This essay analyzes that the nurse relies upon a specialized body of knowledge, skills, and experience to provide care to patients and families and create environments that are healing, humane, and caring and they practice in settings where patients require complex assessment…
The case that is undertaken for discussion is a 26 year old pedestrian male who is struck by a high speeding car, consequent to which he suffers multiple injuries which includes deep 5cm laceration on his forehead, sharp pain in the back of the neck, unequal chest movements, abdominal injury and injury to the pelvis and right femur. The 3 main injuries which will be specifically discussed are the sharp pain in the back of the neck, unequal chest movement and injury to the pelvis.
The sharp pain in the back of the neck of the patient hints at probable spine injury at that area. Most cervical spine fractures occur predominantly at 2 levels -at the level of C2 and at the level of C6 or C7 (Mueller 2006). The normal cervical spine has 3 distinct columns- the anterior column is composed of anterior longitudinal ligament and the anterior 2/3rds of the vertebral bodies, the middle column consists of the posterior longitudinal ligament and the posterior 1/3rd of the vertebral bodies, the annulus and intervertebral discs and the posterior column includes all of the bony elements formed by the pedicles, transverse processes, articulating facets, laminae, and spinous processes. Disruption of more than one of these columns makes the spine move as 2 separate units, increasing the likelihood of spinal cord injury. Based on the mechanism of injury, cervical spine injury can be classified into flexion, flexion-rotation, extension, extension-rotation, vertical compression, lateral flexion, and imprecisely understood mechanisms (Mueller 2006). The patient can present with the spinal shock which manifests as flaccidity, areflexia, loss of anal sphincter tone, fetal incontinence, priapism and loss of bulbocavernosus reflex. He can also manifest with signs of neurogenic shock like hypotension, paradoxical bradycardia and flushed but dry skin.
The 26-year-old man who met with a road traffic accident was admitted with multiple injuries involving the spine, chest and the pelvis. He was managed in the intensive care with continuous monitoring of his vital signs. He was given appropriate fluids, electrolytes, blood transfusion, diet, and medications. The main concern in this patient is the prognosis of spinal cord injury which is poor. Hence it is obvious that the patient and his family members are worried about his prospects in terms of recovery, day-to-day activities, employment, social and married life. The patient and the relatives will need emotional and psychological help before discharge. In addition, the patient will also need rehabilitation measures including physiotherapy and occupational therapy.
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