f E mergency Room 2 (ER 2) FAQ Copyright of Paul Pike [KawaiiNeko333@aol.com] ER 2 is copyright of Legacy Interactive (www.legacyinteractive.com) Version .91E Ok everyone listen up! I want everyone to know that this is my work and I don't want anybody ripping this FAQ off for themselves. What is Emergency Room 2? ========================= Emergency Room 2, created by Legacy Interactive, is a sim game in which you take in patients, exam them and treat them. The whole goal of the game is to make Chief of Staff by handling 100+ missions. The Med-o-matic =============== The Med-o-matic is your best friend in this game. The functions of it are: S.O.A.P. (Subjective, Objective, Assessment and Plan) Notes (Used to review which tests you've done) Comm. (Used to talk to either Dr. D. Boss or whomever the doctor is in the room for help) Glossary (Used to look up medical terms for problems and body parts) S.O.A.P.: Answering the questions of the S.O.A.P. allows you to get more points and make good with Dr. D. Boss. The S.O.A.P. quesations here are done in respective order from top to bottom (ex. S: 2nd and 1st choices. That means on the Subjective Part, click on the 2nd circle, go down, then click the 1st circle.) Notes: You can look at the notes to see what the results were of the test you did. Comm.: Besides talking to Dr. D. Boss, you can use this to ask for help from other doctors in the current room. Examination Room: Keri Taker Imaging Room: C.N. Sideyou Laboratory: Mike Roscope Treatment: Drew R. Dyer Glossary: Do I need to say anything more? Tools of the trade ================== Examination Room ---------------- EKG: Used on the heart to record the electric impulses in the heart Sphygmomanometer [say that 3X fast ;)]: Used on the upper arm to measure blood pressure Thermometer: Used in the mouth to measure the body temperature Respirometer: Used to measure the patient's respiration rate Magnifying Glass: Used to examine a part of the body Glove: Used to get palpation info on a body part Pulsometer: Used on a finger to measure the pulse rate Stethoscope: Used on the heart to hear heart sounds, on the lungs to hear respiration sounds, and on the abdomen to hear bowel sounds Penlight: Used on the eye to check pupil response Nasoscope: Used on the nose to examine the nasal mucosa Othalmoscope: Used on the eye to inspect the inside of the eye Tongue depressor: Used in the mouth to examine the mouth and throat Othoscope: Used on the ear to view inside the ear Eye dye: Used on the eye to detect abnormalities in the cornea Imaging room ------------ X-ray: Used to take a photograph of the inside of the body Ultrasound: Used for diagnostic or therapeutic purposes CAT Scan: Used to get tomography info Laboratory ---------- (NOTE: These are tests I've seen so far) Blood test: Used to measure hemoglobin/hematocrit, type and cross, complete blood count, amylase, glucose, liver enzyme, kidney panel, toxic screen Urine test: Used to measure dipstick, microbiology/chemistry/cytology Swab culture: Used to measure throat/quick Blood gas test: Used to measure O2/CO2 Stool test: Used to measure bacteria and hemoccult Treatment --------- Nasal Prongs: Inserted into the nostrils to administer oxygen as treatment protocol Ear, Eye and Nose Drops: Medication administered into the ear, eye or nose Sponge: Used to cleanse a wound skin area Ambu Bag: Squeezable air reservoir used over the mouth to provide ventilation Cervical Collar: Used to immobilize the neck Silver Nitrate/Hot Cautery Tip: Used to stop a wound from bleeding or to release a subungal hematoma Wrap: Used to apply compression on an extremity ET (Endo-tracheal) Tube: Placed in the trachea through the mouth for ventilation Tongue Guard: Used in the mouth for seizure protection Irrigation Syringe: Used to irrigate a wound Medication Syringe: Used to inject medication in the upper arm or locally at the wound site Forceps: Used to explore and debride wounds, and to remove foreign bodies Oxygen Mask: Placed over the mouth and nose to improve oxygen PO Meds (Per Oral Medications): Medications taken by mouth Compress: Used to apply a warm or cool compress to an area Topical Medication: Medications placed topically on the skin Aerosolized Medications: Medications inhaled through the mouth into the airways IV Medications: Medication infused through the IV system (usually in the forearm) NG (Nasal-gastric) Tube: Inserted into the nose to pump the stomach of its contents or to decompress air in the GI tract Gauze: Used to pack wounds Splint Material: Used to immobilize an extremity Nasal Splint: Used to immobilize the nose Bandage: Used to dress a wound Gel: Anesthetic applied to certain wounds IV: Inserted into a vein (usually the forearm) to established an IV route, increase fluid volume, or infuse blood Needle (not on tool explanation list): Used to suture wounds The patients await you, doc! ----------------------------------------------------------------------------------------------- Level 1 cases-Very simple. Nothing life threatening here Patient 000 Case: Itchy hands S.O.A.P. Questions S: 1st and 2nd choices O: All 1st choices A: 4th choices P: 3rd and 1st choices. Examination room -Magnify glass on left and right hands -Stethoscope on chest Treatment -Medication syringe on right upper arm (1st) -Sponge on left and right hand (2nd and 3rd) -Discharge -Hospital orders -Recheck patient Patient 001 Case: Wheezing S.O.A.P. Questions S: 1st and 1st choices O: 1st and 3rd choices A: 1st choice P: 2nd and 1st choice Examination room -Stethoscope on chest and heart -Sphygmomanometer on upper arm -Respirometer in mouth -Magnifying glass on chest -EKG on heart Treatment -Med syringe on upper arm (1st) -Aero med to mouth (2nd) -Discharge -Hospital orders -Patient under constant monitoring -Patient rechecked -Patient encouraged to drink fluids Patient 002 Case: Burnt forearm S.O.A.P. Questions S: 2nd and 1st choices O: 3rd and 3rd choices A: 2nd choice P: 3rd and 2nd choices Examination room -Glove and magnifying glass on left forearm Treatment -Sponge (1st), forceps (2nd), topical med (3rd) and bandage (4th) on left forearm -Discharge Patient 003 Case: Hurt playing soccer S.O.A.P. Questions S: 3rd and 4th choices O: 2nd and 4th choices A: 1st choice P: 4th and 1st choices Examination room -Magnifying glass and glove on left ankle Imaging room -X-ray on left ankle Treatment -Compress (1st) and splint (2nd) on left ankle -Discharge -Hospital orders -Dispense crutches -Extremity elevated -Area immobilized Patient 004 Case: Hurt wrist while rough housing S.O.A.P. Questions S: 3rd and 1st choices O: 4th and 2nd choices A: 3rd choice P: 2nd and 1st choices Examination room -Magnifying glass and glove on left wrist Imaging room -X-ray left wrist Treatment -Compress (1st) and splint (2nd) on left wrist -Discharge -Hospital orders -Area elevated -Area immobilized Patient 005 Case: Stuck something up nose S.O.A.P. Questions S: 4th and 3rd choices O: 3rd and 4th choices A: 1st choice P: 1st and 1st choices Examination room -Magnifying glass, glove, and nasoscope on nose -Glove on both cheeks Treatment -Nasal spray (1st), magnetized instrument (2nd) irrigation syringe (3rd) and drops (4th) on nose -Discharge Patient 006 Case: Ear hurts S.O.A.P. Questions S: 2nd and 1st choices O: 3rd and 1st choices A: 4th choice P: 1st and 1st choices Examination room -Othoscope on right ear -Thermometer in mouth Treatment -Nasal spray on nose -PO meds in mouth -Drops on right ear -Discharge Patient 007 Case: Ear painful S.O.A.P. Questions S: 3rd and 2nd choices O: 3rd and 4th choices A: 4th choice P: 3rd and 1st choices Examination room -Othoscope on right ear Treatment -PO meds in mouth -Discharge Patient 008 Case: Fell on bars, hurt elbow S.O.A.P. Questions S: 4th and 2nd choices O: 1st and 3rd choices A: 1st choice P: 4th and 1st choice Examination room -Magnifying glass and glove on right elbow Imaging room -X-ray on right elbow Treatment -Compress (1st) and splint (2nd) on right elbow -Discharge -Hospital orders -Area elevated -Area immobilized Patient 009 Case: Stepped on something S.O.A.P. Questions S: 4th and 2nd choices O: 3rd and 4th choices A: 4th choice P: 4th and 1st choices Examination room -Magnifying glass and glove on left foot Imaging room -X-ray on left foot Treatment -Spongue (1st), med syringe (2nd,) forceps (3rd), irrigation syringe (4th), magnetized instrument (5th), topical med (6th) and bandage (7th) on left foot -Discharge Patient 010 Case: Sore throat, hurts to swallow S.O.A.P. Questions S: 2nd and 1st choices O: 2nd and 1st choices A: 3rd choice P: 2nd and 1st choices Examination room -Glove on chin/neck -Thermometer and tongue depressor in mouth Treatment -PO meds in mouth -Discharge -Hospital orders -Warm salt water gargle -Anesthetic swallow administered Patient 011 Case: Fell by pool, hurt thigh S.O.A.P. Questions S: 3rd and 1st choices O: 4th and 1st choices A: 2nd choice P: 2nd and 1st choice Examination room -Glove on left hip, left thigh and pelvis -Magnify glass on left thigh and left hip Treatment -Sponge (1st), forceps (2nd), topical med (3rd) and bandage (4th) on left thigh -Discharge Patient 012 Case: Hurt leg moving furniture S.O.A.P. Questions S: 3rd and 2nd choices O: 2nd and 1st choices A: 1st choice P: 4th and 1st choices Examination room -Magnifying glass on left leg -Glove on left ankle, left leg and left knee Imaging room -X-ray left knee Treatment -Sponge (1st), forceps (2nd), topical med (3rd) and bandage (4th) on left leg -Discharge Patient 013 Case: Hurt arm playing baseball S.O.A.P. Questions S: 4th and 2nd choices O: 3rd and 1st choices A: 3rd choice P: 2nd and 1st choices Examination room -Glove on right elbow, right forearm and right wrist -Magnifying glass on right forearm Treatment -Compress (1st) and wrap (2nd) right forearm -Discharge -Hospital orders -Patient advised to rest injured extremity -Extremity elevated Patient 014 Case: Fell ice skating, hurt ankle S.O.A.P. Questions S: 4th and 3rd choices O: 2nd and 3rd choices A: 4th choice P: 2nd and 1st choices Examination room -Magnifying glass and glove on right ankle Imaging room -X-ray right ankle Treatment -Compress (1st) and spling (2nd) on right ankle -Discharge -Hospital orders -Ankle elevated -Ankle immobilized -Crutches dispensed -X-ray confirms anatomical positioning ----------------------------------------------------------------------------------------------- Level 2 Patients-They're getting a little sicker. Patient 015 Case: Stomach pain, vomitting S.O.A.P. Questions S: 4th and 4th choices O: 1st and 4th choices A: 1st choice P: 3rd and 3rd choice Examination room -Stepthoscope on heart and abdomen -Glove and magnifying glass on abdomen -Thermometer in mouth Imaging room -X-ray on abdomen Laboratory -Blood test hemoglobin/hematocrit, glucose, complete bloodcount and sodium/potassium on elbow -Urine test microchemistry on pelvis Treatment -PO meds in mouth (1st), IV med in forearm (2nd) -Call in surgeon to continue care and admit -Hospital orders -Patient advised to take nothing by mouth except medications Patient 016 Case: Sore throat, coughing, fever S.O.A.P. Questions S: 2nd and 3rd choices O: 1st and 2nd choices A: 1st choice P: 2nd and 1st choices Examination room -Stethoscope on heart and chest -EKG on heart -Tongue depressor, thermometer, magnifying glass and respirometer in mouth -Sphygmomanometer on upper arm Imaging room -X-ray chest Laboratory -Blood gas test Oxygen & Carbon