Question

Case Scenario: A 23-year-old patient was the victim of a hit-and-run auto-pedestrian accident and suffered multiple abrasions, a concussion, and a deep laceration of his left thigh. He was discovered approximately two hours after the incident and is now in the ER. His vital signs and hematocrit suggest that he has had a blood loss of about 2500 ml. A urinary catheter is inserted to monitor urine output, and fluid resuscitation is initiated while his wounds are cleaned and sutured. The urine output is averaging 15 ml/hr, with a high urine osmolality and low urine sodium.

Question: Without adequate therapy, what complication may develop? Why? What is the best therapy for preventing this complication? You will need to defend your answer using specific facts, data, and other information drawn from the textbook and at least one other supplemental source

Answer 1

Complications may occur because of the consequences of blood loss or because of the underlying disease or situation that causes the fluid loss.

• Kidney failure

Kidney failure occur mainly when blood loss occur in the body and the blood reaching kidney reduce tremendously leading to kidney failure

• Coma

Decreased blood supply to the brain may cause confusion and even coma.

• Shock

When the fluid loss is greater than what body can compensate it will lead to malfunction of organs and lead to shock.

• Dehiscence

If no proper surgical care and aseptic technique are used then it can lead to dehiscence of wound

• Hematomas

Hematomas in chronic non healing wounds due to incisional dehiscence .

• Edema and Periwound Edema

Another complication periwound edema and edema which can cause slowing the healing process and expose the wound . Even compartment syndrome can occur

• Tissue Necrosis and Gangrene

It can occur due to reduced blood supply and infection at the site of abrasions

• Osteomyelitis

Infection in chronic wounds can spread to surrounding underlying bone and tissue

• Infection

It can occur due to microbe's in the wound from the injury

To prevent these complications

Rehydration therapy should be initiated with proper fluids like NS ,RL etc

If needed blood transfusion can be done

Proper cleaning of wound using antiseptic solution should occur

All procedure conducted should be sterile

If the wound is so dirty then debridement of infected tissue should be done before suturing to prevent infection

Antibiotic therapy should be stated immediately with a broad spectrum antibiotic