|
CCS TRAUMA CASE explosion - sami2004
|
03-04-2011, 11:11 AM
45 yrs old male, brought by ambulance while he was working at rail road stations, he has severe sob, tachpnea, drowsey, complain of chest pain. Just by looking at the patient, he had few laceration on his head and chest.
03-05-2011, 04:47 AM
EXPLOSION
45 yrs old male, brought by ambulance while he was working at rail road stations, he has severe sob, tachpnea, drowsey, complain of chest pain. Just by looking at the patient, he had few laceration on his head and chest. ER IV access Normal saline, IV, continuous Pulse oximetry Oxygen inhalation Continuous BP monitoring Continuous cardiac monitoring Morphine, IV, bolus Portable CXR UA Focused exam,..general, CVS, Resp ABG stat & hrly Urgent intervention if needed…..tension pneumothorax -needle followed by Chest tube, Hemothorex -Chest tube drain CT head, chest, abdomen,pelvis Blood type and cross match, stat CBC with diff, stat BMP, stat 12 lead EKG, stat Serum amylase, stat LFTs, stat Urine analysis, stat PT/INR,PTT, stat Blood ethanol, stat Urine toxicology screen, stat Interval HO & Complete PE Advance the clock to get the results Tetanus injection IV Antibiotics Consult trauma team for suture of chest and head If need to go OT,…NPO, consult Anaesthetist, HBs Ag, HIV, lFT Admit to ICU /Floor Order review: Hb and hematocrit, every 6 hours (Type H&H) Surgery consult, stat Blood transfusion if needed Oximetry every 6 hours Take brief history and examine focused for every 4-6 hours Repeat the CXR or CT next day Ambulation Compression stocking Discharge: Acetaminophen oral and codeine combination (Percocet for pain) *Follow up visit in one week 5min screen Patient counseling No smoking No alcohol Seat belts use Helmet Chest physiotherapy Educated safety precaution Influenza dater later inform authority or social service ( not sure what is in soft ware) |
| « Next Oldest | Next Newest » |
