Trauma C-Spine
This essay is not intended to criticize any emergency medical or hospital staff. I am writing this essay out of concern for patients who come into the emergency room that may have a jeopardized spinal cord resulting from an injury or suspected injury to their cervical spine. I am a certified emergency medical technician, farm-medic instructor and currently a medical diagnostic student doing clinicial's. In the United States each year there are approximately 10,000 reported cervical spine injuries that come into emergency rooms. Motor vehicle accidents account for approximately 45%, falls approximately 30%, the remaining 25% from sports and miscellaneous. Although only a small amount of these spinal injuries are life threatening, they all need to be treated as such. Survival of these patients depends on pre-hospital care, emergency room care and quality diagnostic radiographs, all done at times under extreme time restraints and pressure.
The number one goal in patient care is not to make any situation worse than it already is. Most pre-hospital care is usually done by emergency medical technicians. Their main concern is to assess, stabilize and transport the patient to a facility that can give additional care and treatment. The emergency room staff is the second step to the patient’s survival. Their duties include further stabilization, evaluation and treatment of the patients’ injuries. Radiographers are to supply ER doctors with quality diagnostic X-rays so they can make informed decisions about further patient care. Each of these groups need to be aware of what is involved with the other’s job, so that the patient will receive the best of care.
Emergency medical personnel are trained in the proper pre-hospital care of patients in the field. Pre-hospital care of patients suffering from suspected cervical spine injury involves making sure the patient has a patent airway. Placing a properly sized C-collar on the patient to stabilize the neck. Packaging the patient for transport to the emergency room, which involves proper placement and securing of patient on backboard, and making sure to secure the head and shoulders so there is no movement of these areas by the patient. While enroute to the hospital emergency room further assessment of patient can b...
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...this! EMS responds to a motor vehicle accident and have to place a patient on backboard with a c-collar applied. The EMS crew just had a continuing education program presented by an X-ray technician that showed them what they could do to help speed up c-spine exam time and also help reduce patient risk, so the EMS crew removed the patients jewelry before they applied the c-collar. Upon arrival at the hospital the proper X-rays were ordered to evaluate the patient for cervical spine injury. The radiographer arrived with help to do the necessary exam. The patient was taken into the exam room and since the radiographers had just completed a continuing education program on patient care, where cervical spine injuries were involved, they were very careful when moving the patient. They kept the patient on the backboard and did not attempt to move the patient’s head or neck. The radiographers made sure that the films they showed to the doctors were of diagnostic quality.
Could this happen? Yes, if everyone involved was properly trained, took pride in their work and departments were adequately staffed.
Does this happen? I hope so.
Per AME report dated 05/02/12 by Dr. Perelman, the IW is P & S 8-12 months post injury. Future medical care includes orthopedic evaluations, PT, chiropractic care, and acupuncture to the cervical spine. The patient underwent a cervical ESI at C5-6 per procedure report dated 02/10/12 with no benefit.
...iately discovered and the patient was fine, but had there been proper communication between the healthcare staff, such blunders could have been avoided altogether (Dolanksy, 2013).
There is nothing traumatizing in the world has adding pain to where it already exists. This is the hell situation which every medical error victim is exposed. As the statistics are currently showing, the fatalities are increasing day by day. The trend seems to be hiding on the old ideology of “man is to error”. However this is not being tolerated any more and the American medical facilities are being held 100% accountable for the mistakes they make in their service delivery. Professional diligence is not a matter of negotiation in this generation and probably future generations. If a medical facility cannot treat people diligently, then the only better option remaining for that facility is to be made to account for the losses they have caused on affected patients and be closed down immediately.
...l. "[The Use Of Physical Restraints In An Acute Care Hospital]." Assistenza Infermieristica E Ricerca: AIR 23.2 (2004): 68-75. MEDLINE. Web. 22 Oct. 2013.
In our organization we have had many revisions to our safety process. Originally, it was at our hospital that the 1996 well known “Willy King” incident, about the amputation of the “wrong” leg occurred. As a response to the incident, we were required to develop a root-cause-analysis and develop a plan to avoid similar situations in the future. We were one of the first hospitals to establish a “safety process” in the surgical environment. Through inter-disciplinary collaborati...
