| Course | PA 531 Emergency Medicine |
|---|---|
| Week | 5 |
| Paper type | Stabilization sequence write-up |
| Length | About 700 words, 5 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | Master of Physician Assistant Studies (MPAS) |
| Updated | October 2026 |
Free sample paper for PA 531 Week 5
Stabilization Sequence Write-Up: A.N.'s First Ninety Minutes After the CT Showed Blood, From a Falling Glasgow Score at 02:58 to Intubation, Pressure Control and Transfer, Each Step Defended Only With What Was Known Then
Student Name
Chamberlain University
PA 531: Emergency Medicine
Instructor Name
Month Day, Year
Stabilization Sequence Write-Up: A.N.'s First Ninety Minutes After the CT Showed Blood, From a Falling Glasgow Score at 02:58 to Intubation, Pressure Control and Transfer, Each Step Defended Only With What Was Known Then
State on Arrival in Resuscitation
At 02:52, eight minutes after the scan and well inside the six-hour window in which a negative CT would have been reliable (Perry et al., 2011), the CT showed diffuse blood in the basal cisterns and the sylvian fissures, and a small amount in the fourth ventricle, with no hydrocephalus yet. A.N. at that moment: Glasgow Coma Scale 15, blood pressure 188/102, pulse 88, oxygen saturation 97 percent on room air, glucose 142 mg/dL.
The Actions in the Order They Happened
02:55. Call to the regional neurosurgical center to request transfer. Reason at the time: A.N. needs aneurysm treatment and possible drainage of spinal fluid, neither of which this hospital can provide; the guideline recommends treatment at high-volume centers (Hoh et al., 2023).
02:58, together with the call. Glasgow score fell to 13 with new confusion and a second vomit. Head of bed raised to 30 degrees; antiemetic given. Reason: protect against aspiration and reduce pressure on the brain.
03:02. Nicardipine infusion started to bring systolic pressure below 160. Reason: the guideline supports controlling blood pressure before the aneurysm is secured, to lower the risk of rebleeding, while avoiding low pressure (Hoh et al., 2023).
03:10. Glasgow score 9; A.N. no longer protecting the airway and snoring. Decision to intubate.
03:18. Rapid sequence intubation with etomidate and rocuronium; tube confirmed by waveform capnography. Reason: airway protection and control of carbon dioxide.
03:25. Ventilator set to keep end-tidal carbon dioxide near 35 to 40 mm Hg. Reason: avoid both high carbon dioxide, which raises brain pressure, and deliberate hyperventilation, which reduces brain blood flow.
Actions Taken Together
The call to neurosurgery and the first nursing measures happened in the same three minutes, by different people, and are shown together. The nicardipine and the preparation for intubation overlapped. Writing them as if they had been sequential would hide how the team divided the work.
What Each Action Told
Raising the head and treating vomiting did not change the falling Glasgow score, which told the team that the problem was in the brain, not only nausea. The pressure response to nicardipine, down to 152 systolic by 03:20, told them the infusion was working. The capnography trace after intubation confirmed the tube and gave a figure to steer the ventilator.
The Step That Could Not Be Undone
Intubation. Once done, A.N.'s neurological examination would be masked by sedation for hours, and the receiving neurosurgeon would lose the ability to follow the Glasgow score. Before the drugs were given, a brief neurological examination was recorded, pupils equal and reactive, moving all limbs to pain, so the receiving team had a last baseline. Everything behind the choice was on the chart by 03:10: a score of 9, snoring respirations and two vomits.
Figures at Both Ends
At 03:10: Glasgow 9, blood pressure 168/94, saturation 93 percent. At 04:15, when the transport team arrived: sedated and ventilated, blood pressure 148/86, end-tidal carbon dioxide 37 mm Hg, saturation 99 percent, pupils equal. Nimodipine was not started here because A.N. could not swallow before intubation and the receiving center planned to give it by tube.
Defended Without the Answer
Nothing above relies on what the receiving center later found, which was an aneurysm of the anterior communicating artery and early hydrocephalus. Every decision is defended with the information available at its time stamp.
What Was Considered and Not Done
A dose of tranexamic acid to reduce rebleeding was discussed and not given; the guideline does not recommend it routinely before aneurysm treatment, and the receiving center did not request it. Hypertonic saline was not given, because the pupils were equal and reactive and there was no sign of herniation.