Dioxide -Blood test complete blood count Treatment -PO meds in mouth -Discharge Patient 017 Case: Painful to look at light S.O.A.P. Questions S: 2nd and 2nd choices O: 1st and 2nd choices A: 3rd choice P: 4th and 1st choice Examination room -Magnifying glass, othalmoscope, penlight and eyedrops on right eye Treatment -Irrigation syringe and drops on right eye -Discharge Patient 018 Case: Stabbed in side S.O.A.P. Questions S: 1st and 3rd choices O: 2nd and 2nd choices A: 3rd choice P: 4th and 1st choice Examination room -Magnifying glass and glove on abdomen -Sphygmomanometer on upper arm -Respirometer in mouth -Stethoscope on heart and abdomen Treatment -IV and IV med in forearm -Nasal prongs in nose -Transfer to trauma unit Patient 019 Case: Sore throat, fever S.O.A.P. Questions S: 2nd and 2nd choice O: 3rd and 1st choice A: 4th choice P: 1st and 1st choice Examination room -Stethoscope and glove on abdomen -Glove on chin/neck -Tongue depressor and thermometer in mouth Laboratory -Blood test complete blood count Treatment -Discharge -Hospital orders -Patient advised some antibiotics may cause rash -Patient advised that no specific medication is available Patient 020 Case: Splinter in palm S.O.A.P. Questions S: 2nd and 1st choices O: 1st and 2nd choices A: 4th choice P: 4th and 1st choices Examination room -Magnifying glass and glove on left hand Treatment -PO meds in mouth (1st) -Sponge (1st), med syringe (2nd), forceps (3rd), irrigation syringe (4th), bandage on left hand -Discharge -Hospital orders -Elevate area Patient 021 Case: Stabbed in arm S.O.A.P. Questions S: 1st and 2nd choices O: 2nd and 2nd choices A: 4th choice P: 2nd and 1st choice Examination room -Magnifying glass and glove on right forearm Treatment -Sponge (1st), med syringe (2nd), forceps (3rd), irrigation syringe (4th), gauze (5th), topical med (6th) and bandage (7th) on left arm -Discharge Patient 022 Case: Inflamed throat, fever S.O.A.P. Questions S: 2nd and 3rd choices O: 4th and 4th choices A: 1st choice P: 2nd and 1st choice Examination room -Thermometer, tongue depressor and magnifying glass in mouth -Glove on chin/neck Laboratory -Swab culture throat/quick in mouth Treatment -PO meds in mouth -Discharge -Hospital orders -Warm salt water gargle administered -Anesthetic swallow administered Patient 023 Case: Sore throat, swollen glands S.O.A.P. Questions S: 1st and 1st choices O: 2nd and 4th choices A: 3rd choice P: 3rd and 1st choices Examination room -Tongue depressor, thermometer and magnifying glass in mouth -Glove on chin/neck Treatment -PO meds to mouth (1st) -Compress to left and right cheek (2nd and 3rd) -Discharge -Hopsital orders -Warm salt water gargle administered Patient 024 Case: Rash S.O.A.P. Questions S: 4th and 2nd choices O: 2nd and 2nd choices A: 4th choice P: 3rd and 1st choices Examination room -Magnify mouth and nose -Tongue depressor in mouth Treatment -PO meds (1st), sponge (2nd) and topical med (3rd) to mouth -Discharge Patient 025 Case: Fell from skateboard, hurt elbow S.O.A.P. Questions S: 1st and 1st choices O: 2nd and 3rd choices A: 2nd choice P: 2nd and 3rd choices Examination room -Magnifying glass and glove on left elbow Imaging room -X-ray left elbow Laboratory -Urine test microbiology, microchemistry and microbiolgy on pelvis -Blood test type, hemoglobin/hematocrit and complete on elbow Treatment -Compress on left elbow -Call in orthopedist to continue care and admit -Hospital orders -Extremity elevated -Elbow immobilized Patient 026 Case: Hurt shoulder playing football S.O.A.P. Questions S: 2nd and 1st choices O: 3rd and 3rd choices A: 3rd choice P: 2nd and 3rd choices Examination room -Magnifying glass and glove on right shoulder Imaging room -X-ray on right shoulder Laboratory -Blood test complete blood count, hemoglobin/hematocrit and type and cross on elbow -Urine test microbiology, microchemistry and microcytology on pelvis Treatment -Compress on right shoulder -Call in orthopedist to continue care and admit -Hospital orders -Shoulder immobilized Patient 027 Case: Scraped side S.O.A.P. Questions S: 2nd and 3rd choices O: 2nd and 4th choices A: 4th choice P: 4th and 1st choices Examination room -Magnify left flank -Glove on abdomen, left flank and chest -Stethoscope on heart Laboratory -Urine test dipstick on pelvis Treatment -Sponge (1st), topical med (2nd) and bandage (3rd) on left flank -Med Syringe on upper arm -Discharge Patient 028 Case: Fell on sprinkler S.O.A.P. Questions S: 4th and 4th choice O: 4th and 2nd choice A: 1st choice P: 2nd and 1st choice Examination room -Magnifying glass, glove, penlight and eye dye on right eye -Glove on chin/neck Treatment -Sponge (1st), forceps (2nd), topical med (3rd) and bandage (4th) on right eye -Med syringe (5th) on upper arm -Discharge Patient 029 Case: Cut chin in car accident S.O.A.P. Questions S: 3rd and 3rd choices O: 3rd and 2nd choices A: 2nd choice P: 1st and 2nd choice Examination room -Maginfying glass and glove on chin/neck -Glove and tongue depressor in mouth Treatment -Sponge (1st), forceps (2nd) and bandage (3rd) on chin -Med syringe on upper arm -Call plastic surgeon to continue treatment Patient 030 Case: Cut thigh while woodworking S.O.A.P. Questions S: 4th and 3rd choices O: 2nd and 1st choices A: 4th choice P: 3rd and 1st choices Examination room -Magnifying glass and glove on right thigh -Stethoscope on heart Treatment -Sponge (1st), med syringe (2nd), forceps (3rd), irrigation syringe (4th), needle (5th), topical med (6th) and bandage (7th) on right thigh -Discharge Patient 31 Case: Cut finger with knife S.O.A.P. Questions S: 3rd and 1st choices O: 1st and 3rd choices A: 2nd choice P: 4th and 2nd choice Examination room -Magnifying glass and glove on left hand Imaging