Case Study using Western (preferably Australian peer reviewed journals), will attach some I already got.
You are the Clinical Nurse on duty in the Emergency Department and have just received a call from the local ambulance station that there has been a collision between a bus full of tourists (up to 49 passengers) and a 4 wheel drive with 6 backpackers. It is 15:00 on Friday. The Emergency department is busy and at present you have only have 2 out 25 beds available.
Question 1
Utilising the triage sieve process what are the priority categories for these casualties? How will you allocate patients to each category? What 3 clinical parameters are assessed and give a Triage Revised Trauma Score (TRTS)?
Several of the patients in the above incident need intubation and immediate airlifting to hospital. It is decided that this will be done from the scene of the crash for the majority of victims.
Question 2
What are the physiologic effects of increased air pressure on body cavities? What strategies or equipment can you use to minimise air pressure impact on body cavities? Compare the benefits of ground versus air transport.
The patients start to arrive at your emergency department along with many anxious parents. You are allocated a 5 year old boy – Tom – who was on holiday with his parents.
Question 3
Outline the paediatric considerations that need to be taken into consideration during the triage assessment process when admitting Tom to the Emergency Department. Tom shows signs of poor peripheral perfusion briefly outline his immediate treatment?
Tom’s injuries are severe and he deteriorates rapidly.
Question 4
Discuss the current research and recommendations regarding family presence during paediatric resuscitation. Where can you find information/guidelines to support family presence during resuscitation in your department? How can you support the family while they are present in the resuscitation room?
The emergency staff successfully resuscitate Tom and he is transferred to a tertiary hospital. Kindly you relieve one of your team members for dinner and take over the care of Jayne. Jayne was with the backpackers in the 4 wheel drive and is currently being ventilated while waiting for a bed in ICU.
Question 5
You receive the results of Jayne’s latest Arterial Blood Gas (ABG): pH 7.54, CO2 19, pO2 100, HCO3 16, SaO2 98%, what is your interpretation of this result? Briefly describe the appropriate interventions? Before you can act Jayne starts to deteriorate rapidly and needs urgent reassessment. Discuss the signs, symptoms and treatment of a tension pneumothorax for a ventilated patient.
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