References
Hoh, B. L., Ko, N. U., Amin-Hanjani, S., Chou, S. H.-Y., Cruz-Flores, S., Dangayach, N. S., Derdeyn, C. P., Du, R., Hanggi, D., Hetts, S. W., Ifejika, N. L., Johnson, R., Keigher, K. M., Leslie-Mazwi, T. M., Lucke-Wold, B., Rabinstein, A. A., Robicsek, S. A., Stapleton, C. J., Suarez, J. I., . . . Welch, B. G. (2023). 2023 guideline for the management of patients with aneurysmal subarachnoid hemorrhage: A guideline from the American Heart Association/American Stroke Association. Stroke, 54(7), e314-e370. https://doi.org/10.1161/STR.0000000000000436
Perry, J. J., Stiell, I. G., Sivilotti, M. L. A., Bullard, M. J., Emond, M., Symington, C., Sutherland, J., Worster, A., Hohl, C., Lee, J. S., Eisenhauer, M. A., Mortensen, M., Mackey, D., Pauls, M., Lesiuk, H., & Wells, G. A. (2011). Sensitivity of computed tomography performed within six hours of onset of headache for diagnosis of subarachnoid haemorrhage: Prospective cohort study. BMJ, 343, Article d4277. https://doi.org/10.1136/bmj.d4277
What the PA 531 Week 5 assignment asks for
Week five asks for an account of a stabilization already finished. Begin with the state on arrival in a few figures. List the actions in the order they were performed, each with the reason available at the time and nothing borrowed from later results. Show actions taken at the same time together rather than as a false sequence. Say what each action revealed. Identify the step that could not be undone and explain how the decision was made and protected, such as by recording an examination first. Give figures at the start and at the end. Note anything considered and not done, with the reason. State explicitly that the account is defended without the later answer. Cite the guideline that supports key actions.
Inside the PA 531 Week 5 example
The write-up opens at 02:52 with the CT findings and A.N.'s Glasgow score of 15, pressure of 188/102 and glucose. Time-stamped actions follow: a transfer call citing high-volume care, head elevation and an antiemetic as the score falls, nicardipine to a systolic below 160 citing the 2023 guideline, intubation with etomidate and rocuronium and capnography-guided ventilation. A section shows the call and nursing measures as simultaneous. Another explains what each action told the team, from the pressure response to the capnography trace. Intubation is named as irreversible, with pupils and limb movement recorded first. Figures at 03:10 and 04:15 are compared, with nimodipine left to the receiving team. Considered-but-not-done items include tranexamic acid and hypertonic saline, and a closing section disclaims hindsight.
PA 531 Week 5 rubric: what full points look like
The rubric starts with tense and timing. A document written as a plan, or one that justifies early steps with later findings, loses the largest share. Faculty then check order: actions must appear as they happened, with simultaneous actions shown together. Each action needs a reason available at its time. Credit grows when the write-up says what each action revealed rather than only listing it. The irreversible step must be identified and its safeguards described; missing this is a heavy deduction. Figures at both ends are expected. Items considered and not done earn marks for showing judgment. Guideline support should be cited for key actions, and time stamps should be consistent throughout.
PA 531 Week 5 help: mistakes that cost points
Students often lose marks on this account by writing it as a protocol or by explaining early decisions with results that came later. Share your case's timeline and figures, and your account would open with the arrival state, list the actions in true order with their reasons, group simultaneous actions and say what each revealed. The irreversible step is named with how it was protected. Figures at both ends and items considered but not done are included. If your case is trauma, sepsis or overdose, the same structure fits with different actions. Keep every time stamp in your account consistent with your own case record.
Get a PA-531 Week 5 example written to your instructions
Send the scenario your classroom uses, with the arrival figures and whatever your section says about what was available in the department, and a custom PA-531 Week 5 write-up is built around it and returned within 24 to 48 hours, the first one free of charge. Tell us if a template with fixed fields is supplied.
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PA 531 Week 5 questions, answered
Our scenario ends before anything is resolved.
That is usual and it is not a problem. The document covers a stretch, not a case, so it can close with the patient still undiagnosed and still being watched. What the closing lines owe is the state at the end in figures and a statement of what the stretch ruled out or narrowed. A write-up that invents a resolution the material never supplied loses more than one that ends open.
Should a step that turned out badly be left in?
Yes, and removing it is the more expensive choice. Sections mark the reasoning available at the time, so a step that was reasonable on the figures and unhelpful afterward still earns its entry, provided the account says what happened and what was done next. Tidying the record until every action worked produces exactly the document markers are trained to spot.
Is this the same document as the Week 6 plan?
No. This one reports a stretch that has already happened and defends it from what was known then; the later assignment looks forward and puts deadlines on results that have not come back. One is an account, the other is a schedule. Anyone merging them usually loses both sets of rows, so send whichever assignment you actually have.
Where can I find a free PA 531 Week 5 sample paper?
This page holds the full PA 531 Week 5 stabilization account, ninety minutes from a CT showing blood to intubation and transfer, defended without hindsight.
What is the irreversible step in the PA 531 Week 5 sample?
Intubation, because sedation masks the neurological examination for hours, so pupils and limb movement were recorded first as a baseline for the receiving team.