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Pre-hospital Setting - Nursing Management PDF

   

Added on  2020-12-29

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PRE-HOSPITAL SETTING-NURSING MANAGEMENT

TABLE OF CONTENTSDISCUSSION..................................................................................................................................1CASUALTY 3 ................................................................................................................................1CASUALTY 1.................................................................................................................................3CASUALTY 2 ................................................................................................................................4CONCLUSION................................................................................................................................6REFERENCES................................................................................................................................8

DISCUSSIONCASUALTY 3 The third casualty on accident site is an old man who is aged 60. This casualty isdiscussed at first because due to penetration of metallic piece he has been experiencing activebleeding in the region. His condition need to be managed to control the severity of the situation.For his assessment nurses make following analysis: Airway:This assessment is the first and prior in the ABCDE approach. Nurses monitor that theman is sobbing and his breathing sounds can be heard so airways of victim are not obstructed.However, with increasing pain if swelling is and vomiting occurs then nurses provides first aidtreatment for airway obstruction. Airway treatment: If nurses observe that breathing sounds are not proper along withasymmetrical expansion of abdomen and chest then they ensure to give proper supply of oxygen.Suction can also be provided. And gradually and carefully he is shifted into lateral position. Thedelay in airway treatment can lead to organ damage and cardiac arrest. Breathing:The accident and bleeding has caused the increased heart rate of the patient. He is highlysweating thus is suffering from diaphoretic condition. The panic situation is making it difficultfor him to breathe. The respiratory rate of the victim is 28 which is very high. It indicates that hiscondition is deteriorating. Nurses use pulse oximeter for measuring the peripheral saturation ofoxygen. It must be in the range 94-98 percent. The various gases such as oxygen, carbon dioxideand PH are also measured so that breathing issues can be controlled. Treatment for breathing: The patient must be provided emotional condolence so that his anxietycan be regulated and he can breathe easily. Usually upright position can help patient but for thegiven casualty due to metallic penetration it may be difficult. Circulation:The shocking stage of the old man can cause difficulties in circulation. Nurses measuresheart rate and blood pressure for the assessment. The heart rate is very high. The metallic1

penetration in groin is causing blood flow. The urine output is also reduced so it is alsomonitored. For preventing the blood loss nurses immediately cover it with bandage. On the basisof blood flow, it can be changed. To give more relief to the patient cold compress can also beeffective approach used by the nurses. For measuring circulation capillary refill time and thetemperature of patient is also used. Circulation treatments: Due to active blood flow fluid replacement is preferred by the nurses.For efficient administration of emergency fluids, the victim must have intravenous cannula. Formaintaining the continuous circulation tissue perfusion is also restored and blood pressure, heartrate as well as haemorrhage are maintained. Disability:This assessment is used by the nurses to analyse the neurological functionality of thepatient. The consciousness, pain level is used as critical criteria. The man is sobbing with thepain and trauma. For managing such situations, the nurses first try to give emotional support tothe patient so that its anxiety and stress can be minimised (Mellor & et.al., 2016). The man isawake and is crying in pain which means that he is conscious and responsive. Blood glucoselevel, size of pupil and Glasgow coma scale can also be used to analyse the consciousness if theman does not remain awake. Treatment strategies after disability assessment: After the assessment of aiways, breathingpatterns and circulation nurses regularly check and ensure that hypotension and hypoxia are notintroduced and are eliminated. Lateral position will avoid the risk of airway if patient becomeunconscious. Exposure: The metallic piece has been penetrated in groin region. It can lead to severe damageto the genitals (McIntosh & Mok, 2017). Depending on the depth of penetration there ispossibility that urethra can also be damaged. The pelvis bones are also analysed by the nurses insuch situations because the sharp objects like metal piece may have injured the region betweenperineum and genitals. The damaged urethra can make it difficult to pass urine and blood tracescan also be observed at the genitals opening. Treatment for exposure: It is essential to remove metallic piece from the body thus health careproviders may also perform immediate surgery to avoid excessive blood loss and infections. The2

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