room -X-ray left hand Treatment -Sponge (1st) and bandage (2nd) on left hand -IV med (3rd) on forearm -Call in hand surgeon to continue care and admit -Hospital orders -Extremity elevated ----------------------------------------------------------------------------------------------- Level 3 patients-Now it gets harder Patient 032 Case: Vomitted blood S.O.A.P. Questions S: 2nd and 2nd choices O: 3rd and 2nd choices A: 3rd choice P: 2nd and 3rd choices Examination room -EKG on heart -Glove, magnifying glass and stethoscope on abdomen -Tongue depressor and magnifying glass in mouth Imaging room -X-ray abdomen Laboratory -Blood test amylase, bleeding times, hemoglobin/hematocrit and type and cross on elbow -Stool test hemoccult on pelvis Treatment -IV and IV med in forearm -Call in gastroenterologist to continue care and admit Patient 033 Case: Stomach pain, vomitting, diarrhea S.O.A.P. Questions S: 1st and 2nd choices O: 4th and 2nd choices A: 4th choice P: 4th and 1st Examination room -Magnifying glass, glove and stethoscope on abdomen Imaging room -Stoll test ova/parasites on pelvis (I need help! I don't know how to do it in this room!) Laboratory -Stool test hemoccult on pelvis -Blood test sodium/potassium/chloride, glucose and complete blood count on elbow Treatment -PO meds in mouth -Discharge Patient 034 Case: Abdominal distress S.O.A.P. Questions S: 4th and 1st choices O: 1st and 4th choices A: 4th choice P: 4th and 3rd choices Examination room -Glove and magnifying glass on abdomen -Stethoscope on heart and abdomen -EKG on heart -Tongue depressor and magnifying glass on mouth Imaging room -X-ray abdomen Laboratory -Stool test hemoccult on pelvis -Blood test hemoglobin/hemacrotit, amylase, type and cross and bleeding times on elbow -Treatment -IV (1st) and IV med (2nd) on forearm -NG tube in nose (3rd) -Call in surgeon to continue care and admit Patient 035 Case: Kitchen fire while cooking S.O.A.P. Questions S: 2nd and 2nd choices O: 3rd and 1st choices A: 3rd choice P: 4th and 3rd choices Examination room -EKG on heart -Magnify glass on left eye, right eye and nose -Tongue depressor, magnifying glass and respirometer in mouth -Stethoscope on chest and heart -Sphygmomanometer on upper arm Imaging room -X-ray chest Laboatory -Blood gas test carboxyhemoglobin and oxygen/carbon dioxide Treatment -EKG on heart (1st) -Oxygen mask on mouth (2nd) -Call in pulmonologist to continue care and treatment -Hospital orders -Patient rechecked; normalizing Patient 036 Case: Chills, coughing, fever S.O.A.P. Questions S: 2nd and 3rd choices O: 4th and 1st choices A: 1st choice P: 2nd and 3rd choices Examination room -Sphygmomanometer on upper arm -Stethoscope on heart and chest -EKG on heart -Thermometer, tongue depressor, magnifying glass and respirometer in mouth Imaging -X-ray chest Laboratory -Blood gas test oxygen/carbon dioxide on wrist -Blood test complete blood count on elbow Treatment -EKG on heart (1st) -PO meds in mouth (2nd) -Oxygen mask on mouth (3rd) -IV med on forearm (4th) -Call in pulmonologist to continue care and admit Patient 037 Case: Chest pain, difficulty breathing S.O.A.P. Questions S: 1st and 4th choices O: 2nd and 3rd choices A: 2nd choice P: 3rd and 3rd choices Examination room -Stethoscope on chest and heart -EKG on heart -Glove on left hand and right hand -Sphygmomanometer on upper arm Laboratory -Blood test complete blood count and bleeding times on elbow Treatment -EKG on heart (1st) -IV (2nd) and IV med (3rd) on forearm -PO meds in mouth (4th) -Oxygen mask on mouth (5th) -Call in cardiologist to continue care and admit Patient 038 Case: Stabbed in chest S.O.A.P. Questions S: 2nd and 1st choices O: 2nd and 3rd choices A: 3rd choice P: 4th and 1st choices Examination room -Magnify and glove on chest -Stethoscope on heart and chest Imaging room -X-ray chest Treatment -Sponge (1st), med syringe (2nd), needle (3rd), topical med (4th) and bandage (5th) on chest -Discharge -Hospital orders -Deep breathing exercises advised Patient 039 Case: Hit by ball, unconcious S.O.A.P. Questions S: 2nd and 3rd choices O: 3rd and 3rd choices A: 2nd choice P: 1st and 4th choice Examination room -Magnifying glass and glove on forehead -Stethoscope on heart -Sphygmomanometer on upper arm -Respirometer and tongue depressor in mouth -Othoscope on left ear -Penlight in right eye Treatment -Cervical collar to chin/neck (1st) -IV (2nd) and IV med (3rd) to forearm -Tongue guard in mouth (4th) -Transfer to trauma unit Patient 040 Case: Fell, hurt shoulder S.O.A.P. Questions S: 2nd and 3rd choices O: 4th and 3rd choices A: 3rd choice P: 2nd and 2nd choices Examination room -Magnifying glass and glove on right shoulder -Glove on right upper arm Imaging room -X-ray right shoulder Treatment -Compress on right shoulder -Call in orthopedist to continue care and treatment -Hospital orders -Neurovascularity intact -Shoulder immobilized Patient 041 Case: Sinus headache S.O.A.P. Questions S: 2nd and 3rd choices O: 4th and 4th choices A: 2nd choice P: 3rd and 1st choices Examination room -Thermometer and tongue depressor in mouth -Othoscope on left and right ears -Nasoscope in nose -Glove on forehead Imaging room -X-ray skull Treatment -Nasal spray in nose (1st) -PO meds in mouth (2nd) -Discharge Patient 042 Case: Hurt ear while rough housing S.O.A.P. Questions S: 2nd and 1st choices O: 4th and 1st choices A: 3rd choice P: 3rd and 1st choices Examination room -Magnifying glass, glove and othoscope on right ear Treatment -Sponge (1st), med syringe (2nd) and bandage (3rd) on right ear -Discharge Patient 043 Case: Ear bleeding S.O.A.P. Questions S: 3rd and 3rd choices O: 4th and 1st choices A: 3rd choice P: 2nd and 2nd choices Examination room -Magnifying glass, glove and othoscope