It's 11pm and you are sent out into the middle of nowhere for an unwell.
After turning left at the General Store and continuing over yonder past the Johnson farm you locate at the address. It's a rambling old country farm house where the patient lives with Nana and Pa.
O/A you are met by Pa who leads you into one of the bedrooms where a 21 yof is in bed with her boyfriend, the farm help, keeping her company.
Both the patient and her boyfriend are quite insistant she is fine and that you can go on back to where the city folk come from. Pa is not convinced and is sure some meddlin is afoot so he called you as Nana was unable to reach ole Doc Shoemarker who ain't been since he went over range to go fishin yesterday. The doctor did give her an Rx for, as Pa puts it, some of the robotics.
PMHx none
Hx/cc of felling unwell x 3 days with cough, mild SOB and pyrexia
O/E GCS 14
BP 110/70
RR 22
PR 130
Temp 38
Meds amoxicillin and paracetamol po x 3 days
Now, those of you who think Brown is loosing his touch and that this case is potentially quite easy, you are correct, I blame 8 weeks of 6am starts.
You are 45 minutes from a small secondary level rural hospital where you might have a Post Graduate Year 2 junior doctor doing his rural rotation asleep in the lounge who can ring up the local GP for some orders and three hours to any sort of primary facility that has one or more of those funny Registered type doctors.
Oh, and no the HEMS jokers in thier funny orange getup are not avaliable, they are having a nap this evening. They have to testify in court the following day about some funny bugger who was rolling around passing himself off as one of the helicopter doctors.
After turning left at the General Store and continuing over yonder past the Johnson farm you locate at the address. It's a rambling old country farm house where the patient lives with Nana and Pa.
O/A you are met by Pa who leads you into one of the bedrooms where a 21 yof is in bed with her boyfriend, the farm help, keeping her company.
Both the patient and her boyfriend are quite insistant she is fine and that you can go on back to where the city folk come from. Pa is not convinced and is sure some meddlin is afoot so he called you as Nana was unable to reach ole Doc Shoemarker who ain't been since he went over range to go fishin yesterday. The doctor did give her an Rx for, as Pa puts it, some of the robotics.
PMHx none
Hx/cc of felling unwell x 3 days with cough, mild SOB and pyrexia
O/E GCS 14
BP 110/70
RR 22
PR 130
Temp 38
Meds amoxicillin and paracetamol po x 3 days
Now, those of you who think Brown is loosing his touch and that this case is potentially quite easy, you are correct, I blame 8 weeks of 6am starts.
You are 45 minutes from a small secondary level rural hospital where you might have a Post Graduate Year 2 junior doctor doing his rural rotation asleep in the lounge who can ring up the local GP for some orders and three hours to any sort of primary facility that has one or more of those funny Registered type doctors.
Oh, and no the HEMS jokers in thier funny orange getup are not avaliable, they are having a nap this evening. They have to testify in court the following day about some funny bugger who was rolling around passing himself off as one of the helicopter doctors.