The current patient may be experiencing a range of traumatic injuries after his accident, the injuries that the paramedic will focus on are those that are most life threatening. These injuries include: a possible tension pneumothroax or a haemothorax, hypovolemic shock, a mild or stable pelvic fracture and tibia fibula fracture.
A pneumothorax is defined as “the presence of air or gas in the plural cavity which can impair oxygenation and/or ventilation” (Daley, 2014). The development of a pneumothorax to a tension pneumothorax can be caused from positive pressure ventilation.
A tension pneumothorax can be caused by a blunt or penetrating trauma, in the case study provided it would be a blunt trauma. The trauma to the chest area causes damage to the plural cavity; either the visceral (lines either lung) or parietal plura (lines the thoracic wall), or can be caused by trauma to the traceobronchial tree (Daley, 2014). The trauma to the chest area causes the formation of a one-way-valve, this allows for the air to flow into the plural space on inhalation, but on exhalation cannot be expelled (Curtis, Ramsden, & Lord, 2011). As the trapped air in the lungs build up within the affected side it can cause serious complications. In the case study it is the left lung that is in distress, and as the pressure increases within the left lung it can cause an impaired venus return to the right atrium (Daley, 2014). The increased pressure can eventually affect the right lung as the pressure builds in the left side and causes mediastinal shift which increases pressure on the right lung, which decreases the patients ability to breath, and diffuse the bodies tissues appropriately. The increase in pressure on the left side where the original traum...
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...14, January 29). Hemothorax. Retrieved from http://emedicine.medscape.com/article/2047916-overview#aw2aab6b2b4
Norvell, J. G. (2013, June 11). Tibia and Fibula Fracture Clinical Presentation. Retrieved from http://emedicine.medscape.com/article/826304-clinical
Queensland Government. (2013, July 8). Trauma Emergencies. Retrieved from https://ambulance.qld.gov.au/docs/09_cpg_trauma.pdf
renin-angiotensin system. (2014). In Encyclopaedia Britannica. Retrieved from http://www.britannica.com/EBchecked/topic/498140/renin-angiotensin-system
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State Government of Victoria. (2013, July 10). Bone fractures. Retrieved from http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Bone_fractures
Hunter, Annadurai and Rothwell defines ventialtor-associated pneumonia as nosocomial pneumonia occurring in patients receiving more than 48 hours of mechanical ventilation via tracheal or trascheotomy tube. It is commonly classified as either early onset (occurring within 96 hours of start of mechanical ventilation) or late onset (>96 hours after start of mechanical ventilation. A ventilator is a machine that is used to help a patient breathe by giving oxygen through an endotracheal tube, which is a tube placed in a patient’s mouth or nose, or through a tracheostomy, which is a surgical opening created trough the trachea in front of the neck. Infection may occur if bacteria or virus enters the tube into the lungs or airways by manual manipulation of the ventilator tubing.
Tension Pneumothorax requires immediate attention. A needle or chest tube needs to be inserted into the chest cavity to release the pressure as soon as possible. If an evacuation is going to take a long period of time you may have to do this procedure yourself. That is not recommended though.
If a spinal cord injury is suspected, emergency medical services takes special precautions at the accident scene. The first step is to stabilize the person and to ensure the person is able to breathe. If the accident victim is conscious, he or she must remain completely still to avoid causing more damage to the spinal cord. Emergency personnel utilize a carrying board and neck collar to immobilize the spine to prevent further damage. The person is
Ruppert, S, D., Shiao, S, K., Tolentino-DelosReyes, A. F.,(2007). Evidence- Based Practice. Use of the Ventilator Bundle to prevent Ventilator associated pneumonia (3rd ed). American Journal of Critical Care.
Person, A. & Mintz, M., (2006), Anatomy and Physiology of the Respiratory Tract, Disorders of the Respiratory Tract, pp. 11-17, New Jersey: Human Press Inc.
