutorial case study for week 11. The following are my notes:

Image 1: My notes for Part A of the tutorial.

Image 2: My noted for Part B of the tutorial.

Biggest Impression

This semester and in this course, the thing that made the biggest impression on me as a paramedic is all the drugs and managements i learned this semester. Through the practical sessions and scenarios i was able to apply what i learned from the lectures. This helped me advance greatly in my clinical approach and critical thinking. Therefore, the biggest impression would be my overall advancement in my ability to manage a various range of respiratory conditions. Moreover, through this course i learned a very wide range of advanced skills such as IV cannulation, IMI, SC injection, and intubation. As a paramedic, this course has had a huge impact on my growth and progression to becoming skilled and efficient.

Strengths and Limitations
I believe my strengths include managing asthmatic and COPD patients. Also, i feel i am strong in remembering medications, their indications, and doses. However, i feel i am a little weak in remembering the contraindications for the drugs, which is really bad. To improve on that i will try to allocate some time everyday to learn the contraindications of the drugs i learned till now. Moreover, i feel strong in the advanced skills like IV, IM, and SC injections since i practiced these skills multiple times. Also, i believe i became stronger in my intubation skills. However, i think my knowledge about pediatrics and their management is still not where i want it to be. This is a limitation i need to work on by reading more about pediatrics and giving more time to this topic to fully understand the complications pediatrics face, that are unique to them.