CLINICAL REASONING REPORT

Table of Contents

A comprehensive analysis of Jessie’s situation, after he left the game 2

Key cues noticed/considered while examining Jessie 2

Interpretation and analysis of the preliminary observations 3

Recommendations for further follow-up, and additional remarks 4

References 6

A comprehensive analysis of Jessie’s situation, after he left the game

Jessie has been involved in a physically regressive activity, which is significantly above the usual standards of business. She was involved in the game of bubbled football, which is an energy-intensive game and requires high metabolic capacity and aggravated physical prowess and durability. She is, in general fatigued. She is not habituated with the local climatic conditions, as she has recently shifted from a new state, and is still adjusting and adapting to the present circumstances.

Key cues noticed/considered while examining Jessie.

Some of the noticeable physical symptoms are:

• The subject has lost a lot of fluids due to physical exertion, as can be observed from the drenched shirt.
• The subject has performed a comparatively physically regressive activity, one that stressed-out his natural balance, as can be noticed from the flushed skin, which is a sign of the body getting rid of excess heat.
• The tympanic body temperature is slightly elevated by 1.2 degrees, taking into consideration that the tympanic temperature is 0.3 degrees more than average body temperature. (Normal body temperature- 37 degrees).
• The pulse rate is significantly higher than the normal range, by 40 bpm (the standard parameter is between 70 and 100 bpm).
• The respiratory rate is elevated considerably by about twice the ratio. (Normal range is between 12-18 breaths).
• The blood pressure seems to be in the normal range (between 120/80 and 140/90).

Interpretation and analysis of the preliminary observations

It can be observed that the weather conditions on a particular day were sunny, hot, and averagely humid, and prolonged supplementary continuation of a physically-intensive sport had caused significant exertion on the subject. The subject has lost a lot of fluids, which can be reasonably deduced from the drenched clothes and observed excessive sweating. This happens as the body tries to cool down the body temperature and get rid of the excess heat that is generated during a body-contact exerting sport like soccer, hockey, and basketball. The immediate response of the body to this accumulating heat is transferring blood to the vessels and dilating those who are near the skin. To maintain a functional temperature, the subject’s compensatory mechanisms have fallen into place, but the fatigue has been slightly aggravated by the fact that he hasn’t completely adapted to the climatic conditions of the site he has recently shifted to. Therefore, all the physical cues can be considered as healthy. These cues will recover in a few minutes after the subject has recuperated his balance and fluid intake (Babu et al. 2016).

The elevation of tympanic temperature is because the body gets rid of excess heat after physical stress through the tympanic membrane, and this is also a typical symptom. The recorded, slightly elevated body temperature is also average. As excess secretion of adrenaline and dopamine, accentuated by increased metabolism levels, and increased respiration, has caused the body to generate more heat than it can timely get rid of. Therefore it justifies the same. The heart rate is noticeably more than the normal resting heart rate but is well within the normal parameters of the price during the performance of the rigorous activity. To meet up with the increased demand for oxygen, the heart starts pumping in more blood, therefore relating to the significantly increased heart rate. The elevated heart rate can be attributed to the increased respiratory rate as well. This is both co-related, which has grown as comparatively higher aerobic respiration is taking place due to the injected stimulants and hormones during the activity, as well as due to the matching metabolic potential required to meet the anatomical energy demands (Rizzo & Thompson 2017). It is also noticeable that due to lack of movement, the dissipation of heat is comparatively reduced, which gives rise to these uncomfortable occurrences but is nothing out of the normal bandwidth of nursing and recuperation. The subject has been recorded at average blood pressures in the last few days, which shows that there are no inherent underlying conditions associated with this.

With regards to the process of homeostasis, all the above symptoms are frequent altercations for the increased needs to meet the metabolic demand of the body, and in due process, heat, water, and carbon dioxide are released as by-products. The body adapts to normal conditions, just like a reflex loop, when it has adjusted to the new relaxed state. Jessie, on being given adequate fluids, a proper supply of oxygen and a significant cooling-off period, will recover completely and be stable again (Haengseok and Keun-Hong 2020).

Recommendations for further follow-up, and additional remarks

Some of the immediate steps I would take to deal with the medical emergency would be:

• Pausing the activity immediately and shifting to a colder area, with a back-rest and support available where the subject can lie.
• The legs should be raised above the height of the head to induce positive heat dissipation.
• They are removing excess apparel to cool down faster.
• Consume an oral rehydration solution, or an electrolyte solution, and spray cold water all over the subject.

It is likely that the subject will recover within half an hour the aforementioned preliminary treatment (Unger et al. 2010).

Keeping in mind, the nubile age of the item, I would like to point out that the above can be classified as a simple case of heat exhaustion, and there is minimal chance of any long-term health complications like damage to organs or cognitive problems. The probabilities of whether a mild case of stroke has occurred or not has to be reasonably investigated, to be on the safe side. Some of the tests that I would recommend are:

• Sample blood tests to examine the tendency of infections and gauging the electrolyte level.
• A retrograde drug-panel analysis to figure out and pharmaceutics related abnormalities, or responses to any drugs, as the resultant high temperature.
• Conduct a chest X-ray to examine the condition of the lungs.
• Conduct an ECG (electrocardiogram) to check the rhythm of the heart and aortic valve.

The subject needs to be given a sleep-off period and a relatively light diet, rich in fluids to ensure faster recovery (Börjesson et al. 2016).

References

Babu, A S, Padmakumar, R, Maiya, A G, Mohapatra, A K, & Kamath, R L 2016, ‘Effects of exercise training on exercise capacity in pulmonary arterial hypertension: a systematic review of clinical trials’, Heart, Lung and Circulation, Vol 25, No. 4, pp 333-341.

Börjesson, M, Onerup, A, Lundqvist, S, & Dahlöf, B 2016, ‘Physical activity and exercise lower blood pressure in individuals with hypertension: narrative review of 27 RCTs’, Br J Sports Med,Vol 50, No. 6, pp. 356-361.

Haengseok, S and Keun-Hong, P 2020, ‘Regulation and function of SOX9 during cartilage development and regeneration’ Seminars in Cancer Biology.

Rizzo, L & Thompson, M W 2017, ‘An Investigation of the Fluid Replacement Effects on Cardiovascular Drift Responses to Strenous Prolonged Exercise’, J Phy Med Rehab, Vol 1, No 101.

Unger, R H, Clark, G O, Scherer, P E, & Orci, L 2010, ‘Lipid homeostasis, lipotoxicity and the metabolic syndrome’, Biochimica et Biophysica Acta (BBA)-Molecular and Cell Biology of Lipids, Vol 1801, No 3, pp. 209-214.