There was inappropriate staffing in the Emergency Room which was a factor in the event. There was one registered nurse (RN) and one licensed practical nurse (LPN) on duty at the time of the incident. Additional staff was available and not called in. The Emergency Nurses Association holds the position there should be two registered nurses whose responsibility is to prov...
Safety is focused on reducing the chance of harm to staff and patients. The 2016 National Patient Safety Goals for Hospitals includes criteria such as using two forms of identification when caring for a patient to ensure the right patient is being treated, proper hand washing techniques to prevent nosocomial infections and reporting critical information promptly (Joint Commission, 2015). It is important that nurses follow standards and protocols intending to patients to decrease adverse
warm) in the left upper and lower extremities; decreased strength and movement of the right upper and lower extremities and of the left abdominal muscles; lack of triceps and biceps reflexes in the right upper extremity; atypical response of patellar, Achilles (hyper) reflexes in the right lower extremity; abnormal cremasteric reflex in the right groin; fracture in cervical vertebrae #7; and significant swelling in the C7-T12 region of the spinal canal (Signs and symptoms, n.d.). The objective complaint of a severe headache could also be consistent with a spinal cord injury (Headache, nausea, and vomiting,
..., Ducker, T.B., ….. Young, W. (1997). International Standards for Neurological and Functional Classification of Spinal Cord Injury: International Medical Society of Paraplegia, 35, 266 – 274.
Emergency room physicians are on the front lines in a crisis, caring for everyone from trauma victims to sick kids. An ability to think quickly and care for a wide variety of patients makes them valuable assets at every hospital. It also brings some perks. When sudden illness or acute injury strikes, patients turn to hospital emergency rooms for immediate medical assistance. An ER doctor, or emergency medicine specialist, is a physician who diagnoses and treats illnesses and injuries in a hospital emergency room or other urgent care setting. Emergency medicine is a financially rewarding career, and it also comes with the reward of saving lives. ER doctors require intensive training to know how to shoulder their intensive responsibilities.
To be able to perform patient vital signs, talk to parents and record patient history, perform EKGs and other tests, obtain accurate patient information needed for diagnosis and treatment, work with other medical staff and non-medical personnel, communicate with other medical service providers, and to educate patients about procedures or
example, patients who are going in for major abdominal surgery, or even normal childbirth. Nurses
There are many members of the inter-professional team, all of which are contributing to the healthcare of acute and critically ill patients. Every member of the team has had education and obtained a license of practice compatible to their level of knowledge (Prater, Fundamentals of Nursing, 2013). As a practical nurse you need to be mindful of your scope of practice in relation to registered nurses, certified nurses’ assistants and other healthcare professionals. With so many different people involved in the immediate care of a patient, there is always the possibility of a mix up. The purpose of this paper is to help differentiate between the roles of the healthcare staff, which will in turn help develop a knowledge base for prioritizing care;
Pre hospital care and clinical practice in civilian life is not a new idea, in fact it is has been around in one form or another for roughly 200 years. Its foundations lie in the military. During the Napoleonic wars with a French surgeon named Dominique-Jean Larrey. (1) Pre hospital care has come a long way from hauling fallen soldiers off the battlefield in a horse drawn carriage (1) to transporting patients in a different kind of carriage, a four wheel drive one to be precise. Pre hospital care and clinical practice owes many of its advancements in the 200 years since it has existed to the military. Their practices or research conducted during military conflicts has influenced civilian pre hospital care and clinical practice in the areas of triage systems, transport systems, clinical management, equipment and education to name but a few, but where it has had the most influence has been on the transport systems and clinical practices used. Their uses in the military pre hospital care world have worked particularly well in the civilian world. As a result of such they have been adapted by civilian paramedics quite readily.
Although students were not allowed in the recovery unit, I was able to talk to one of the recovery nurses. I learned that a nurse’s duty of care includes monitoring the patient’s vital signs and level of consciousness, and maintaining airway patency. Assessing pain and the effectiveness of pain management is also necessary. Once patients are transferred to the surgical ward, the goal is to assist in the recovery process, as well as providing referral details and education on care required when the patient returns home (Hamlin, 2010).