on right ear Treatment -Med syringe on upper arm -Call in plastic surgeon to continue care and treatment Patient 044 Case: Put something in ear S.O.A.P. Questions S: 3rd and 1st choices O: 3rd and 4th choices A: 3rd choice P: 2nd and 4th choices Examination room -Othoscope on left ear Treatment -Forceps (1st), irrigation syringe (2nd), drops (3rd) on left ear -Discharge Patient 045 Case: Got something in eye S.O.A.P. Questions S: 2nd and 1st choices O: 4th and 2nd choices A: 1st choice P: 2nd and 3rd choices Examination room -Stethoscope on heart -Sphygmomanometer on upper arm -Magnifying glass and penlight on left eye Imaging room -X-ray skull Treatment -Bandage left eye (1st) -IV med in forearm (2nd) -Call in opthamologist to continue care and treatment -Hospital orders -Patient advised to stay in bed rest position Patient 046 Case: Eye is red S.O.A.P. Questions S: 2nd and 2nd choices O: 2nd and 1st choice A: 4th choice P: 1st and 1st choices Examination room -Magnifying glass, eye dye, penlight and othalmoscope on right eye Treatment -Compress right eye -Discharge -Hopsital orders -Blood thinning med and bleeding level to be monitored -Patient advised that appearance is worse than condition Patient 047 Case: Eye hurts, painful to look at light S.O.A.P. Questions S: 4th and 1st choices O: 3rd and 3rd choices A: 1st choice P: 4th and 1st choices Examination room -Magnify, othalmoscope, penlight and eye dye on left eye Treatment -Drops (1st), irrigation syringe (2nd), bandage (3rd) on left eye -Discharge Patient 048 Case: Stepped on rusty nail S.O.A.P. Questions S: 1st and 3rd choices O: 1st and 2nd choices A: 4th choice P: 1st and 1st choices Examination room -Magnifying glass and glove on right foot Treatment -Sponge (1st), med syringe (2nd), forceps (3rd), irrigation syringe (4th), gauze (5th), topical med (6th), bandage (7th) on right foot -PO meds in mouth (8th) -Discharge Patient 049 Case: Hurts to swallow S.O.A.P. Questions S: 1st and 2nd choices O: 3rd and 4th choices A: 4th choice P: 2nd and 3rd choices Examination room -Tongue depressor, magnifying glass and thermometer in mouth -Stethoscope on heart -Glove on chin/neck Laboratory -Blood test complete blood count on elbow -Urine test microbiology, microchemistry and microcytology on pelvis Treatment -PO meds in mouth (1st) -IV (2nd) and IV meds (3rd) on forearm -EKG on heart (4th) -Call in otolaryngologyst to continue care and admit Patient 050 Case: Bungee jumping accident S.O.A.P. Questions S: 1st and 2nd choices O: 4th and 3rd choices A: 1st choice P: 4th and 4th choices Examination room -Stethoscope on heart and chest -Sphygmomanometer on upper arm -Magnifying glass and glove on forehead -Glove on chin/neck, left hand, right hand, left foot and right foot -Penlight and othalmoscope on left eye and right eye Treatment -Cervical collar on chin/neck (1st) -IV (2nd) and IV med (3rd) on forearm -Tongue guard (4th) and oxygen mask (5th) on mouth -Transfer to trauma unit Patient 051 Case: Drowned in bathtub S.O.A.P. Questions S: 1st and 3rd choices O: 2nd and 1st choices A: 2nd choice P: 2nd and 4th choices Examination room -EKG and stethoscope on heart -Stethoscope on chest -Magnifying glass, tongue depressor and respirometer in mouth -Pulsometer on hand Treatment -ET tube (1st) and ambu bag (2nd) on mouth -IV (3rd) on forearm -Aero med (4rd) on mouth -Transfer to trauma unit Patient 052 Case: Rash S.O.A.P. Questions S: 2nd and 1st choices O: 4th and 2nd choices A: 4th choice P: 1st and 1st choices Examination room -Magnifying glass on chest, mouth, chin/neck, left and right ears, left and right eyes and nose (whew!) -Thermometer and tongue depressor in mouth -Glove on chin/neck -othoscope on left and right ears Treatment -PO meds in mouth -Discharge -Hospital orders -Patient given tepid bath Patient 053 Case: Fell from rollerblades S.O.A.P. Questions S: 4th and 1st choices O: 1st and 2nd choices A: 1st choice P: 3rd and 1st choice Examination room -Magnify left knee -Glove on left knee, left leg and left thigh Imaging room -X-ray left knee Treatment -Sponge (1st), forceps (2nd), topical med (3rd), bandage (4th), wrap (5th) on left knee -Discharge -Hospital orders -Area immobilized Patient 054 Case: Hurts when urinating, fever S.O.A.P. Questions S: 2nd and 1st choices O: 2nd and 3rd choices A: 4th choice P: 3rd and 3rd choices Examination room -Glove on pelvis and right flank -Sphygmomanometer on upper arm -Stethoscope on heart -Thermometer in mouth Imaging room -Ultrasound on pelvis Laboratory -Blood test complete blood count and kidney panel on elbow -Urine test microbiolgy and microcytology on pelvis Treatment -IV and IV med to forearm -PO meds to mouth -Call in nephrologist to continue care and admit Patient 055 Case: Cut left heel in lawn mower S.O.A.P. Questions S: 1st and 4th choices O: 4th and 1st choices A: 4th choice P: 3rd and 2nd choices Examination room -Magnifying glass and glove on left foot Treatment -Sponge (1st), med syringe (2nd), forceps (3rd), irrigation syringe (4th), cautery (5th), needle (6th), topical med (7th), bandage (8th) on left foot -Discharge ----------------------------------------------------------------------------------------------- Level 4 patients-For the most part, all I can say for some is...OUCH! (especially Patient 073) Patient 056 Case: Passed blood S.O.A.P. Questions S: 2nd and 2nd choices O: 4th and 3rd choices A: 3rd choice P: 3rd and 3rd choices Examination room -Magnifying glass and glove on abdomen -Tongue depressor in mouth Imaging room -X-ray abdomen Lboratory -Stool test hemoccult on pelvis -Blood test hemoglobin/hemacrotit, complete blood count, bleeding times and type and cross on elbow Treatment -IV on forearm -Call in gastroenterologist