| Course | PA 531 Emergency Medicine |
|---|---|
| Week | 7 |
| Paper type | Disposition decision write-up |
| Length | About 640 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 7
Disposition Decision Write-Up: Four Endings Weighed for A.N., Home, Observation, the Local ICU and Transfer, With the Missing Capability Named and the Local ICU Admission That Was Nearly Chosen
Student Name
Chamberlain University
PA 531: Emergency Medicine
Instructor Name
Month Day, Year
Disposition Decision Write-Up: Four Endings Weighed for A.N., Home, Observation, the Local ICU and Transfer, With the Missing Capability Named and the Local ICU Admission That Was Nearly Chosen
Placement Before Findings
The question for this document is where A.N. can safely be, not what A.N. has. The findings that bear on placement are a narrower set: a confirmed subarachnoid hemorrhage, a falling Glasgow score now managed with intubation, a need for aneurysm treatment within hours and a risk of hydrocephalus that may need a drain.
Home
Not safe. A patient with a confirmed bleed and a ventilator cannot leave hospital care. This ending is listed so that the reasoning is complete and so that the comparison with the other endings is explicit.
Observation in the Emergency Department
Not safe. Observation suits a patient whose likely course is improvement with a defined set of checks over hours. A.N.'s course is unpredictable, with a known risk of rebleeding before the aneurysm is treated, and the department has no ability to treat the cause. Watching has to be bounded by what can be done if the watching finds something; here, nothing could be done.
Admission to the Local Intensive Care Unit
Possible, and nearly chosen. The local unit has ventilators, nurses trained in neurological checks and an intensivist on call. It could keep A.N. sedated, ventilated and with controlled blood pressure overnight. What it lacks is the capability that matters most: securing the aneurysm by coiling or clipping, and placing a drain for hydrocephalus. The guideline recommends that patients with aneurysmal subarachnoid hemorrhage be treated at centers with high case volumes and specialized neurocritical care, and that the aneurysm be secured as early as feasible to reduce rebleeding (Hoh et al., 2023).
Transfer to the Regional Neurosurgical Center
Chosen. The receiving center provides neurosurgery and interventional radiology around the clock, a neurocritical care unit and the ability to place a drain. The transfer adds risk, about 90 minutes in an ambulance with a ventilated patient, but that risk is smaller than the risk of rebleeding or hydrocephalus in a unit that cannot treat either.
The Missing Capability
The single capability that decided the disposition was aneurysm treatment, closely followed by the ability to drain spinal fluid. Everything else the local unit could match.
The Ending Nearly Taken
At 03:05, the local intensivist suggested admitting A.N. overnight and transferring in the morning, because of icy roads and a long transport time. The argument was serious: an icy road increases transport risk. It was rejected because the risk of rebleeding is highest in the first hours, and because the receiving center accepted immediately and had a critical care transport team available. A ground ambulance with a critical care crew was chosen over the helicopter, which was grounded by weather.
Communication
A.N.'s spouse arrived at 03:30 and was told the diagnosis, the reason for transfer and the risks of the road. The spouse agreed and followed by car.
Documentation of the Transfer
The transfer note lists the reason for transfer, the accepting physician and time, the condition at departure, the medicines running and the receiving unit. A copy of the CT and angiogram images, the laboratory results and the nursing neurological checks went with the crew.
What the Write-Up Does Not Do
It does not decide how the aneurysm should be treated or when. Those belong to the receiving team. The CT timing, within six hours of onset, made the diagnosis at the local hospital without a lumbar puncture (Perry et al., 2011).
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
Reading the PA 531 Week 7 instructions
For week seven you decide where a patient can safely be. Compress the case at the front to the findings that bear on placement, a narrower set than those that bear on diagnosis. Then give each possible ending a short entry in its own terms: discharge home, observation, admission locally, and transfer or a higher level of care. Explain why watching must be bounded by an action available if things worsen. Name the capability that decides the placement. Describe the ending that was nearly taken and why it lost. Record what the patient or family was told. Say what the write-up does not decide. Use headings named after the endings, and cite the guidance that supports the choice.
Inside the PA 531 Week 7 example
The write-up compresses A.N.'s placement findings: a confirmed bleed, a falling score now managed with intubation, a need for aneurysm treatment and a hydrocephalus risk. Home is rejected for completeness. Observation is rejected because no action would be available if watching found deterioration. The local ICU is described as able to ventilate and monitor but unable to coil, clip or drain, citing the 2023 guideline. Transfer is chosen despite a 90-minute road trip. A section names aneurysm treatment as the missing capability. The near choice, an overnight local admission proposed because of icy roads, is set out fairly and rejected given early rebleeding risk and an available critical care crew. The spouse's agreement, transfer documentation and the limits of the write-up follow, with Perry cited on CT timing.
Reading the PA 531 Week 7 grading rubric
Grading begins with the front of the document: placing findings about diagnosis there instead of findings about placement loses the largest share. Faculty then expect each ending to receive its own case, including endings rejected; skipping obvious ones is marked down. Credit goes to bounding observation by an available action. Naming the single missing capability earns significant marks because it makes the decision transparent. The near-chosen ending must be argued fairly before it is rejected. Communication with the patient or family adds credit. A disposition that strays into treatment decisions belonging to another team is deducted. Guidelines supporting the level of care should be cited, and headings should name the endings.
PA 531 Week 7 help: mistakes that cost points
Disposition write-ups often lose points by describing the patient's illness at length and naming the destination at the end. Share your case and the options open to your patient, and the write-up drafted around them would compress the case to placement findings, argue each ending in its own section and name the capability that decides it. The ending nearly taken is set out fairly before it loses. Family communication is recorded. If your patient is a candidate for discharge or observation rather than transfer, the same four-way comparison applies. Make sure the capabilities you list match what your own hospital actually offers.
Get a PA-531 Week 7 example written to your instructions
Send the case and whatever your section says about the endings available in the scenario, including any observation area or transfer arrangement, and a custom PA-531 Week 7 write-up is argued to it and returned in 24 to 48 hours. No charge on the first, and the rubric is matched row by row.
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PA 531 Week 7 questions, answered
Can the write-up argue for more than one ending?
It has to consider all of them and then pick one. A document leaving two options open has not made the decision the assignment is built around, and the rows for conditions and for what was told to whom cannot be filled from an undecided page. Where the case genuinely supports two, the stronger answer commits and states the single finding that would move it.
Is leaving the easiest of the four to argue?
It is the one most often argued badly. Sending somebody home is the only ending that transfers the watching to the patient, so it carries obligations the other three do not: written instructions, a named place to return to, and a stated interval for being seen again. Write-ups treating it as the default because nothing was found lose more here than anywhere.
Ours names a specific unit to admit to.
Then the write-up says why that level and not the one below it, which is usually the sharper question. Sections supplying named units are testing whether the argument reaches the level of care rather than stopping at the building. Send the list of units your scenario offers and the example argues the choice against its nearest neighbor.
Where can I find a free PA 531 Week 7 sample paper?
This page carries the full PA 531 Week 7 disposition write-up, four endings weighed for a patient with subarachnoid hemorrhage and the missing capability named.
Why is the local ICU rejected in the PA 531 Week 7 sample?
It can ventilate and monitor but cannot coil or clip the aneurysm or place a drain, which the 2023 guideline expects at specialized centers.