Categories
Healthcare

Please follow PCR formate as attached to the assignment as last one came as an e

Swamped with your writing assignments? Take the weight off your shoulder!

Submit your assignment instructions

Please follow PCR formate as attached to the assignment as last one came as an essay but it should have been in the formate provided. Thank you!
A “thread” must consist of three parts: 1) a working diagnosis of the case study (what injuries do you suspect), 2) the appropriate treatment for your scope of practice (listed in the appropriate order and differentiating what will be done on scene versus what will be done enroute to the ED and 3) a ED notification report (ED notification template is listed under “Content”). Here is Case #1:
You have responded to a motor vehicle accident involving a motorcycle at the intersection of Broadway and Littleton Blvd. and see the following as you arrive:
Upon your arrival at the patient you see this:
Scene Size Up:
You find a badly damaged motorcycle that had one rider. You see the rider beyond the car he hit. He is in a crumpled heap on the ground and the only protective gear he is wearing is a helmet (pictured above) which is still in place. He is moaning and screaming. Witnesses estimate he was going 45 miles per hour. You do see skid marks which indicate the patient was conscious at the time of the impact and he did slow his speed somewhat. You notice severe trauma to his lower extremities.
General Impression:
A male patient with multi-systems trauma secondary to a high-speed motorcycle impact. He has near amputations to both legs with significant bleeding coming from the pt.’s left leg. He had minimal protection which exposes him to the chance of great injury. He appears to be conscious and have an airway due to the fact that he is moaning and screaming. It can be further extrapolated that he has a pulse and some kind of blood pressure.
Primary Assessment:
The patient is conscious. He initially does not respond to your questions as he continues to scream in pain.
The airway is open without obvious obstructions. (question, what about the helmet? Can you assess the airway with it in place? Do you leave it on or take it off? Other than airway are there other considerations with the helmet?)
The patient is breathing 26 times per minute and shallow. As you expose the chest you see use of the intercostals muscles. He does have an area of reddening and abrasions to the right chest. His chest expansion is symmetrical without abnormal movement. He has breath sounds present bilaterally, but diminished on the right as compared to the left.
The patient has a weak, rapid, radial pulse of 126. His skin is pale, cool, and diaphoretic. He has life threatening hemorrhage from the lower extremities. The abdomen is soft and non tender, it is not distended.
Head: The head shows no obvious signs of trauma, there is no hemorrhage, depressions, crepitus, swelling, or soft spots. There is no drainage from the ears or nose. The teeth are intact and in place. His pupils are equal, dilated, and responsive but sluggish.
Neck: The trachea is inline, there is no JVD, the c-spine is inline without deformity or step-offs. There is no soft tissue trauma to the neck.
Chest: The clavicles are intact. The chest wall is stable with equal symmetrical expansion, but it is minimal due to the shallow respirations. Breath sounds do not change from what was found in the initial assessment. There is an area of redness and abrasions to the right chest.
Abdomen: There is no change from what you found in the initial assessment
Pelvis: Stable
Extremities: The upper extremities have several abrasions, but minimal bleeding. There are no angulations, swelling, or deformity. The lower extremities are as you found them in the initial assessment with near amputations bilaterally. There are no pulses to either of the extremities.
Posterior: There are numerous abrasions across the pt.’s posterior. There are no palpable deformities noted along the T and L midline spine. SAMPLE history and Vitals:
Due to the patient’s pain, screaming, etc. it is difficult to get a SAMPLE history. He has no allergies, takes no medications, and has no past medical history. His last meal was an hour ago and he has had 8 beers in the last 2 hours. His initial vitals are respirations of 26, pulse of 126, a blood pressure of 94/82, and his skin is pale, cool, and diaphoretic. His pulse ox is 78%.
Secondary Assessment:
Due to this patient’s life threatening conditions you will likely be occupied with what you find and not have time to complete a detailed assessment.
Continued Assessment:
Regardless of interventions pt continues to deteriorate. Reassessment enroute reveals V/S of BP 88/50, RR12 & shallow, BS C&E BL equal rise and fall, HR 140, SPO2 89%, Pale/ Cool/ Diaphoretic. LOC: Pt opens his eyes and groans upon trap pinch. .

Swamped with your writing assignments? Take the weight off your shoulder!

Submit your assignment instructions

Leave a Reply