to continue care and admit -Hospital orders -Patient advised to take nothing by mouth except medications Patient 057 Case: Stomach pain, vomitting S.O.A.P. Questions S: 3rd and 4th choices O: 3rd and 3rd choices A: 3rd choice P: 4th and 3rd choices Examination room -Magnifying glass, glove and stethoscope on abdomen -Stethoscope and EKG on heart -Tongue depressor and thermometer in mouth Imaging room -X-ray abdomen Laboratory -Stool test hemoccult on pelvis -Blood test hemoglobin/hemactotit, complete blood count, amylase and glucose on elbow Treatment -NG tube on nose (1st) -IV (2nd) and IV med (3rd) in forearm -PO meds in mouth (4th) -Call in surgeon to continue care and treatment Patient 058 Case: Stomach pain, vomitting, fever S.O.A.P. Questions S: 3rd and 2nd choices O: 3rd and 3rd choices A: 1st choice P: 4th and 3rd choices Examination room -Magnifying glass, glove and stethoscope on abdomen -Stethoscope on heart -Tongue depressor and thermometer in mouth Imaging room -X-ray abdomen Laboratory -Stool test hemoccult on pelvis -Blood test complete blood count, hemoglobin/hemacrotit, glucose and sodium/potassium/chloride on elbow Treatment -NG tube on nose (1st) -PO meds in mouth (2nd) -IV (3rd) and IV med (4th) in forearm -Call in surgeon to continue care and admit Patient 059 Case: Itching and wheezing S.O.A.P. Questions S: 1st and 4th choices O: 4th and 1st choices A: 1st choice P: 2nd and 1st choices Examination room -Sphygmomanometer on upper arm -EKG on heart -Stethoscope on heart and chest -Magnifying glass on cheeks, eyes, mouth, chin/neck and chest -Tongue depressor in mouth Laboratory -Blood gas test oxygen/carbon dioxide on wrist Treatment -Med syringe on upper arm -Discharge -Hospital orders -Patient under constant monitoring Patient 060 Case: Itching and wheezing S.O.A.P. Questions S: 3rd and 3rd choices O: 4th and 1st choices A: 2nd choice P: 1st and 1st choices Examination room -Sphygmomanometer on upper arm -EKG on heart -Stethoscope on heart and chest -Magnifying glass on cheeks, eyes, mouth, chin/neck and chest -Tongue depressor in mouth Laboratory -Blood gas test oxygen/carbon dioxide on wrist Treatment -Med syringe on upper arm -Discharge -Hospital orders -Patient under constant monitoring -Patient rechecked; normalizing Patient 061 Case: Wheezing S.O.A.P. Questions S: 4th and 1st choices O: 3rd and 3rd choices A: 1st choice P: 1st and 3rd choices Examination room -EKG and stethoscope on heart -Stethoscope on chest -Magnifying glass on mouth, chest and nose -Respirometer, tongue depressor and thermometer in mouth Imaging room -X-ray chest Laboratory -Blood gas test oxygen/carbon dioxide on wrist -Blood test complete blood count on elbow Treatment -Aero med in mouth (1st) -Med syringe on upper arm (2nd) -IV med in forearm (3rd) -Call in pulmonologist to continue care and admit -Hospital orders -Patient advised to drink fluids Patient 062 Case: Burned hand S.O.A.P. Questions S: 2nd and 4th choices O: 1st and 2nd choices A: 4th choice P: 1st and 1st choices Examination room -Magnifying glass and glove on right hand Treatment -PO meds in mouth (1st) -Sponge (2nd), forceps (3rd), topical med (4th), bandage (5th) on right hand -Med syringe on upper arm (6th) -Discharge Patient 063 Case: Burned feet S.O.A.P. Questions S: 3rd and 4th choices O: 1st and 2nd choices A: 2nd choice P: 4th and 1st choices Examination room -Magnifying glass and glove on left and right feet Treatment -PO meds in mouth (1st) -Sponge (2nd), forceps (3rd), topical med (4th) and bandage (5th) on right foot -Sponge (6th), forceps (7th), topical med (8th) and bandage (9th) on left foot -Discharge Patient 064 Case: Heart pounding S.O.A.P. Questions S: 4th and 3rd choices O: 2nd and 4th choices A: 3rd choice P: 2nd and 3rd choices Examination room -Stethoscope and EKG on heart -Sphygmomanometer on upper arm -Respirometer in mouth Laboratory -Blood test complete blood count and bleeding times on elbow Treatment -Oxygen mask on mouth (1st) -IV (2nd) and IV med (3rd) on forearm -EKG on heart (4th) -Call in cardiologist to continue care and admit Patient 065 Case: Difficulty breathing S.O.A.P. Questions S: 2nd and 3rd choices O: 2nd and 1st choices A: 3rd choice P: 4th and 3rd choices Examination room -Stethoscope and EKG on heart -Sphygmomanometer on upper arm -Stethoscope on chest -Magnifying glass on chin/neck Imaging room -X-ray chest Laboratory -Blood gas test oxygen/carbon dioxide on wrist -Blood test complete blood count, bleeding times and sodium/potassium/chloride on elbow Treatment -Oxygen mask on mouth (1st) -IV (2nd) and IV med (3rd) on forearm -EKG on heart (4th) -Call in cardiologist to continue care and admit Patient 066 Case: Fainted S.O.A.P. Questions S: 2nd and 3rd choices O: 2nd and 2nd choices A: 3rd choice P: 2nd and 2nd choices Examination -EKG on heart -Stethoscope on heart and chest -Sphygmomanometer on upper arm -Glove on left and right hands Laboratory -Blood test complete blood count, bleeding times and enzymes on elbow Treatment -Oxygen mask on mouth (1st) -IV (2nd) and IV med (3rd) on forearm -EKG on heart (4th) -Call in cardiologist to continue care and admit Patient 067 Case: Fell off bike S.O.A.P. Questions S: 2nd and 3rd choices O: 3rd and 2nd choices A: 3rd choice P: 1st and 3rd choices Examination room -Sphygmomanometer on upper arm -Stethoscope on heart -Magnifying glass and glove on forehead -Penlight and othalmoscope on eyes -Glove on chin/neck Imaging room -CAT Scan skull Laboratory -Blood test complete blood count, type and cross and glucose on elbow -Urine test microbiology, microchemistry and microcytology on pelvis Treatment -Cervical collar on neck (1st) -IV on forearm (2nd) -Tongue guard in mouth (3rd) -Call in neurologoist