1. The circle is located in the left-thoracic region, over the diaphragm and near the floating ribs and the left lung. It marks the area that is closely related to respiratory abilities.
2. The circle marks the right squadron area in the abdominal region, near the liver, right kidney. It may indicate complications arising from internal bleeding, renal or hepatic complexities in patients.
3. The circle shows the minor pectoral area, near the heart. Markings in these regions can indicate cardiopulmonary complications. Problems in costal cartilages can also be indicated through this circle (Victorio et al. 2016: 28876).
4. The circle indicates a lower right pelvic region, just below the pelvic girdle and near coccyx and sacrum. The marking can be related to problems, such as pelvic inflammatory complications and abscesses.
5. The region marked is near left elbow. This region is connected to the stomach, sigmoid colon, small intestine, left hepatic lobe and pancreas through superior vena cava. This can involve lateral side and medium measurement.
6. This area is close to the right humerus bone and lung. The region marked in near the clavicle and indicates the zone over pectoral muscles. This area encloses pectoralis minor and subclavius through the thoracoacromial artery and cephalic vein. 

1. Adverse effects of Oxygen

• Chemical toxicity tracheobronchial tree capillary endothelium alveolar epithelium
• Retinal damage caused by oxygen
• Endocrine effects adrenal Gonads Thyroid due to excess presence of oxygen
• Toxic effects on cells and enzymes of the central nervous system

1. Indications for oxygen use

• In the case of reducing the oxygen level, the patient can be supported with the proper amount of oxygen (Nunes et al. 2017:198).
• If there is any type of Peri and post-cardiac arrest, the doctor can refer to the use of oxygen  
• For the symptoms of shock and it can help to reduce the shock
• Metabolic acidosis

Administration Save Time On Research and Writing Hire a Pro to Write You a 100% Plagiarism-Free Paper. Get My Paper	Indication
Oxygen therapy	Low blood oxygen, carbon monoxide toxicity
100% on demand Save Time On Research and Writing Hire a Pro to Write You a 100% Plagiarism-Free Paper. Get My Paper	1. Shortness inbreathe 2. A headache 3. Chest pain 4. High blood pressure 5. Restlessness
Intermittent positive pressure Ventilation (IPPV)	Use to provide large breath to patients

Anatomical Positions

Table 1: Oxygen therapy

(Source: Created by the researcher)

Oxygen therapy

1. Adverse effects of Acetylsalicylic acid

• Chest pain and uncomfortability is the common effect
• Muscle cramping and weakness can happen due to this reason
• Vomiting
• The patient can breathe fast than normal percentage

1. Contraindications of Acetylsalicylic acid

• Varicella
• Deficiency of G6PD
• Aspirin triad
• GI bleeding

1. The adult dose of Acetylsalicylic acid

• Pain /fever – 325-650 mg
• MI prevention- 81-325mg
• Coronary syndrome- 162-325mg

1. Adverse effects of Entonox

• Nausea
• Dry mouth
• Dizziness
• Tingling fingers
• Dysphoria

1. Contraindications of Entonox

The seven contraindications of Entonox are:

• Hypersensitivity
• Renal impairment
• Peptic Ulceration
• Changed mental status
• Facial trauma
• Respiratory problems
• Using of drug or intoxication

1. Adverse effects of Methoxyflurane

• Damage of kidney due to excess amount of Methoxyflurane
• Delirium
• The patient can feel drowsiness
• There is a Throwing up feeling inside the body of the patient  

1. Contraindications of Methoxyflurane

• The issue in the liver and kidney functioning reduced
• Unconsciousness can be seen  
• Reduced percentage of urine due to kidney problems
• Malignant hyperthermia
• Diabetes
• Those who are suffering from a reduced or eventual decrease in lung functions
• Pregnancy in seizures
• Unstable heart condition and blood circulation

1. Methoxyflurane   dosage

• Daily dose- 6 ml
• Weekly- 15 ml
• Quantity in inhaler- 3 ml
• Age restriction- 5 years and older
• Activity – 25-30 minutes

1. Precautions for Paracetamol

• As suggested by Nasrollahi et al. (2017:232), paracetamol cannot be taken after 29 weeks of pregnancy
• Prohibited for people who are carrying  liver and kidney disease

1. Paracetamol   dosage

• Adult (above 12 years) – 500-1000 mg in every 4-6 hours till the symptoms last in the patient
• Paediatric (7-12 years)- 480 mg in every 4 hours and maximum until the symptoms removed  

1. Actions of Adrenaline
2. Increase heart rate
3. Enhance blood pressure
4. Extend blood glucose level
5. Expansion of air passage in lungs
6. Redistribute blood in the muscles
7. Response time: In case there is no response after 2-3 minutes after an initial dose, another EpiPen can be tried. 

