Free Medicine Case Study Case Study Sample

The reasoning pathway that the two crew members have taken was largely based on the clinical signs and symptoms that Sam exhibited the past few days and the moment that they arrived to address the situation. Some of the most pertinent and clinically relevant findings in this case were the fact that the patient has to regularly take Ventolin just so he can have comfort; plus the fact that Ventolin intake presents only with limited success. Ventolin, for the record, is a commonly used inhalant by patients who have asthma or any other airway obstruction-related diseases. This information alone, we can assume, can already be considered as a guide for the crew members in forming an initial diagnosis for their patient--that is, their patient may have a formal diagnosis of asthma. Another important consideration that may have the reasoning pathway that the two crew members have taken is the fact that Samuel’s condition got worse particularly when he reported of extreme discomfort one night without any form of fever, cough production. The absence of the said symptoms can be considered as a contradiction to the previous asthma or respiratory signs and symptoms because normally, asthma attacks are coupled with coughs that are often productive, both of which were absent in Samuel’s case. Considering the signs and symptoms that Samuel manifested a few days prior and the exact moment that the crew members arrived to help, there are only two possible diagnosis: the first one being cardiopulmonary in origin and the second one being musculoskeletal in nature. Cardiopulmonary disorders are often associated with difficulty breathing, shortness of breath, fatigue, difficulty in moving, and productive cough with secretions . In Samuel’s case, they were not able to notice any signs of productive cough with secretions, which may well be considered as one of the hallmarks of asthma. The next most probably diagnosis is a condition that is musculoskeletal in nature. Because there was no fever and cough, symptoms that Samuel, according to his mom, often exhibit whenever he experiences an acute asthma attack, were absent the moment the crew members arrived, the most probable diagnosis would really be the second one, the musculoskeletal involvement . The crew members, however, should not entirely rule out the possibility that what happened to Samuel was a result of a pulmonary condition such as asthma because after all, the patient’s history supports this finding.
The knowledge and experience of the crew members on diagnosing different patient medical conditions would play a highly important role in the entire process. This is because the more experienced and knowledgeable the crew members are about a certain condition, which in Samuel’s case may only fall between a musculoskeletal and a cardiopulmonary classification, the easier it would be for them to create an initial although not formal diagnosis. Part of this process, of course, is to know what to do to prevent the exacerbation of the disease, stopping the development of secondary complications, or even altering the disease course altogether. In the case of patients with asthma, specifically those who are experiencing acute asthma attacks, knowing what to do is highly important because patients may suffocate as a result of hypoxia ; if the crew member knows what they are doing, then they may easily administer first aid to stop the acute asthma attack altogether, saving the patient in the process. Naturally, medical institutions must prefer hiring crew members who are experienced in their respective field because experience in the field of allied medicine can be a strong indicator of performance and expertise in the field, especially in diagnosing patients on the spot based on clinical signs and symptoms alone.
There are many types of decision making, reasoning, and analytical skills and strategies that may be used in the field of medicine. Two of the most common are the intuitive clinical reasoning and the hypothetical and deductive one. Medical and health professionals who rely on intuitive clinical reasoning skills are those who use their direct perception on things. This means that they analyze things and use reason based on their current pool of knowledge about something. Between the two, the intuitive clinicians are those who are bound to strictly follow standard operating procedures and protocols because that is what their philosophy tells them to do . Hypothetical-deductive clinical reasoning, on the other hand, teaches a clinician to be a dynamic and out of the box thinker rather than one who simply follows rules, policies, and protocols. Clinicians who follow this approach are often those who want to try something new be it in terms of diagnosing and or treating their patients . In the case of Samuel, the more applicable type of clinical reasoning would be the intuitive type because treatment of asthma often follows a single set of rules only; clinicians in that case would not have to use their dynamic thinking and reasoning abilities because there is already a set way to address the problems.
In every patient case or scenario, there are a lot of things that might affect the clinical decisions, diagnosis, and patient outcomes. In Samuel’s case, however, the ones that are the most significant are the level of knowledge and experience of the practitioners (i.e. the crew members), the way how the patient presents with the clinical signs and symptoms of whatever the medical condition he has. Between the two, the patient presentation would prove to be the highest impact. This is because, firstly, the underlying condition of the patient would be the main determinant that clinicians would use in creating goals for the patient and the treatment plan that would lead them to achieving those goals. Also, the patient’s presentation of signs and symptoms is the most reliable and important factor in making an accurate diagnosis. Having the diagnosis wrong could undermine the patient’s safety and his ability to recover from the medical condition . Next would be the level of knowledge and experience that the crew members have. As with other fields and industries aside from allied medicine and public health, the more experienced and knowledgeable an individual is on what he does, the more reliable and high-performance that individual would be in the field and in the workplace. This is essentially true in the field of medicine. In this case, a more experienced and knowledgeable team of crews would make the diagnostic and treatment and management procedures a lot easier, more accurate, reliable, and consistent , all of which would basically lead to more successful patient outcomes and ultimately, the realization of the patient’s goals and recovery.

References

Asher, M. (2006). Worldwide time trends in the prevalance of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood. The Lancet.
Bowen, J. (2006). Educational Strategies to promote clinical reasoning. New England Journal of Medicine.
Cales, C., Jacqueline, A., Crilly, A., & Rowe, B. (2006). Holding Chambers Versus Nebulisers for beta-agonist treatment of acute asthma. The Cochrane Library.
Chari, S., Smyrk, T., Levy, M., Topazian, M., Takahashi, M., Zhang, L., et al. (2006). Diagnosis of Autoummune Pancreatitis: The Mayo Clinic Experience. Clinical Gastroenterology and Hepatlogy.
Charon, R. (2006). Narrative Medicine: Honoring the stories of Illness.
Hillel, B. (2015). Intuition in Medicine: A Philosophical Defense of Clinical Reasoning. Medhum.
Kim, N., & Woo, A. (2002). Clinical psychologists' theory-based representations of mental disorders predict their diagnostic reasoning and memory. Journal of Experimental Psychology.
Norman, G., & Eva, K. (2010). Diagnostic Error and Clinical Reasoning. Wiley Online Library.
Ober, C., & Nicolae, D. (2011). Meta analysis of genome wide association studies of asthma in ethnically diverse North American populatins. Nature Genetics, 887-892.
Rowe, B. (2001). Early emergency department treatment of acute asthma with systemic corticosteroids. The Cochrane Library.