Case Study Analysis: Kevin's Otitis Media and ISOBAR Handover

This case study presents the scenario of a 4-year-old boy, Kevin, suffering from recurrent severe otitis media with effusion (OME), leading to his admission for bilateral grommet insertion. The report provides a background on OME, its causes, and prevalence, emphasizing the importance of timely intervention to prevent hearing loss. The core of the study involves a clinical handover prepared in the ISOBAR format (Identify, Situation, Observation, Background, Assessment and Action, Response and Rationale) to ensure continuous patient care. The ISOBAR details Kevin's condition, including his history of OME, clinical observations (temperature, heart rate, etc.), and relevant background information (desiccated exudate, dental caries). The assessment highlights the need for grommets, and the response section outlines the pre and post-surgical care plan. The case study underscores the significance of structured communication in healthcare and the importance of a comprehensive approach to patient care, addressing not only the immediate medical needs but also related issues like dental health before the surgery.

Child and Ado
case study

TABLE OF CONTENTS
INTRODUCTION...........................................................................................................................1
BACKGROUND.............................................................................................................................1
REFERENCES................................................................................................................................3

INTRODUCTION
The current report is based on a given case study of a 4 years aged boy who has been found
to suffer from continual incidences of severe otitis media with effusion (OME). Followed by
which, he is now admitted to a hospital for surgical insertion of bilateral grommets. OME is also
known as secretory or serous otitis media or SOM that refers to the collection of a non-infectious
fluid in the central area of the ear. It is mostly an outcome of cold, some sort of infection in the
upper respiratory space or a painful throat (Malik and et. Al., 2016). OME is commonly found in
children who are aged within 6 months to 3 years and it mostly affect the boys in comparison to
girl child’s. Despite of being self-limited where the gathered fluid tends to resolve by its own
within a period of 4 to 6 weeks, in some cases, persistence of this fluid for a long time results in
declining the hearing power of children. This is basically due to an infected fluid that results in
acute otitis media, as in the present case of Kevin. For which, he is currently required to be
treated with a surgically inserted bilateral grommet.
BACKGROUND
This is on the basis of above specified aetiology of OME, a clinical handover will be
prepared in the form of ISOBAR. It is important to assure a continual care to the patients by
together considering their safety. Clinical handover also termed as CH is basically used to define
the procedure of handing over the patient care from one care provider to another (Finnigan,
Marshall and Flanagan, 2010). This process usually takes place in between the shifts or when a
patient is being relocated from one healthcare setting to other. ISOBAR thereby defining a
structured clinical handover is significant in terms of enhancing patient’s safety by together
attempting to reduce any adverse results. Below is the ISOBAR for the given case study of a 4
years old boy, Kevin-
 Identify- This clinical handover is for a 4 years old boy named Kevin who lives in a
remote community.
 Situation- He has been admitted for a surgical insertion of bilateral grommets. It is
however due to a historical occurrence of acute otitis media with effusion on
frequent basis.
 Observations- This states the clinical assessments done before the initial admission
of Kevin where he was found to have a temperature of 37.4 degree Celsius with a
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heart rate of 86, respiratory rate of 26 and blood pressure of 90/55. Also, Kevin’s
measurement states 13.9 Kgs of weight and 100cms of height.
 Background- This involves other related information related to Kevin where an old
desiccated exudate has been found nearby his ears along with the leftovers of a
recently finished medicinal course of ear drops. Also, an extensive dental caries has
together been found, that is largely affecting his baby teeth.
 Assessment and action- This is to specify the present situation where Kevin is
required to be treated for his acute OME. For which, a bilateral grommet will be
inserted surgically in his ear drums.
 Response and rationale- This section is to demonstrate the exact requirements for a
proper treatment of Kevin to effectively provision both pre and post-surgical care to
him. For this purpose, it is important to make a proper care plan based on the
clinical assessments done for the child and which has led to reveal several other
issues that are needed to be resolved before attempting the surgery.
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REFERENCES
Malik, K.I. and et. Al., 2016. Role of grommets in otitis media with effusion. Annals of King
Edward Medical University. 9(3).
Finnigan, M.A., Marshall, S.D. and Flanagan, B.T., 2010. ISBAR for clear communication: one
hospital’s experience spreading the message. Australian Health Review. 34(4). pp.400-404.
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