Question

Hello, having some trouble with my case studies.

Case Study 3 Acute Care Mrs Fox Case Scenario: Acute Care Mrs. Fox, a 40-year-old wife and mother of 2, was involved in a massive motor vehicle accident on the Sawmill Parkway in which her car struck the center divider and flipped twice. A good Samaritan immediately dialed 911. First responders found the patient unconscious with severe injuries but were able to safely transport her to St. John’s Riverside Hospital. Upon arrival at the emergency department, Mrs. Fox was immediately triaged and the following impairments were found: blunt force trauma to the head, open fracture to the right leg, possible closed fracture to the right wrist/forearm, and internal bleeding to the upper right abdominal quadrant (possibly from the liver). Hospital staff was able to contact the patient’s next of kin (family) to inform them of her condition. Mrs. Fox was stabilized, imaging and tests were ordered/performed, and medically necessary surgical intervention was carried out. The patient was transferred to the ICU of the hospital as she continued to fluctuate in and out of consciousness and had difficulty breathing without the use of a respirator. Within a week, the patient fully regained consciousness, was able to breathe on her own, and was determined to be safe enough to be transferred to the general inpatient floor of the hospital. It was determined that Mrs. Fox had sustained a traumatic brain injury predominately affecting sensation and motor function to the right side of her body. She was placed on a restrictive diet and prescribed medication to treat her healing liver as well as diuretics to decrease the fluid compressing her brain. A pin was placed in the patient’s right wrist to fixate the fractured scaphoid bone. The right tibia was fixated with an intramedullary rod and pins. Neurovascular structures were repaired to the best of the surgeon’s ability; however, the prognosis of her right leg was undetermined based on the severity of damage. Based on the case scenario above, answer the following questions: 1. Of the health professionals discussed thus far, which may be involved in Mrs. Fox’s care? 2. What would be the role of each provider? 3. Why might providers need to communicate with one and other specific to this case? 4. How might they communicate? 5. What other healthcare team members, not yet discussed, might be involved and what would be their roles?

Answer 1

1. The health care providers included in Mrs. Fox’s care are ambulance staffs, triage department, emergency department, neurological department, orthopedic department, gastrointestinal surgery department, public relation office department, radiology, laboratory, ICU, respiratory medicine department, dietician.

2. The role of each provider are:

• Ambulance staffs: Stabilize the patient, check for consciousness level, provide BLS if needed, immobilize the patient and shift the patient without further damage, contact the nearby hospital and shift the patient.
• Emergency department: The staff members should receive the patient and provide first aid care, stabilize the patient.
• Triage department: The triage staff should perform triage on the patient and provide care according to the protocols.
• Neurological department: As the patient has met with a road traffic accident and is unconscious. The emergency department should inform the neurological department and they should provide care, check for level of consciousness, if surgery needed it should be performed.
• Orthopedic department: As the patient is having many injuries to her extremities, this department should be called for and examination should be done and the treatment should be given.
• Gastrointestinal department: As the patient is having internal bleeding, the gastrointestinal department should be called for and examination should be done and treatment should be provided.
• Public relation officer: The duty of the PRO is to inform the family members regarding the patient condition, the place of incident and the hospital details.
• Radiology and laboratory department: They should perform the diagnostic tests to rule out the condition of the patient.
• ICU: After the emergency care is provided, the patient should be shifted and received by the intensive care unit and care should be provided accordingly.
• Respiratory medicine department: The patient is having difficulty in breathing thus a respiratory medicine department should have a check on the patient.
• Dietician: As the patient is on restricted diet, it is the duty of the dietician to have a check and provide the diet and assess the dietary requirement of the patient

3. As the care given to patient should be a holistic care, which means all the required departments should be included in the care of the patient. There should be proper communication between all the departments to provide optimum care to the patient and treat the patient.

4. They can communicate with each other through the medical records or verbally giving orders.

5. The other health care providers to be involved are physiotherapists. They are needed because the patient is affected sensory and motor function to the right side of the body and many orthopedic surgeries. They should provide passive and active exercises to the patient and reduce the disability.