Question

Groupamber Scenario You are the trauma nurse working in the emergency desamor E a bus tertiary receive a call from the paramedics that they are on route with the victim of qurshot wound and abdomen. They started two large bore I nes with lactated Ringer's and oxygen min. The patient has a sucking chest wurd on the lett w urdin the right uppe abdomen. Vital signs in the field are very pale, and con we held are 80/38, 149, Ind 42 The partis captore fused. The estimated time of arrivalis 4 minutes Dia busy tertiary care facility. You route with the victim of gunshot wounds to the chest es with lactated Ringer's and oxygen toy mask at 150 wound in the right upper quadrant of the h e mainportant informats 1. To determine the possible to the t nurse needs to ask the paramediosis a. "How long ago was the patient shot?" b. "Do you have the w on that was used? "What was the reason this incident occurred d. "Where are the assumed entry and it wounds 2. List at least six things you will do to prepare for this patient's arrival 3. Prioritize the actions of the possicians and nurses in the trauma situation 533

Answer 1

1. To determine the possible extend of patient's injury, the nurse will ask the paramedics about the assumed entry and exit wound. The stem says that there is a sucking chest wound on the left which would probably mean it is the entry wound. Also information regarding the exit wound is also needed. This will give us an idea regarding the path of bullet inside the body and thus the organs at risk.

options b and c seems inappropriate.

option a might seem to be true, but since his vitals are already given and it says that he is haemodynamically unstable, the time of injury is irrelevant.

2. first priority is always airway- make sure it is patent and also keep INTUBATION SET ready.

the patient is in hypovolemia- arrange IV FLUIDS and 2 pints of O NEGATIVE BLOOD.

he can go into shock any time, so arrange- ADRENALINE shots ready.

also, in order to remove the bullet, make sure IV ANALGESICS and STERILE DRESSING SET are arranged.

and get the SURGEON ready.

3. always follow ABCDE rule in emergency/ trauma situation. They are

A- airway.

B- breating

C- circulation

D- disability

E- exposure

assess each of the step in order.