Reflection - Case Study | Lip Laceration

Running head: REFLECTION
Reflection
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1Nursing
Description
The case is about a child who was accompanied by his mother because he sustained a lip
laceration. The doctor commented on the patient and the mother belonging from a loose tooth
family to which the mother nodded with a sheepish smile. A verbal consent from the mother was
taken and a video was made of the whole procedural sedation of the child for the lip laceration
surgery. The physician asked the paramedic about the medication and went on to divert the child
for the injection of the sedative. The mother was given the choice to stay with the child during
the procedure which, she agreed. The child was increasingly restless of being administered with
the sedative. The SOAPME procedure was undertaken for checking the presence of equipments
such that the surgery could be started. To maintain an open airway, a towel support was
provided. The superior labial artery got cut in the middle of the procedure and he started
bleeding. 9 milligrams of ketamine was again administered as he was waking up. The edges of
the skin were put together while he woke and another dose was given. He was monitored until no
risk of respiratory depression and regain consciousness.
Feelings
As a paramedic, one of my responsibilities is to ensure that the best care for the patient is
delivered irrespective of their age, gender, belonging and race. However, it is was my inability to
give an exact amount of ketamine as a form of sedative to the patient at one go which resulted in
him waking up quite some times during the duration of the whole procedure. It was evident that
numerous times he lost consciousness which mad made me anxious that he may feel the pain of
the procedure. It was during this time that the child was stopped from moving and administered
the dosage again. The nurse could not comfort the child and make him feel less scared. It is

2Nursing
because of the inability of the nurse to make a therapeutic relationship with the child which made
me even more anxious of the whole procedure. In addition, the inability to take a written consent
from the mother about a video being taken for the procedural sedation of the child was another
instance which I just took in an instance because of the growing pressure. I think because of the
patient being small in age and the pain that he is going through, is why it did not cross my mind
to take a consent form for the mother and make her sign it after giving her the appropriate
information.
Evaluation
It is because of the young age of the patient which made me more nervous and made me
shaky at first. A therapeutic relationship between the nurse, me and the physician was not
developed which, in turn, increased the chances of the child being very anxious and scared when
he was being injected with the ketamine dose. It would have been better if I would have struck a
professional and a therapeutic relationship to make the child more comfortable and calm about
the procedure of injection and the laceration surgery. The SiO2 started working entirely after the
half of the procedure was conducted which could have increased the chances of the child
suffering from bleeding internally or externally. This could be avoided if immense attention was
paid to each thing before the start of the surgery. Procedural sedation and analgesia (PSA) for
situations, for example, reduction of fracture and repair of lacerations are basic signs for IV
inclusion in childrens. IN ketamine has increased late notoriety for repair of laceration and
analgesia and has shown great hemodynamic dependability. However, in the case of the child, it
was not able to generate a positive result.