to continue care and admit Patient 068 Case: Swallowed stuffed toy part S.O.A.P. Questions S: 2nd and 3rd choices O: 3rd and 1st choices A: 2nd choice P: 1st and 3rd choices Examination room -EKG and stethoscope on heart -Respirometer, tongue depressor and magnifying glass on mouth -Stethoscope on chest -Pulsometer on hand Imaging -X-ray chest Treatment -Oxygen mask on mouth -Call in pulmonologist to continue care and admit -Hospital orders -Patient monitored Patient 069 Case: Swallowed toy S.O.A.P. Questions S: 2nd and 3rd choices O: 3rd and 1st choices A: 4th choice P: 3rd and 3rd choices Examination room -Magnifying glass, respirometer and tongue depressor in mouth -Stethoscope on chest Imaging room -X-ray chest Treatment -Oxygen mask on mouth -Call in gastroenterologist to continue care and admit -Hospital orders -Patient monitored Patient 070 Case: Slipped and hurt hip S.O.A.P. Questions S: 3rd and 1st choices O: 3rd and 1st choices A: 3rd choice P: 4th and 3rd choice Examination room -Magnifying glass and glove on right hip -Glove on right knee Imaging room -X-ray pelvis Laboratory -Blood test type and cross on elbow -Urine test microbiology, microchemistry and microcytology on pelvis Treatment -EKG on heart -IV (1st) and IV med (2nd) on forearm -Call in orthopedist to continue care and admit -Hospital orders -Patient advised to take nothing by mouth -Neuro-vascularity intact Patient 071 Case: Twisted thumb in revolving door S.O.A.P. Questions S: 4th and 3rd choices O: 2nd and 3rd choices A: 3rd choice P: 2nd and 2nd choices Examination room -Magnifying glass and glove on left hand Imaging room -X-ray left hand Laboratory -Urine test microbiology, microchemistry and microcytology on pelvis -Blood test type and cross and complete blood count on elbow Treatment -Compress on left hand (1st) -IV (2nd) and IV med (3rd) on forearm -Call in orthopedist to continue care and treatment -Hospital orders -Thumb immobilized -Extremity elevated -Patient advised to take nothing by mouth -Neurovascularity intact Patient 072 Case: Caught finger in car engine S.O.A.P. Questions S: 2nd and 3rd choices O: 1st and 3rd choices A: 2nd choice P: 2nd and 3rd choices Examination room -Magnifying glass and glove on right hand Imaging room -X-ray right hand Laboratory -Urine test microbiology, microchemistry and microcytology on pelvis -Blood test complete blood count and type and cross on elbow Treatment -Sponge (1st), bandage (2nd) and compress (3rd) on right hand -IV (4th) and IV med (5th) on forearm -Call in orthopedic surgeon to continue care and admit -Hospital orders -Area elevated -Area immobilized -Neurovascularity intact -Patient advised to take nothing by mouth Patient 073 Case: Injured foot chopping wood S.O.A.P. Questions S: 1st and 1st choices O: 4th and 4th choices A: 3rd choice P: 2nd and 3rd choices Examination room -Stethoscope on heart -Respirometer in mouth -Sphygmomanometer on upper arm -Magnifying glass and glove on left foot Imaging room -X-ray left foot Laboratory -Urine test microbiology, microchemistry and microcytology on pelvis -Blood test complete blood count and type and cross on elbow Treatment -Sponge (1st), bandage (2nd), compress (3rd), IV (4th) and IV med (5th) on left foot -Call in orthopedic surgeon to continue care and admit -Hospital orders -Area elevated -Area immobilized -Patient advised to take nothing by mouth -Neurovascularity intact Patient 074 Case: Gunshot injury to thigh S.O.A.P. Questions S: 1st and 4th choices O: 1st and 2nd choices A: 3rd choice P: 3rd and 3rd choices Examination room -Magnifying glass and glove on left thigh Imaging room -X-ray left thigh Laboratory -Urine test microbiology, microchemistry and microcytology on pelvis -Blood test complete blood count and type and cross on elbow Treatment -Sponge (1st), bandage (2nd) and compress (3rd) on left thigh -IV (4th) and IV med (5th) on forearm -Call in orthopedic surgeon to continue care and admit -Hospital orders -Area elevated -Area immobilized -Patient advised to take nothing by mouth -Neurovascularity intact Patient 075 Case: Hit in nose by elbow S.O.A.P. Questions S: 3rd and 4th choices O: 3rd and 1st choices A: 4th choice P: 4th and 1st choices Examination room -Magnifying glass, glove and nasocope on nose -Glove on left and right cheeks -Tongue depressor in mouth Imaging room -X-ray skull Treatment -Irrigation syringe (1st), nasal spray (2nd), compress (3rd) and cautery (4th) on nose -Discharge Patient 076 Case: Pain in side S.O.A.P. Questions S: 3rd and 3rd choices O: 1st and 3rd choices A: 1st choice P: 1st and 4th choices Examination room -Magnifying glass and glove on abdomen -Stethoscope on heart and abdomen -Respirometer in mouth -Sphygmomanometer on upper arm Treatment -IV (1st) and IV med (2nd) on forearm -Nasal prongs on nose (3rd) -Transfer to trauma unit Patient 077 Case: Feels nauseated S.O.A.P. Questions S: 3rd and 3rd choices O: 1st and 2nd choices A: 4th choice P: 2nd and 3rd choices Examination room -Stethoscope and glove on abdomen -Thermometer in mouth -EKG on heart Laboratory -Urine test microbiology and microchemistry on pelvis -Blood test complete blood count, glucose and liver enzyme test on elbow Treatment -IV (1st) and IV med (2nd) on forearm -Call in infectious disease specialist to continue care and admit Patient 078 Case: Scraped side S: 3rd and 1st choices O: 3rd and 3rd choices A: 2nd choice P: 2nd and 2nd choices Examination room -Magnifying glass, glove and stethoscope on abdomen -Stethoscope on heart Imaging room -CAT Scan on abdomen Laboratory -Blood test complete blood count, type and cross and bleeding times on elbow -Urine test microbiology, microchemistry and microcytology on pelvis Treatment -IV on upper arm -Call in