Case details Alleged assault Called to: A 18-year-old male involved in an alleged assault at a hotel in the CBD. The call was made to the Ambulance Communications Centre at 0130 hours and you arrive on scene at 0200 hours. On arrival: At scene the patient is found to have an altered level of consciousness and is situated in the front passenger seat of a car parked outside the hotel. The assailant had fled the scene and hotel security officers are actively controlling the crowd and traffic. First Aid Officers are in attendance. On examination: A bystander (the patients friend) provides the following information to you: The patients name is Bob and both Bob and his friend were outside the hotel talking when Bob was punched with a closed fist to the left side of the face at approximately 0030 hours by a young male (approximately 21 years of age). Bob fell backwards hitting his head on the cement footpath. PMC2201 Sem.2,2021 Page 1|5 Bob was unconscious for approximately 1 to 2 minutes and then regained consciousness, Bob appeared to be slightly confused but insisted he was OK and did not want to go to hospital. Bob and his friend then went back into the hotel for about 30 minutes and during this time Bob began to feel nauseous and complained of a headache. Bob then stated that the headache wouldnt go away and that he felt tired. Bob then went to have a sleep in his friends car. Bobs friend remained in the hotel until approximately 0130 hours when he walked to the car and found Bob slumped in the front passengers seat. He was not able to wake Bob and so called 000. The friend stated that he was the designated driver and that Bob had received some good news, so they were at the hotel celebrating. The friend also stated that Bob had been drinking moderately during the night consuming about 8 full strength beers over a 2-hour period and denied the use of any other substances. The First Aid Officers on scene have regularly assessed Bob and provide you with three (3) sets of patient assessment taken 10 minutes apart. The first assessment is at 0140 hours, then 0150 hours and then at 0200 hours. These sets of observations are listed WITHOUT treatment or intervention. Use this information to assist you with answering the case study questions. Assessment Task: All the follow questions will need to be answered to satisfactorily complete this assessment piece. Through scrutiny of the case details students are required to: 1. Provide a provisional diagnosis for Bob with reference to the mechanism and pattern of injury (MOI/POI). (Approximately150 words) 2. Discuss the pathophysiology of Bobs condition, providing a complete explanation of the alteration in his vital signs. (Approximately- 500 words) 3. You have three sets of patient observations for Bob. Provide a best practice management plan for Bob ensuring that goal/s of treatment and rationale for management strategies are included. (Approximately 500 words) 4. Describe the possible long-term, residual neurological conditions/issues (prognosis) that Bob may experience.
