Nursing Essay 代写:急诊科护理

2017-01-13 09:41


Emergency Department care plays a crucial part in the healing process. (Cole, 2009) Based on information through observation, Mark appears quite pale yet conscious when answering questions asked, which may be due to certain amount of blood loss. His upper body seems normal. His lower limbs represent gross deformities with multiple bruising and abrasions. Obvious compound fracture in the right and left tibial shaft can be detected. These damages resulted from the fall cause his disability in action. He is not labored and has no use of accessory muscles. Severe physical damage can be confirmed. Radial pulse can’t be palpated while brachial pulse seems thread with low volume. Apparently, his circulation is disrupted. Mark’s respiration appears rapid. Slight problem connected with his breathing can be concluded as part of the assessment problems. Lastly, with regard to environmental factors, his wife is on the way after dropping the child off the neighbor.
In accordance with symptoms and manifestation diagnosed in the assessment, relative intervention means are provided to Mark. Given an ATS score of 1-life threatening, Mark was transferred to the resus area at 1402hrs. A triple lumen central line and a large bore peripheral line in the right cephalic vein are inserted. Besides, the senior trauma physician inserts a left arterial line and demands Arterial BP (ABP) and CVP monitoring and constant ECG. In addition, she orders 4 units O neg whole blood stat via warmer. And ketamine by subcutaneous infusion (0.2 – 0.4 mg/kg/h) – approx. weight 95 kgs and then 1/24 NS then 2/24 Hartmanns with 10mmol KCl is ordered as the following step. Other intervention means are also requested, including IVI Cephalosporin 1gram (given 1415hrs), CaT scan on spine board with stiff neck in place, Cx match 5 units WB and 5 units PC, ABG, FBC, PCV, HcT, U&E, RFT, Gluc and IDC, 1/24 measures. 

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