Automated External Defibrillation

1. a
2. c
3. d
4. a
5. a
6. b
7. True
8. c
9. c
10. b
11. d
12. d
13. d
14. b
15. d
16. d
17. True
18. c
19. d
20. Body jewelry, medication patches, transdermal patches, clothes
21. True
22. b
23. False   

Question 1: Assessment and treatment in detail using API in case of asthma

To identify the type of asthma, it is necessary to classify according to the types. As for, a mild intermittent, asthma effect can stay up to two days in a week or two nights in one month. On the other hand, for those who are mild persistent. Symptoms can last more than twice a week. Severe asthma persistent can suffer throughout a whole day and frequently in the night. The child can be assisted with short-acting beta-agonists that will be helpful to access quick-relief bronchodilators (Rizzo, 2015:12). This strategy can be helpful to work within a minute and reduce the symptoms of an asthma attack. In these case ProAir HFA, Ventolin HFA is suggested with levalbuterol. Apart from this, Ipratropium can also be a good help that is quick and effective to relax the way of air (Shier et al. 2015:45). She can have more quick responses as it is easier to breathe. This help is appropriate for chronic bronchitis. Medication with oral and intravenous corticosteroids can release airway inflammation.

To diagnose the back pain, it will be helpful to conduct a CT scan, X-ray or MRI can be done to conduct a proper physical exam. Spinal stenosis and the herniated disc can be identified. Non-steroidal anti-inflammatory drugs like Advil, Naproxen Sodium or Motrin IB can help to relieve the acute back pain. Edlow et al. (2014: 2064) said that the medical practitioner could provide a muscle relaxant in case the situation is not improved after using OTC pain relievers. After, the patient can be taken to the health support center and injected with anti-inflammatory medication process.  Antidepressant medication can be prescribed in a lower dosage, like ibuprofen or aspirin (Miguel-Montanes et al. 2015:574).

On the other hand, for the larger issue, it is helpful to use chemotherapy. Permanent lasting of paresthesia is a very rare case, and it hardly stays for a month. Thus, the back pain, in this case, should be given more attention than the leg paresthesia. 

In this case, the primary reason can be reflected on the overuse injury, muscle strain from playing a sport such as golf, rugby or tennis. Thus, it is necessary to provide primary relief to him in this condition. Initially, his forearm can be rest over some solid part which will give him relief from hanging the hand. Fatemian et al. (2016:1197) suggested that icing can be done in the affected areas that will reduce the scope of swelling. The splint can be used to reduce the mobility, and it will also be helpful to heal the injury.

Extending the forearm from shoulder and bending the wrist will be helpful to keep the blood circulation normal. Reduction of inflammation in muscle can be done with cortisone that is helpful to reduce the forearm pain (Futier et al. 2016: 1888-1898). On the other hand, the place should be monitored as the pain can also generate from a blood clot. Pain or tenderness not only caused by injury can also be the reason for the blood clot.

Pharmacology

Initially, the pressure is the most important thing. It is necessary to identify if the blood is coming out fr4om the hole. The dressing is required to do with gauze as it can make blood clot and seal the wound immediately. As opined by Hussain et al. (2014: 396), the seal of a gunshot wound with some plastic material can be helpful as air usually sucked in the wound. It is helpful to prevent the collapsed lung.  Direct pressure on wound and IV fluids can prevent dehydration and increase blood flow in major organs. Inserting the chest tube as a suction device can remove air and relieves and keeps circulation normal.

Tom is a 70-year-old male who had undergone a hip injury in the left leg at Parramatta Football stadium at 13.00 p.m. The temperature at this time is 40 c. He was approaching the gate when directly hit with an iron stand. He had a medical history of slight dementia and Angina 16 years ago and has breathing problems as well as a tendency of allergies. GCS rate was exactly 13; blood pressure was 160/90, respiratory rate was 30, and the heart rate was 100. SPO2 was 95; capillary refill was 54. According to a preliminary examination, it has identified that his situation is combative, but he is confused as well as feared due to the condition of the leg. He was complaining that his left leg is in pain and he can’t walk by himself. Initially, the assistance had provided with hemodynamics. Drs ABCD was applied for his first assessment while second assessment had done with COWS, AMPLE and PQRST. Epipen can be given according to his health condition, and he was on the full requirement of therapy musk (Hassani et al. 2015, 4).. He has undergone a dislocated knee and can be supported by general pain relief drugs. After proper diagnosis, he can be provided with surgery or any other necessary medication. 

