CNA618/Trauma Nursing and Triage
This assessment task requires you to select and investigate the management of a complex or critically unwell patient with a trauma presentation that has been explored in module 2 (weeks 4 – 9). Your trauma patient must have sustained, or be suspected to have sustained, two or more trauma-related injuries. This could be as "simple" as a fractured femur, with a mild head injury or fractured ribs; up to complex presentations from high speed MVA/MBA. The more injuries your patient has sustained, the more difficult it can be to write about (within the word limit), so do be careful not to pick a patient that is too complicated. Prior to commencement of the case study, you may wish to discuss your choice of topic with your tutor or the unit coordinator to ensure sufficient trauma content can be addressed. If you are struggling to come up with an appropriate patient because you have not been exposed to recent trauma in your workplace, please make contact with the Unit Coordinator to discuss alternatives (you can be allocated a fictional patient). Within the paper, write a brief past and present history, including presenting problem, mechanism of injury and emergency management of the patient. Summarise the overall management of the patient provided by the health care team including key diagnostic indicators and immediate pharmacological interventions. Identify the trauma issues to be explored in more depth, using recent evidence based literature. Critically analyse and discuss the emergency care related to the identified trauma with reference to the pathophysiology and the individual needs of the patient. Within your critique of the nursing management, you need to propose recommendations for future practice if indicated. Expand upon and justify the nursing management, by identifying and discussing key nursing interventions, including clinical assessment, physiological monitoring, emergency management and evaluation of the care provided. Include social, ethical and legal aspects where relevant. You must maintain patient confidentiality by assigning the person a pseudonym and abide by your organisation’s ethics policy on using patient information. Academic writing style and referencing should be used. SUMMARY: Pick a trauma patient. The patient will need to have at least 1 major injury that you can discuss in further detail, but ideally 2-3. Any more than this will prevent you from going into the correct amount of detail within the confines of the word limit. Introduce the patient, describe their presenting history and pre-hospital treatment briefly. Define the MoI in relation to their presentation and injuries. Relate the MoI and pathophysiology, assessment and management to the patient’s clinical condition. Explain the pathophysiology of injuries, considering complications trauma patients may experience. Discuss, analyse and evaluate the management of your patient. You may want to include potential/actual complications. You can also consider social, ethical and legal aspects if you feel necessary. Highlight any relevant consideration for future practice. Did anything go wrong? What could you have done better? Relate it back to best practice / recent literature. Conclusion - sum up what you've spoken about. Some people like to update on the patient's progress (but this is not essential). 66yo male, MBA travelling at 50kms/hour, ran off the road into a ditch. Was wearing a helmet but not protective clothing. Landed on R) side. Complaining of R) chest/rib pain (likely pneumothorax but could be haemopneumothorax), compound fracture to R) femur, generalised R) upper quadrant abdominal pain with some distention (likely liver injury). A - patent, c-spine immobilised on scene B - RR36-40, SaO2 90% on room air, pain on inspiration C - BP74/35, HR128, obvious large blood loss from femur and ? intra-abdominal bleed D - GCS15 although amnesic to accident E - T35.1, bruising to R) ribs, grazes to R) arm, distention and bruising to R) upper quadrant
