Question

Scenario: At work, you are called to give care for a co-worker who has fallen from an 8-foot ladder. As you arrive, you see the injured person lying on the ground. They are crying and moaning in pain. A bystander says that the person landed on their back. The injured person has not moved from this position. The person says that they have tingling and numbness in their legs and feet and pain in their back. The person also has a 2-inch laceration on the side of their head. You want to help. Describe the immediate steps that you should take in responding to the emergency to determine what your plan of care should be.

Answer 1

In the given scenario, the person is conscious and oriented and complains of pain on back, tingling and numbness in the legs and feet which may be sign injury to spinal cord.He also has laceration and bleeding on side of head. the first priority should be given to the suspected back bone injury.

1. Ask the person to stay still and do not try to move or sit because he has symptoms suggestive of spinal cord injury.

2. Call for emergency team response.

3. Apply pressure on the bleeding wound on the head to minimize bleeding.

4. Assess the person for signs of fracture in other parts of body. Try to immobilize the part with splint if suspected for fracture.

5. Close monitor the person for any signs of confusion or shock. Reassure the patient till the ambulance arrives.

6. If the patient stop breathing or loose pulse, start CPR immediately.

PLAN OF CARE

1. Risk for trauma related to weakness of body part secondary to spinal cord damage.

• The main goal is to maintain proper body alienment and posture to prevent further damage to the spinal cord.
• Bed rest is very important.
• Ask assistance while handling the patient. use logrolling technique while moving the patient.

2. Impaired physical mobility related to neuromuscular impairment.

• Assess the level of mobility, motor function.
• Check for level of impairment and take action to prevent contractures ad foot drop.
• consider range of motion excersises

3. Acute pain related to physical injury.

• Assess the level of pain by using pain scale.
• Provide comfortable position, hot or cold applications.
• Administer pain medications as ordered.
• Teach relaxation techniques to deviate mind.

4. Risk for impaired skin integrity related to immobilization, decreased sensory perception and decreased peripheral circulation.

• Assess the skin for signs like redness, selling, warm especially on pressure areas and bony prominence.
• keep skin dry and clean, avoid wrinkles on bed covering.