Case Studies with Critical Thinking Questions

Question

Scenario 1
Mr. Karnes, a diabetic patient, tells the receptionist that he is not feeling very well and wants to
know if he can be taken to an exam room right away. He took his insulin this morning but did not
have time to eat before his appointment. While waiting for the medical assistant to escort him to
the room, Mr. Karnes becomes unconscious and falls to the floor in the waiting room. The
medical assistant summons the provider and gets the crash cart, only to find that there is no
glucose in the cart.
1. What must be done immediately after the emergency has been dealt with?
2. How can an inadequately stocked crash cart be prevented in the future?
Scenario 2
A frantic mother has just called your office and reports that her three-year-old son has just
ingested household cleaner. She is hysterical and is asking questions so quickly that you can
hardly understand what she is saying.
1. What information should be obtained from the caller?
2. Who should the mother be instructed to call?

Answer 1

Scenario 1

1. What must be done immediately after the emergency has been dealt with?

   • After the emergency has been addressed and Mr. Karnes has been stabilized, the first step is to ensure that he receives immediate medical attention, such as administering glucose if available or transferring him to a medical professional who can provide further care. Following that, documentation of the incident should be completed, including noting the time the incident occurred, Mr. Karnes's condition before and after the event, and the actions taken by the staff. It's important to inform the medical team about the inadequacy of the crash cart to prevent future incidents as well.

2. How can an inadequately stocked crash cart be prevented in the future?

   • To prevent an inadequately stocked crash cart in the future, the facility should implement a regular, scheduled inventory check protocol for all emergency equipment and medications, including crash carts. Staff should be trained to check the stock regularly and immediately report any missing or expired items. Additionally, a checklist of required items should be made accessible and maintained as part of the emergency response protocol. Regular training and drills on emergency procedures can also reinforce the importance of preparedness among staff.

Scenario 2

1. What information should be obtained from the caller?

   • When speaking with the frantic mother, the following critical information should be obtained:
     • The exact name of the household cleaner ingested (if possible) and its ingredients.
     • The approximate amount ingested.
     • The child's current symptoms (e.g., any signs of distress, vomiting, difficulty breathing).
     • The child's age, weight, and any previous medical history (including allergies or medications).
     • The time of ingestion.
     • Any immediate actions already taken by the mother (e.g., whether she induced vomiting or administered any antidote).

2. Who should the mother be instructed to call?

   • The mother should be instructed to immediately call the Poison Control Center for guidance on what steps to take next, as they are equipped to provide specific advice based on the substance ingested. If the child is showing severe symptoms or is having difficulty breathing, she should be advised to call 911 or go to the nearest emergency room. In emergency situations, staying calm and following proper protocol is crucial for the safety of the child.