Case Study 1.pdf - Case Study#1 QUESTIONS 1 Which of the...

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Case Study #1 QUESTIONS 1. Which of the above diagnostic possibilities above would be the most critical to rule out immediately and why? What would be the best imaging choice (XRay, MRI, CT) to rule it in or out? a. I feel like it would be an x-ray because they said that when they took the x-rays they found no fractures. Also with an MRI and a CT it gives more visual detail than what an x-ray could give. 2. What, if any errors or "gaps" do you think may have occurred in her first visit to the Hospital Emergency Department? A) Is there any evidence of an infection? Why or why not? B) Would the excuse of "the patient couldn't pay for the test so we didn't do it" a valid excuse in your opinion? Is there a potential moral and/or legal issue involved in this case? a. I feel like although the patient used the excuse that they didn’t really have insurance and couldn’t pay for the testing. I feel that legally and ethically they wouldn’t have left her hanging because medicaid was brought up and I feel like they wouldn’t have brought it up if they didn’t think she would've qualified for it, which would take care of most if not all of the bill. I feel that within her first visit they used that excuse though because I feel that in the first visit they weren’t as thorough as they coulda been and did not explore near as many options as the second time she went nor did they bring up medicaid as a possibility for her. 3. Do you feel it is very likely, moderately likely, or unlikely that there are more than one problem likely at play in this patient's case? Why do you feel that way? a. WIth the patient- She is not sure if she had brief loss of consciousness, cannot state if there was unaccounted time lapse, and denies any altered state of alertness at the time of the accident or since the accident. She also denies tingling, numbness or paresthesia in any body region. So she denies a lot of things but isn’t really giving a ton of information. Then she does not have health insurance and has not seen a doctor in over 10 years. b. At her first visit- She had plain x-rays performed of her head and pelvis, which came back negative for any fractures. If looking for a concussion they definitely would not find one on an x-ray because a lot of times it won’t show up on a CT. Then there was no lab work performed which if it had anything to do with diabetes of acetaminophen intake they would have to check her blood work to see if she was testing to see if she had excessive amounts in her blood, which could lead to the headaches. Then then a CT was discussed and the patient brought up the concern of not having the money. They could of brought up applying for medicaid, but didn’t until her second visit. And then when she was assessed in the ED she told her she didn’t have a concussion. But if she hit her head hard enough and was having the symptoms she had, a concussion should not have been ruled out, I have had plenty of them to know how it works going to
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the hospital to get evaluated for them. So I definitely don’t think a concussion
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