Station 47
Pete Barns
Age: 65 years old male
Patient
Patient's Story (Role player’s brief)
Patient’s Story
You are Paramedic Keith Howard, calling the GP surgery regarding a patient named Pete Barns (65 years old) , who you believe is registered with the practice.
You were contacted by Mr. Barns’ neighbour, who expressed concern after speaking with Pete’s wife. The neighbour explained that the wife was worried because Pete seemed a bit confused this morning. She also reported that he hasn’t opened his bowels for the past three (3) days, despite regular use of two prescribed laxatives. He appears bloated and has been experiencing some generalised abdominal discomfort.
If asked about patient’s wife: Pete’s wife is hard of hearing and is unable to speak on the phone. She is currently upstairs with the patient.
If asked to speak directly to Pete: He is fluctuating in and out of confusion and may not be able to engage meaningfully in a telephone consultation.
Additional Information (if prompted):
Pete reports increased thirst and is urinating more frequently than usual. No other symptoms reported
You have examined him. On examination- Temperature: 36.0°C Blood Pressure: 120/75 mmHg, Pulse: 99 bpm, Oxygen Saturation: 98% on air
He appears mildly dehydrated. Abdomen: Soft, non-tender, mildly distended; bowel sounds reduced but present
No vomiting, and no obvious signs of obstruction. No back pain, although Pete mentioned some bone pain in both legs
Social History: Pete lives at home with his wife. She appears to be struggling to cope with his care needs. He is a retired bus driver. He does not smoke or drink alcohol.
Idea: You suspect that Pete’s symptoms could represent a progression of his metastatic cancer.
Concern: You’re particularly concerned about his confusion, abdominal discomfort despite no tenderness, and the fact that he’s not opened his bowels for several days despite laxatives.
Expectation: You’re unsure whether hospital admission is appropriate given that Pete is under palliative care, and you’re seeking advice on whether to manage him at home or escalate further.
Pete’s wife, and Pete himself, have expressed that they are comfortable with healthcare professionals making decisions on their behalf over the phone.
Say NO to any other questions asked outside of the details already provided in the scenario. Accept anything offered to you by the doctor.