In the case study provided, the unconscious 82-year-old woman requires an evaluation and differential diagnosis completed so that paramedics know how to treat and determine whether the patient is on time or not critical transport. A differential diagnosis comes from paramedic education and the patient's medical history, current vital signs, and relevant knowledge gained from people at the scene. The paramedic must, after the differential diagnosis, understand the pathophysiological process and how this affects the patient. The patient has an acquired brain injury (ABI), which is an injury that occurs after birth (State Government of Victoria, 2013). The patient also has a traumatic brain injury (TBI), caused by physical force that causes damage to the brain. One aspect of finding a differential diagnosis is understanding the mechanism and type of injury (MOI/POI). When examining brain injuries, MOI/POI can be separated into two parts, primary and secondary injuries. The primary injury is the one that occurs at that moment of impact, i.e. the board that causes a visible hematoma (Rosenfeld, 2012). Secondary harm is the cascade of events and medical conditions, which can aggravate the primary harm (Hughes & Cruickshank, 2011). In this case of patients it is the chronic subdural hematoma that caused secondary conditions, such as Cushing's reflex, and this caused the patient to lose consciousness. Looking at the patients vital signs, they are steadily getting worse and are concerning for an 82 year old female. Patients' heart rate starts out low but within the normal range, however over 15 minutes it drops to 54 bpm, which is within the bradycardia range (Curtis, Ramsden & Lord, 2011). T...... half of the document ......to Pty Ltd., (2014). Avapro HCT. Retrieved from https://www.mimsonline.com.auNational Health Service (NHS)., (2013). Causes of subdural hematoma. Retrieved http://www.nhs.uk/Conditions/Subdural-haematoma/Pages/Causes.aspxPlaha, P., Malhotra, Dr., Heuer, Dr., & Whitfield, P. (2008). Management of chronic subdural hematoma. Advances in Clinical Neuroscience (ANCR), 8(5), 12-15. Retrieved from http://www.acnr.co.ukProfessional Health Systems., (2014). Vital signs table. Retrieved from http://prohealthsys.com/site/resources/assessment/physical-assessment/vital-signs/vital_signs_table/Rosenfeld, V.J., (2012). Practical management of head and neck injuries. Chatswood, NSW: Elsevier AustraliaState Government of Victoria., (2013). Acquired brain injury. Retrieved from http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Acquired_brain_injury?open