1. Three prominent signs that can confirm cardiac arrest are
   1. Discomfort, palpitations or acute angina
   2. Unconsciousness and difficulty in normal breathing
   3. Dizziness or light-headedness   
2. Checking for unconsciousness
   1. It is to be checked whether the person is breathing.
   2. Legs have to be raised more than 12 inches above the ground.
   3. Any restrictive belt or clothing must be loosened.
   4. The airways must be checked to ensure lack of obstruction.
3. Sigmund Freud segregated human consciousness into three major levels, namely, the conscious, preconscious or subconscious, and lastly, the unconscious.
4. Resuscitation
   1. 30:2
   2. 120 compressions, 5 to 6 cm depth
   3. 2
   4. 2
   5. 1
   6. tilted
5. c
6.  
7. A sign is referred to the objective evidence of a disease, which is a phenomenon experienced by the patient (Beaudin et al. 2015: 1072-1083).

A symptom refers to the subjective evidence of a disease, detected by other individuals in the vicinity of the patient.

1. Possible causes of coma
   1. Traumatic neural injuries caused by collisions or violent force
   2. Interrupted or reduced blood supply to the brain, resulting from blocked or burst blood vessels
   3. Tumors in the brain or brainstem
   4. Extreme blood sugar levels (hyperglycemia or  hypoglycemia)
   5. The absence of oxygen resulting from asphyxiation or drowning
   6. Infections like meningitis or encephalitis that can cause cerebral inflammation
2. Possible causes of hypoventilation
   1. Chronic obstructive pulmonary diseases like bronchitis or emphysema
   2. Deformities in the chest wall, such as fibrothorax, kyphoscoliosis, and post-thoracoplasty
   3. Myxedema
   4. Abnormal obesity
   5. Depression in the central respiratory drive from drug abuse, neurological disorder or alveolar hypoventilation
   6. Failure of physiological mechanisms of the respiratory system
   7. Oxygen desaturation during sleep as a form of ventilatory response to enhanced PaCO2 and hypoxia
   8. Carotid body resection resulting from one or the other forms of injury
3. Control of external bleeding
   1. Covering of injury with tourniquet, bandage or moist cloth
   2. Application of direct gentle pressure on the wound to reduce bleeding
   3. Elevate wounds above the heart to reduce blood flow
   4. Pressing on pressure points can slow down blood flow
4. Signs and symptoms of the fracture
   1. Pain, swelling, bruising or discoloration of the affected skin
   2. Angulation of the affected region in an unusual angle
   3. Inability to press on or move the injured area
   4. The grating sensation on the affected joint or bone
   5. A patient may look pale, clammy and feel dizzy or nauseated
5. A traction splint is used in case of mid-shaft femur fracture.
6. Injury management
   1. Hospital sling: Injuries in the rotator cuff, arm fracture, glenohumeral acromioplasty,
   2. Elevation sling: Shoulder injuries such as fracture or dislocation (Nunes et al. 2017:198).
   3. Collar and cuff sling: Injuries on shoulders or arms
7. True or false
   1. False
   2. True
   3. False
   4. False
   5. False
   6. False
8. Flail segment of the chest is a medical condition that can occur when segments of rib cage break under trauma and grow detached from the remaining chest wall. It is a common occurrence when multiple ribs suffer from breaks in various places which enable the chest wall to move independently (Sato et al. 2016: 152-161).
9. Symptoms of tension pneumothorax
   1. Sudden angina and cardiac tightness
   2. Shortness of breath
   3. Increased heart and breathing rate
   4. Coughing, wheezing, and nausea
   5. Malaise and fatigue
10. b
11. c
12. Signs and symptoms of Hypothermia
    1. Cold skin with shivers
    2. The problem in speech, such as mumbling or slurring
    3. Shallow, slow breathing rates with a weak pulse
    4. Lack of coordination, confusion, and clumsiness
    5. Drowsiness, loss of memory and consciousness
13. Signs and symptoms of Hyperthermia
    1. Coma
    2. Confusion and dizziness
    3. Fast heart rate
    4. Unconsciousness
    5. High body temperature and headache.
14. Management of burns is to cool then cover
15. Poison can enter the body through
    1. Oral pathway and swallowing
    2. Absorbed through the epidermal layer
    3. Injecting inside the skin through bites, stings or syringes
    4. By inhaling
16. c
17. Pressure immobilization technique
    1. True
    2. True
18. List of creatures
    1. red back, mouse or white-tailed spiders
    2. Box or bluebottle jellyfish
    3. Stonefish
    4. Venomous snakes
    5. Wasp 

