You are presented with the following obstetric case study and will be required to answer five (5) questions pertinent to the case totally 2000 words (+/- 10%)

You are a paramedic in your first-year post-qualification, working with a graduate who has only been on road for 2 months.

You are dispatched to a 28-year-old female, with imminent delivery. The information you have is:

•       G3: P1, 41 weeks gestation

•        Membranes ruptured 2 hours ago at home

•        Onset of regular painful contractions 30 minutes ago, she called the hospital and was advised to come in; it’s approximately a 20-minute drive from her home.

•       She is unable to move herself to the car between contractions as she has developed a sudden and overwhelming urge to push. Her partner calls 000.

•       You are 15 km from the location with a 9-minute response time

•       Backup is 15 minutes away and dispatched at the same time

•       Unremarkable antenatal history, except for well-controlled gestational diabetes

•       Regular check-ups with GP and midwife.

•       Previous normal singular vaginal births.

On arrival, you find the woman, Sophie, lying on her bed actively pushing and the presenting part appears to be the baby’s head. Her partner, Tom, is relieved to see you. You only have time to place your equipment down when the head is delivered with Sophie's next push.

One the next contraction you then recognise

•       there is no spontaneous restitution of the head

•       the shoulders do not deliver

•       Sophie continues to push with significant pain

1)  Provide a definition and overview of the obstetric condition the patient is presenting with?

2)  List and discuss the pertinent risk factor(s) that could have increased this patient’s risk of presenting with her current condition?

3)  Describe one (1) of the manoeuvres or actions that is linked with this obstetric emergency and provide a pathophysiological rationale?

Once the application of the manoeuvres is complete, the baby is delivered safely with an APGAR of 8.

Sophie is now holding the baby skin to skin on her chest when she states that she doesn’t feel well and you notice considerable PV blood loss. At this point, she delivers the placenta, and with this comes a fresh flow of frank red blood. You feel her abdomen at this point, and it feels soft and boggy.

4)  What is your concern at this point, and outline and discuss the likely potential cause of this substantial blood loss?

5)  Describe that pathophysiology behind ONE of the key pharmacological options used post-delivery in the management of this condition?

Please see the Moodle for a detailed rubric, however, broadly you will be assessed on:

-Knowledge of pathophysiology of a specific obstetric condition.

-Application of pathophysiology to clinical presentation.

-Understanding of aetiology of numerous obstetric conditions.

Please write your assessment using the following style and format and then upload it to the PMSC12003 Moodle page under the Case Study link in the Assessment tab.

Presentation:

Your assessment should be formatted on A4 International Standard paper with margins of 2.54cm. Arial font and size set to 12 point, and line spacing set to 1.5.

Format:

Cover page: a cover page must be included for this assessment in the following format:

• Assessment name
• Unit number and name (PMSC12003 Special Populations in Paramedic Practice)
• Your name
• Student number
• Word count (not including cover page, headings, in-text references and reference page)
• Assessment due date (if you have an approved extension this needs to be noted here)

Body of assessment:

• Headings may be used (i.e. Provisional Diagnosis, Definition, Pathophysiology etc.)
• Appropriately referenced using the APA 7th Edition format

Reference page:

• The reference list must be on a separate page at the end of your assessment
• References must be listed using the APA 7th Edition format

The word limit for this assessment is 2000 words (+/-10%, not including cover page, headings, in-text references and reference page).

The assessment will be marked against a rubric, which will be available on the Moodle page.

You must provide a reference list of no less than 7 reference sources, published after 2013, which can include peer-reviewed scientific journal articles, Australian and/or New Zealand ambulance service guidelines, expert textbooks and websites, as appropriate.

In the absence of an approved extension, a penalty of 5% of the total marks for the assessment will be deducted for each full or part calendar day the assessment is overdue, in accordance with the Assessment Policy and Procedure.

The pass mark for this assessment is 50%

This written assessment will be worth 40% of the total percentage mark for this unit.

This quiz is worth 20% of the total mark for the unit. Marks are awarded if a question is answered correctly and the total marks are tallied after each quiz has been attempted. Non-attempts will score a zero mark.

Quizzes are open-book, so the use of Clinical Practice Guidelines, book chapters, journal articles etc are allowed. Please take note that this is an individual assessment. Collaboration is not allowed and may lead to disciplinary action.

Each quiz will have a specific time limit imposed to complete the quiz. When the time for the quiz expires, any open attempt are automatically submitted. You must therefore commence the quiz allowing the appropriate amount of time to complete the attempt. 

In the absence of an approved extension, there will be no opportunity to complete the task after the due date, and there will be no opportunity to apply a late penalty of five percent per day. Quizzes may not be re-attempted.

This quiz will involve a combination of multiple-choice and short answer questions. It will primarily cover the assessment and management of paediatric and geriatric patients. The quiz will involve case studies that will require drug calculations and will require critical thinking in your application of knowledge.

This quiz is worth 40% of the total mark for the unit. Marks are awarded if a question is answered correctly and the total marks are tallied after each quiz has been attempted. Non-attempts will score a zero mark.

The quiz is open-book, so the use of Clinical Practice Guidelines, book chapters, journal articles etc are allowed. Please take note that this is an individual assessment. Collaboration is not allowed and may lead to disciplinary action.

There will be a specific time limit imposed to complete the quiz. When the time for the quiz expires, any open attempt are automatically submitted. You must therefore commence the quiz allowing the appropriate amount of time to complete the attempt.

In the absence of an approved extension, there will be no opportunity to complete the task after the due date, and there will be no opportunity to apply a late penalty of five percent per day. Quizzes may not be re-attempted.

This assessment is a Pass/Fail Assessment.

This is an Objective Structured Clinical Examination (OSCE), which will be conducted at the Residential School. There will be two (2) OSCE stations, each designed to assess your knowledge and practical skills acquired during this unit.

There will be one (1) short case OSCE station and one (1) long case. You will be allocated 15 and 20 minutes respectively to complete the assessment. The short and long case OSCEs will be delivered in the format of a structured scenario, looking at the following areas:

• Patient assessment and history taking.
• Evidence gathering and patient treatment.
• Implementation of interventions, procedures, pharmacology and skills.
• Overall patient and scene management.

Feedback for the short and long cases will be provided AFTER the residential school. Further information will be given to students upon arrival at the residential school.

An example assessment rubric will be provided on the unit Moodle page. The result from each OSCE will be added together to form a cumulative mark across all 3 assessment items you complete on the day. This will determine the pass/fail result. You will be required to achieve an overall score of 50% to achieve a pass mark. Due to being awarded a cumulative mark, there will be no opportunity for any re-sits.

Failure to attempt/undertake an assessment task will result in a fail for this assessment.