Question

An 18-year-old male (grade 12 learner), was involved in a pedestrian vehicle accident (PVA), four days ago. He sustained head injuries with subdural haemorrhage and fractures of ribs 2-4 on the left with left haemothorax.

He is day 4 in the intensive care unit (ICU), intubated and mechanically ventilated on SIMV (pressure control) + pressure support mode. His GCS is 2/10. An intercostal drainage (ICD) was inserted on the left. .

Formulate a concept map that has the following criteria:

• Explain a detailed Physiotherapy assessment plan for this patient and justify your answer.
• Explain the mode of ventilation that this patient is on and describe how this patient

will benefit from it.

• Explain the key multidisciplinary professionals that are needed for this patient at this stage and how they will work together for achieving a holistic approach.

Instructions to students: concept map to fit in no more than 3-4 pages. Arial size 11 to be used and a list of all used references should be included.

Answer 1

1. Haemothorax is defined as the entry of plural fluid and blood in the plural cavity. It needs to be plural fluid with a hematocrit of 25% to 50% of the patients blood to be diagnosed as a haemothorax.

Physiotherapy is a technic that adress removal of secretìoń an improve airway clearence.

Physiotherapy assesment plan include-:

*To facilitate removal of retained porfuse airway secretions.

* Optimize lung compilance and prevent it from collapsing.

*To dicrease the work of breathing

* To optimize the ventilation-perfusion ratio/improvd gas exchange.

* turning side to side for lung

*vibration

-increased tolerance for procedure (Vs clinical appearance and ABG)

-sputum amount, consistency, amount, colour

-auscultation of chest

Percussion

-improved chest xary

-Airway clearence and proper suctioning

Benifits of chest physiotherapy

Helps the patient to breath more easily

Prevent chest infections

Reduce bouts of coughing

Remove airway obstruction

Helps to prevent pneumonia

*Needed professionals

Neuro surgeon

Cardiothoracic surgeon

Pulmonologist

Anesthetist

Radiologist

Physiotherapist

Nursing professional (ICU)

Dietician

Infection control nurse  

Clinical pathologist and  lab technicians

All these health professonals should work as a team for patients easy recovery through the surgeries nd follow up cares. Health care teams that communicate effectively and work collabratively reduce the potential for error resulting in enhanced patient safety and improved clinical performances.

References : physiopedia.com, www.lifemar.ca,www.aha.org