Below is a summary of Brittany’s EHR activity during her first hour in the ED. As an ED physician, you are responsible for examining the patient, ordering tests and procedures and diagnosing Brittany’s condition. Using her EHR, Virtual Physical Exam (VPE) and Internet research, answer the questions and be prepared to discuss the responses with the rest of Brittany’s healthcare team.

1. Review Brittany’s VPE: You order an X-ray and CT scan of Brittany’s head. Using VPE, explain what information these procedures provide?
• X-ray:
  
  
• CT scan:



2. Internet Research: In addition to head trauma, you are also concerned about other injuries so you order the same tests (X-ray and CT scan) for her spinal cord. What are the three movable and two unmovable areas of the spinal cord?



3. Internet Research: You order a drug screen and a blood typing test. Why do you order these tests for Brittany?
   
   Review Brittany’s ED EHR: What are her test results?
   
   Internet Research: How might her results impact her treatment?

Below is a summary of Brittany’s EHR activity during her first hour in the ED. As an ED nurse, in addition to getting Brittany prepared for the tests and procedures ordered by the physician, you are responsible for obtaining, reading and monitoring her vital signs. Using her EHR, Virtual Physical Exam (VPE) and Internet research, answer the questions and be prepared to discuss the responses with the rest of Brittany’s healthcare team.

1. Internet Research: As the nurse in charge of Brittany’s care, you have to get her ready for an examination. What might make this process hard for Brittany?



2. Review Brittany’s VPE: The ED physician has ordered an X-Ray and CT scan of Brittany’s head and spine. What do these results tell the physician?
• X-ray:
  
  
• CT scan:



3. Review Brittany’s ED EHR: You are responsible for maintaining Brittany’s medical information during her first critical hour in the ED. Using her EHR, what do her vital signs tell you?
   
   Internet Research: As a nurse, what tools do you use to measure Brittany’s vital signs and monitor her health?

Below is a summary of Brittany’s EHR activity during her first hour in the ED. As a laboratory or radiology technologist, you are responsible for obtaining and providing test results to assist the physician in diagnosing Brittany’s condition. Using her EHR, Virtual Physical Exam (VPE) and Internet research, answer the questions and be prepared to discuss the responses with the rest of Brittany’s healthcare team.

1. Review Brittany’s VPE: Brittany’s results must be obtained quickly. The physician orders an X-ray and CT scan of her head and spine. Using VPE, describe the difference between the tests.
• X-ray:
  
  
• CT scan:
  
  


2. Review Brittany’s ED EHR: In addition to the images ordered by the physician, he also orders a drug screen and pregnancy test. Using her EHR, what do these results show?
   
   Internet Research: Why were they ordered?



3. Review Brittany’s ED EHR: The physician orders a blood typing test. Using her EHR, what is Brittany’s blood type?
   
   Internet Research: Should she need a blood transfusion, what type of blood can she receive?
   
   Internet Research: What would happen if she received the wrong type of blood?

Below is a summary of Brittany’s EHR activity during her first hour in the ED. As a pharmacist, you are responsible for ensuring that Brittany receives the proper medications and dosage ordered by the physician. You are also responsible for reviewing any adverse interactions Brittany might have with her current medications. Using her EHR, Virtual Physical Exam (VPE) and Internet research, answer the questions and be prepared to discuss the responses with the rest of Brittany’s healthcare team.

1. Internet Research: The nurse inserted a large bore intravenous line (IV) and started a saline solution immediately. Why is an IV started immediately for an accident victim?



2. Review Brittany’s VPE: Are there any possible adverse reactions to the contrast materials used in the CT exam?



3. Review Brittany’s ED EHR: You review Brittany’s EHR and notice that she has an allergy. What is Brittany allergic to?
   
   Internet Research: Why is it necessary to have this noted in her EHR?



4. Review Brittany’s ED EHR: Brittany is prescribed several medications. Using her EHR, list these medications.
   
   Internet Research: Explain the purpose of each medication and why it is used on a brain injury patient.

Below is a summary of Brittany’s electronic health record (EHR) activity during her stay at the hospital. As a medical and health services manager, you are responsible for making sure she receives excellent care. You will also figure Brittany’s bills, consisting of her tests, procedures, room charges, supplies and medications. Using her EHRs, Virtual Physical Exam (VPE) and Internet research, fill out the billing statements and be prepared to share this information with the rest of Brittany’s healthcare team.

• MHSM – Bill (which includes both an ED and ICU statement)
• MHSM – Bill Reference
• Brittany’s EHR – ED Chart (link below)
• Virtual Physical Exam (link below)
• View Brittany’s EHR – ICU Chart

1. Use the blank copy of Brittany’s ED and ICU bills and the Bill Reference to calculate her costs. In her EHRs, look for the number of times a test is administered, number of days a cost is incurred or the units per day a medication is administered. You may need to do additional Internet research. Some helpful sites are www.healthcarebluebook.com, www.fairhealthconsumer.org and www.pharmacychecker.com.

Below is a summary of Brittany’s EHR activity during her first hour in the ED. As a health coach, your job is to recommend lifestyle changes to alleviate symptoms, prevent symptoms from recurring and decrease the need for future emergency care or hospitalization. You will also provide Brittany the education she needs to understand her diagnosis and the risk factors that may have caused her condition. Using her EHR, Virtual Physical Exam (VPE) and Internet research, answer the questions below and be prepared to discuss the responses with the rest of Brittany’s healthcare team.

1. Review Brittany’s ED EHR: You review Brittany’s EHR and notice several diagnoses. List these diagnoses.
   
   Internet Research: For each of the diagnoses above, provide information to educate Brittany on how they could impact her future health.



2. Internet Research: One of Brittany’s diagnoses is a spine fracture which could include a spinal cord injury. As her health coach, you begin to put in place a plan to help her learn to live with her new condition. What might this plan include?



3. Review Brittany’s VPE: The physician ordered an x-ray and CT scan of Brittany’s body. Explain these tests and results to Brittany.



4. Internet Research: Brittany was unconscious for 30 minutes after the accident. The physician has indicated, in her EHR radiology results, that she is experiencing swelling of the brain. What are the possible long-term effects of brain swelling?