1. Stages of complete Spinal immobilization
   1. Placing the patient’s head in midline
   2. Logrolling the said patient
   3. The utilization of special mattresses, cervical collars, backboards, straps, and sandbags
   4. Check for discomfort and tissue pressure
2. a
3. Complications of the rigid cervical collar
   1. Pressure Sores
   2. Intracranial pressure due to the snug fit of the collar that can
   3. Distortion of jugular venous architecture
4. KED complications
   1. The requirement of significant movement of the patient to apply a device that can cause further aggravation or pain
   2. It can expose rescuer and patients to risk owing to operating under on-scene conditions
   3. The requirement of a minimum of two operators that burden emergency services crews to search for other personnel
5. KED point of contact
   1. Thorax
   2. Abdomen or pelvic girdle
   3. Neck
   4. Legs
6. a
7. Allergies, Medications, Past Medical History, Last Eaten, Events Leading
8. The burns are assessed using an APOMI structure.
   1. Action: The burn is immediately cooled by applying wet and cold compresses for 10 minutes.
   2. Planning: A burn protocol is planned for application of petroleum jelly for three times for the next week.
   3. Observation: It is observed that he has partial and full thickness burns to the posterior and anterior aspects of his body.
   4. Medication: The burn areas are covered non-stick and sterile bandages. Medication involves ibuprofen or acetaminophen to reduce inflammation and relieve pain (Samadzadeh et al. 2017: 11-16).
   5. Inference: The burnt area is to be protected from direct sun rays. Appropriate information chart must be maintained.
9. Alert, voice, pain, and unresponsive
10. Questions
    1. What instrument has been used to hit the woman?
    2. How long ago (in minutes) has the incident taken place?
    3. Has she taken any medication or remedy after this incident?
    4. Is she feeling dizziness or nausea?
    5. How many times has the woman been struck?
11. P: Precipitating or palliative factors; Q: Pain quality; R: Radiation or region of pain; S: Subjective overview of pain; T: Time or temporal nature of the pain
12. Case study
    1. Action: Temperature is checked to determine core body temperature and amount of heat absorbed in the body
    2. Planning: Blood test is done to potassium, sodium and gaseous content in the blood.
    3. Observation: Skin is pressed over the abdomen to check for lump or swelling
    4. Medication: Muscle relaxant like benzodiazepine can be given, or ice packs can be applied to pressure points
    5. Inference: Heatstroke treatment focuses on making the body return to its normal temperature and reduces or prevent damage to the brain or vital organs.
13. X-rays and other imaging tests to check for damage to your internal organs.
14. True
15. d
16. Case study
    1. Action: The patient is interviewed to know whether he is suffering from headaches, fatigue or insomnia. The wound is bandaged and pressured to prevent blood loss.
    2. Planning: Appropriate wound management is planned to reduce swelling or infection (Platz et al. 2015: 906-916)
    3. Observation: Skin is observed so that no additional infection is contracted.
    4. Medication: Vasoconstrictor and Blood pressure support
    5. Inference: Supportive care with fluid and oxygen management
17. True or false
    1. True
    2. False
    3. False
    4. True
    5. True
    6. True
    7. False
    8. Shocks
18. Hypovolemic shock
19. Neurogenic shock
20. Cardiogenic shock
21. Anaphylactic Shock
22. Multiple choice questions
23. a
24. b 

Reference list

Books:

Rizzo, D. C. (2015). Fundamentals of anatomy and physiology. Ed 2 US: Cengage Learning.

Shier, D., Butler, J., & Lewis, R. (2015). Hole’s Essentials of human anatomy & physiology.  Ed 3 New York: McGraw-Hill Education.

Journals:

Edlow, J. A., Rabinstein, A., Traub, S. J., & Wijdicks, E. F. (2014). Diagnosis of reversible causes of coma. The Lancet, 384(9959), 2064-2076.

Fatemian, M., Herigstad, M., Croft, Q. P., Formenti, F., Cardenas, R., Wheeler, C., … & Robbins, P. A. (2016). Determinants of ventilation and pulmonary artery pressure during early acclimatization to hypoxia in humans. The Journal of physiology, 594(5), 1197-1213.

Hussain, L., Ikram, J., Rehman, K., Tariq, M., Ibrahim, M., & Akash, M. S. H. (2014). Hepatoprotective effects of Malva sylvestris L. against paracetamol-induced hepatotoxicity. Turkish Journal of Biology, 38(3), 396-402.