Fibular fractures may be complete or incomplete fractures. Fibula fractures may occur anywhere along the bone. The fracture we are trying to fixate is a complete fracture. Fractures occur when a force is placed on the bone that is greater than it can withstand, and when a fracture does occur in the fibula, it’s usually at the same time as the tibia. When only the fibula fractures, it is usually because of a direct blow to the side of the leg or an extreme sideways bend at the ankle or knee. Some other common causes of fibular fracture include, direct hit from doing contact sports such as hockey or lacrosse, stress fracture; weakening of the bone from repeated stress, or indirect injury, caused by twisting, turning quickly, or violent muscle contraction. Tripping, falling or impact during an accident are also major causes of fibular
“Summary Report for: 29-2041.00 - Emergency Medical Technicians and Paramedic.” O*Net. 2008. Web. 18 Feb. 2010.
My case study encompasses pulmonary embolism and a saddle pulmonary embolism. The patient I chose was a female who had just given birth with no complications during labor, but developed a pulmonary embolism that later on was confirmed to be a saddle pulmonary embolism. Not known to me before this clinical study pulmonary embolism is a leading cause of death among pregnant women in the developed world. A pulmonary embolism is a sudden blockage in a lung artery. The blockage is usually by a blood clot that travels to the lung from the vein in the leg. A clot that forms in one part of the body and travels in the bloodstream to another part of the body is called and embolus (NAT13). Pulmonary embolism is a serious condition that can damage your lung due to lack of blood flow to your lung tissue, which can lead to pulmonary hypertension. Pulmonary hypertension is increased pressures in the pulmonary artery. PE can also cause low oxygen levels in your blood and damage other organs in your body because of a lack of oxygen. If a blood clot is very large it can cause death. A pulmonary embolism can also be called a venous thromboembolism.
The definition of emphysema according to the Webster’s Dictionary is “a condition characterized by air-filled expansions of body tissues; specifically: a condition of the lung marked by abnormal enlargement of the alveoli with loss of pulmonary elasticity that is characterized especially by shortness of breath and may lead to impairment of heart action” (Emphysema.). Meaning that within the lungs there are small sacs that are called alveoli, where the exchange of gas and blood occurs is interfered by the sacs over filling causing an obstruction of the sacs leading to breakage. The damage of the sacs can cause complication breathing due to the scaring and of the sacs developing holes decreasing the input of the oxygen in the blood stream.
...o Pneumonia, it causes respiratory failure. The treatment for this would most likely be ventilator breathing for the patient with supplemental oxygen. (Boothby, L. A. (2004)
In conclusion, early diagnosis followed by an appropriate airway intervention is essential to prevent cardiac arrest or irreversible brain damage that occurs within minutes of complete airway obstruction. Although the conventional techniques remains standard option, every physician has to be familiar with the process of evaluating a difficult airway and, in the event of the unanticipated difficult airway and be able to use a wide variety of techniques to avoid complications and fatality. Airway management of the patient requires a coordinated effort from other consultants or colleagues, if available, can be the key to success in some circumstances.
A paramedic’s first job when arriving at the scene of an accident is to categorise patients from lowest to highest casualties according to their status and injuries. When a person suddenly becomes ill or is injured in an accident, they must receive medical treatment immediately. There are people called “Emergency Medical Technicians” (EMTs) or paramedics who are trained to apply First Aid and administer on-site emergency care. The duties of EMTs and paramedics are very similar, but paramedics are trained to deliver more advanced care than EMTs are.
Accidents can happen anywhere at any time, even though some safety measures still exist. The immediate and appropriate measure taken at the right time can save the life of the victim [1]. This is why it is important to have at least a basic awareness of first aid. First aid is defined as the assessment and interventions that can be performed by a layperson immediately with minimal or no medical equipment [2].
First aid trained personnel and the first aid kit are the best tool to prevent further damage to the injured and make sure they are on the recovery path swiftly without any problems.
Immediate medical attention and early medical help is essential to reduce morbidity and mortality associated with such trauma. In America, to ensure the safety and wellbeing of students while they are in school, the students and school personnel are trained to provide first aid and this is the first critical link in the management of trauma (American School Health Association, 2000), each school should have a well-equipped first aid room, a trained first aider available in the first aid room or on call at least one student from each class trained in first aid. They have also pointed out that their pupils will be an asset to children/school at the time of emergency and there is no substitute for proper