Station 71
Dorothy Evans
Age: 80 years old female
Patient
Patient's Story (Role player’s brief)
Patient’s Story
Opening statement: Hi Doctor, I’m John, one of the paramedic practitioners from the GP surgery. I’m calling about a patient, Mrs Dorothy Evans, and was hoping to get your advice if that’s okay?
You are John Butler, a Paramedic Practitioner from the GP surgery. You are calling the GP to provide an update on Mrs Dorothy Evans, an 80-year-old female resident of a care home, and to seek advice regarding her persistent cough. The history is based on your assessment and information from care home staff, with some input from the patient.
ONLY SAY BELOW IF ASKED TO EXPLAIN FURTHER
Mrs Evans has had a persistent dry cough for 3 months. 2months ago, she was reviewed by Dr. Shane Stone who ordered a chest X-ray and prescribed oral antibiotics for suspected infection. Patient completed the course of her antibiotics, and the Chest X-ray results came back normal, but the patient’s cough has persisted.
The care staff have noticed that the cough worsens after eating and is more troublesome at night. There has been no improvement with the antibiotics.
ONLY SAY BELOW IF ASKED
She has no history of smoking but has a history of reflux and occasionally uses Gaviscon to manage symptoms.
The staff are concerned about the impact of the cough on her quality of life, especially at night, as it’s disrupting her sleep. There’s no reported fever, chest pain, or significant shortness of breath. They also mentioned that her oral intake remains adequate but noticed she occasionally clears her throat after swallowing. No weight loss or haemoptysis
You have examined her—her chest remains clear. Blood pressure 135/89mmHg, Pulse 75bpm, sats 97% on air and her respiratory rate is 17cpm.
SAY NO TO ANY OTHER SYMPTOMS ASKED
Ideas: You suspect the cough might be related to her long-term use of Ramipril.
Concerns: Both the nursing team, the patient, and you are concerned about the ongoing nature of the cough and how it is disrupting her sleep and affecting her quality of life.
Expectations: You’re hoping for guidance on whether to trial a change in medication may help.
Say NO to any other questions asked outside of the details already provided in the scenario. Accept anything offered to you by the doctor.