Miguel-Montanes, R., Hajage, D., Messika, J., Bertrand, F., Gaudry, S., Rafat, C., … & Dreyfuss, D. (2015). Use of high-flow nasal cannula oxygen therapy to prevent desaturation during tracheal intubation of intensive care patients with mild-to-moderate hypoxemia. Critical care medicine, 43(3), 574-583.

Nasrollahi, S., Otogara, M., Jahan-ara, S., & Shayan, A. (2017). An investigation into the side effects of entonox on primiparas in painless labor. Indian Journal of Forensic Medicine and Toxicology, 11(2), 232-236.

Nunes, B., Nunes, J., Soares, A. M., Figueira, E., & Freitas, R. (2017). Toxicological effects of paracetamol on the clam Ruditapes philippinarum: exposure vs. recovery. Aquatic Toxicology, 192, 198-206.

Platz, E., Jhund, P. S., Campbell, R. T., & McMurray, J. J. (2015). Assessment and prevalence of pulmonary edema in contemporary acute heart failure trials: a systematic review. European journal of heart failure, 17(9), 906-916.

Samadzadeh, S., Rezavand, N., Yari, M., Rezaei, M., Faizmahdavi, H., & Hematti, M. (2017). Comparison of Entonox and Transcutaneous Electrical Nerve Stimulation (TENS) in Labor Pain. Journal of Medical and Biomedical Sciences, 6(2), 11-16.

Sato, T., Paquet?Fifield, S., Harris, N. C., Roufail, S., Turner, D. J., Yuan, Y., … & Williams, R. A. (2016). VEGF?D promotes pulmonary edema in hyperoxic acute lung injury. The Journal of Pathology, 239(2), 152-161.

Online articles:

Beaudin, A. E., Waltz, X., Pun, M., Wynne-Edwards, K. E., Ahmed, S. B., Anderson, T. J., … & Poulin, M. J. (2015). Human intermittent hypoxia-induced respiratory plasticity is not caused by inflammation. European Respiratory Journal, 46(4), 1072-1083. Available at: https://erj.ersjournals.com/content/46/4/1072.abstract [Accessed on 19th December 2018]

Futier, E., Paugam-Burtz, C., Godet, T., Khoy-Ear, L., Rozencwajg, S., Delay, J. M., … & Constantin, J. M. (2016). Effect of early postextubation high-flow nasal cannula vs. conventional oxygen therapy on hypoxemia in patients after major abdominal surgery: a French multicentre randomized controlled trial (OPERA). Intensive care medicine, 42(12), 1888-1898. Available at: https://icmjournal.esicm.org/journals/abstract.html?v=42&j=134&i=12&a=4594_10.1007_s00134-016-4594-y&doi=[Accessed on 18th December 2018]

Hassani, E., Mahoori, A., Sane, S., & Tolumehr, A. (2015). Comparison the effects of paracetamol with sufentanil infusion on postoperative pain control after craniotomy in patients with brain tumor. Advanced biomedical research, 4. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4374201/[Accessed on 18th December 2018]

Horsting, M. W., Franken, M. D., Meulenbelt, J., van Klei, W. A., & de Lange, D. W. (2015). The etiology and outcome of non-traumatic coma in critical care: a systematic review. BMC Anesthesiology, 15(1), 65. Available at: https://bmcanesthesiol.biomedcentral.com/articles/10.1186/s12871-015-0041-9[Accessed on 15th December 2018]

Maleh, V. A., Monadi, M., Heidari, B., Maleh, P. A., & Bijani, A. (2016). Efficiency and outcome of non-invasive versus invasive positive pressure ventilation therapy in respiratory failure due to chronic obstructive pulmonary disease. Caspian Journal of internal medicine, 7(2), 99. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4913712/[Accessed on 13th December 2018]

Stetzik, L., Deeter, A., Parker, J., & Yukech, C. (2015). Puzzle-based versus traditional lecture: comparing the effects of pedagogy on academic performance in undergraduate human anatomy and physiology II lab. BMC medical education, 15(1), 107. Available at: https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-015-0390-6[Accessed on 10th December 2018]

Victoria, C. B. L., Xu, Y., Ng, Q., Chua, B. H., Alonso, S., Chow, V. T., & Chua, K. B. (2016). A clinically authentic mouse model of enterovirus 71 (EV-A71)-induced neurogenic pulmonary edema. Scientific reports, 6, 28876. Available at: https://www.nature.com/articles/srep28876[Accessed on 19th December 2018]