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Paseo Del Norte

Full Member
10+ Year Member
Not sure exactly where this belongs; however, I will place the thread in this section as it is specific toward an allied health provider's education.

I have completed a major case study that will be turned in for grading early next week. Along with the paper, each person in my class will have to do a 15 minute presentation in front of the class, our instructors, and physicians to include our programme medical director. Physician critique counts for 30% of our overall grade, with the entire project (paper & presentation) composing a large portion of our clinical rotation grade this summer. Clearly, physician input will play a major role in determining my overall grade this semester.

The paper is a case study of a patient involved in an altercation who sustained a closed head injury, but also aspirated prior to EMS arrival. I transported this patient from an emergency room to the local trauma centre. Being that I am a respiratory therapy student, the case study is more involved with the respiratory implications and ventilator management of the patient. The paper follows a pretty standard format of history of present illness, past medical/surgical/social/family history, review of systems, physical exam, labs/radiology, assessment findings, and plan to include the patient response.

I think I covered the case with at least a fair amount detail. In addition, I explained the basic physiology of the various findings and the basic pharmacology and considerations of the medications we used. I also explained the implications of the lab and radiographic findings.

So, after all of that, my primary question is what would you as a physician find to be a critical concept if you were in the position of grading a case study like the one I mentioned above? What would you want a prospective respiratory therapist to cover?
 
One thing I would expect a respiratory therapist/RT student to be cognizant of is the ARDSnet data. You might consider discussing this briefly, including why low tidal volumes/low mean airway and peak pressures would/might be important in this case (aspiration, trauma, setup for ARDS).

Remember, you only have 15 minutes. Depending on how complicated the patient is/was, you'll need to move quickly to cover what you need to cover. Try to hit the important points so you don't run out of time.
 
One thing I would expect a respiratory therapist/RT student to be cognizant of is the ARDSnet data. You might consider discussing this briefly, including why low tidal volumes/low mean airway and peak pressures would/might be important in this case (aspiration, trauma, setup for ARDS).

Remember, you only have 15 minutes. Depending on how complicated the patient is/was, you'll need to move quickly to cover what you need to cover. Try to hit the important points so you don't run out of time.

I appreciate your response. Funny you mention ARDSnet. This is something I expect to explain because apparently NBRC says every adult patient should ventilated with an 8-12 ml/kg of IBW Vt, therefore our instructors see anything outside of this range as a problem. However, my employer adopted a ventilation guideline that roughly matches ARDSnet guidelines for initiating a lung protective strategy a few years ago. So, I am expecting to answer some questions on my choice of a smaller Vt. I did monitor plateau pressures with this patient and I also calculated static and dynamic compliance and airway resistance. I also correlated our end tidal CO2 findings with ABG findings and calculated PAO2, A-a gradient and the PF ratio.

The good news is that I have 15 minutes to present, but the physicians and instructors basically have carte blanche in what they will ask and how long they have to essentially question my decisions and thought process. So, I plan to hit the "high points" and be a bit more vague on other aspects of the presentation with the hope that I can give comprehensive explanations during the Q&A session that will follow the presentation.

The paper was sent in on Monday of this week and I will present this coming Monday.

Thank you again for the reply.