surgeon to continue care and treatment Patient 079 Case: Splinter in finger S.O.A.P. Questions S: 4th and 2nd choices O: 4th and 3rd choices A: 1st choice P: 1st and 2nd choices Examination room -Magnifying glass and glove on left hand -Magnifying glass on left forearm -Glove on left upper arm -Thermometer in mouth Laboratory -Blood test complete blood count and glucose on elbow Treatment -Sponge (1st), med syringe (2nd), forceps (3rd), irrigation syringe (4th), gauze (5th), topical med (6th) and bandage (7th) on left hand -IV med on forearm (8th) -Call in family doctor to continue care and admit Patient 080 Case: Hurt neck in car accident S.O.A.P. Questions S: 2nd and 2nd choices O: 4th and 3rd choices A: 2nd choice P: 3rd and 4th choices Examination room -Sphygmomanometer on upper arm -Stethoscope on heart -Glove on chin/neck, left hand and left foot Treatment -Cervical collar on chin/neck (1st) -IV (2nd) and IV med (3rd) on upper arm -Tongue guard in mouth (4th) -Transfer to trauma unit Patient 081 Case: Sore throat, rash S.O.A.P. Questions S: 2nd and 1st choices O: 2nd and 4th choices A: 1st choice P: 1st and 1st choices Examination room -Magnifying glass on chest, nose, left and right upper arms, left and right eyes, mouth and chin/neck -Stethoscope on heart -Othoscope on left and right ears -Thermometer and tongue depressor in mouth Laboratory -Swab culture throat/quick on mouth Treatment -PO meds in mouth -Discharge Patient 082 Case: Took some pills S.O.A.P. Questions S: 3rd and 1st choices O: 4th and 1st choices A: 2nd choice P: 3rd and 3rd choices Examination room -Sphygmomanometer on upper arm -Stethoscope and EKG on heart -Respirometer and tongue depressor in mouth -Penlight on left and right eyes Laboratory -Blood gas test oxygen/carbon dioxide on wrist -Blood test glucose and toxic screen on elbow Treatment -IV on forearm (1st) -NG tube in nose (2nd) -Call in psychiatrist to continue care and admit -Hospital orders -Poison control consulted -Patient monitored Patient 083 Case: Pain in side, blood in urine S.O.A.P. Questions S: 3rd and 1st choices O: 4th and 3rd choices A: 2nd choice P: 2nd and 3rd choices Examination room -Stethoscope on heart -Thermometer in mouth -Glove on pelvis and right flank Imaging room -Ultrasound on pelvis Laboratory -Urine test microbiology, microchemistry and microcytology on pelvis -Blood test complete blood count and kidney panel on elbow Treatment -IV (1st) and IV med (2nd) on forearm -Call in urologist to continue care and admit Patient 084 Case: Hit on side S.O.A.P. Questions S: 2nd and 3rd choices O: 2nd and 1st choices A: 2nd choice P: 1st and 3rd choices Examination room -Sphygmomanometer on upper arm -Stethoscope on heart -Magnifying glass and glove on left flank -Glove on abdomen and chest Imaging room -Ultrasound on pelvis Laboratory -Blood test complete blood count and type and cross on elbow -Urine test dipstick on pelvis Treatment -IV on forearm -Call in urologist to continue care and admit -Hospital orders -Patient advised to take no food or drink by mouth Patient 085 Case: Caught finger in car door S.O.A.P. Questions S: 4th and 1st choices O: 4th and 1st choices A: 1st choice P: 4th and 1st choices Examination room -Magnifying glass and glove on right hand Treatment -Med syringe on upper arm (1st) -Sponge (2nd), needle (3rd) and bandage (4th) on right hand -PO meds in mouth (5th) -Discharge Patient 086 Case: Cut thumb pad using power saw S.O.A.P. Questions S: 2nd and 3rd choices O: 3rd and 2nd choices A: 2nd choice P: 2nd and 2nd choices Examination room -Magnifying glass and glove on left hand Imaging room -X-ray left hand Treatment -Bandage on left hand (1st) -IV med on forearm (2nd) -Call in hand surgeon to continue care and treatment -Hospital orders -Extremity elevated ----------------------------------------------------------------------------------------------- Level 5 patients-CODE BLUE!! Well, not all, but the patients are hurting. Badly. Patient 087 Case: Severe stomach pain S.O.A.P. Questions S: 3rd and 1st choices O: 1st and 1st choices A: 2nd choice P: 2nd and 3rd choices Examination room -Magnifying glass, glove and stethoscope on abdomen -Thermometer and respirometer in mouth -Stethoscope on heart Laboratory -Blood test amylase, complete blood count, hemoglobin/hemacrotit and bleeding times on elbow -Urine test microchemistry on pelvis Treatment -IV (1st) and IV med (2nd) on forearm -NG tube in nose (3rd) -PO meds in mouth (4th) -Call in gastroenterologist to continue care and admit -Hospital orders -Patient advised to take nothing by mouth except medications Patient 088 Case: Face and neck itch S.O.A.P. Questions S: 3rd and 1st choices O: 1st and 2nd choices A: 2nd choice P: 2nd and 1st choices Examination room -Magnifying glass on left and right cheeks and eyes and chin/neck -Stethoscope on heart and chest -Tongue depressor in mouth Treatment -Med syringe on upper arm -Discharge -Hospital orders -Patient rechecked; normalizing Patient 089 Case: Arms and face itch S.O.A.P. Questions S: 2nd and 3rd choices O: 1st and 1st choices A: 4th choice P: 4th and 1st shot Examination room -Magnifying glass on left and right cheeks and eyes, left and right forearms and chin/neck -Stethoscope on chest -Tongue depressor in mouth Treatment -Med syringe on upper arm (1st) -PO meds in mouth (2nd) -Discharge -Hospital orders -Patient rechecked; normalizing Patient 099 Case: Cut forehead on sprinkler S.O.A.P. Questions S: 4th and 2nd choices O: 1st and 4th choices A: 2nd choice P: 1st and 1st choices Examination room -Magnifying glass and glove on forehead -Glove on neck Treatment -Med syringe (1st), sponge (2nd), forcepts (3rd), needle (4th), topical med (5th) and bandage (6th) on forehead -Discharge