Emergency Nursing Case Study at Flinders University

Patient Arrival to Flinders Medical

Initial assessment

• Airway
• Breathing
• Circulation
• Disability
• Exposure
• Posterior exposure

Abdominal Assessment

• Inspect conures
• Auscultation
• Percussion
• Palpation

Investigation

Focused Assessment with Sonography for Trauma (FAST Scan)

The Focused Assessment with Sonography in Trauma (FAST) ultrasound protocol was created to test for hemoperitoneum and hemopericardium.

In the present case, within the critical first 20 minutes, targeted sonography for trauma (FAST) and a scrotal ultrasound were administered as part of the first medical response.

X-ray

In order to reduce any unnecessary diagnostic lag, rapid diagnostic testing was started with the help of a multidisciplinary team. Underscoring the urgency for time-to-analgesia and applicable diagnostic procedures in traumatic settings, as stressed by Zabler et al., (2021), a thorough abdominal X-ray and computed tomography (CT) scan were quickly completed. These tests confirmed the first nursing assessments, finding no major abdominal injury but pointing out a slight scrotal skin rip that needed surgical repair.

Computed Tomography (CT)

Computed tomography (CT) scans were carried out as soon as possible, highlighting the urgency regarding time-to-analgesia and essential diagnostic testing in traumatic settings that was stressed by Zabler et al. (2021). These tests confirmed the first nursing assessments, finding no major abdominal injury but pointing out a slight scrotal skin rip that needed surgical repair.

Ultrasound

• Ultrasounds were performed right away to evaluate scrotal lacerations.
• Several strengths and opportunities for development are apparent when evaluating the calibre of care and assessment provided in the Emergency Department (ED) for a male patient, 15 years old, who was injured in a cycling accident. Following evidence-based procedures from the moment the patient reported was a key strength. Current recommendations in medical literature are rigorously followed when using pain medication for acute pain relief and performing

Nursing Care with a Holistic Understanding

• Identified and addressed his physical injuries
• Specifically potential abdominal and scrotal trauma.
• Pain management was effectively employed in line with current evidence-based guidelines for acute pain relief in an emergency setting
• In order to promote healing, holistic care places a strong emphasis on the collaboration between the nurse and the patient.

Multidisciplinary team-based holistic understanding

Utilising a multidisciplinary team made up of radiologists, trauma surgeons, and nurses increased the effectiveness of the care that was provided. Their seamless cooperation made it possible to develop a speedy and thorough diagnostic and treatment plan, which benefited the patient's general health.

Critical Analysis

• Analysis of the Emergency Department's (ED) assessment and care for a 15-year-old male who was injured in a bicycle accident reveals both areas of strength and need for improvement. The use of evidence-based processes from the moment the patient reported was a key strength.
• Current recommendations in the medical literature (Randhawa et al., 2019) are closely aligned with the prescription of pain medication for acute pain relief and the prompt use of ultrasound for diagnosing scrotal laceration.

Recommendations for Enhancement of Care

• Improved Clinical Documentation
• Medication Safety
• Enhanced Patient-Centred Communication
• Holistic Follow-Up
• Regular Team Debriefs

References

• Boeykens, D., Sirimsi, M. M., Timmermans, L., Hartmann, M. L., Anthierens, S., De Loof, H., ... & Primary Care Academy. (2023). How do people living with chronic conditions and their informal caregivers experience primary care? A phenomenological‐hermeneutical study. Journal of clinical nursing, 32(3-4), 422-437. https://doi.org/10.1111/jocn.16243

• Kilpelainen, F., & Zechner, M. (2022). Displaced Selves: Older African Adults in Forced Migration. Journal of refugee studies, 35(3), 1126-1142. 

• LeLaurin, J. H., & Shorr, R. I. (2019). Preventing falls in hospitalized patients: state of the science. Clinics in geriatric medicine, 35(2), 273-283. doi:10.1016/j.cger.2019.01.007 

• Lampi, J., Hyvärinen, A., Erhola, M., Haahtela, T., Haukipuro, K., Haverinen-Shaughnessy, U., ... & Pekkanen, J. (2020). Healthy people in healthy premises: the Finnish Indoor Air and Health Programme 2018–2028. Clinical and Translational Allergy, 10(1), 1-15. 

• Newgard, J. T., Hutchinson, T., & McCartney, J. S. (2022, March). Centrifuge shake table tests on rocking footings on sand. In Geo-Congress 2022 (pp. 629-637). 

• Randhawa, A., Chaudhary, N., Gill, B. S., Singh, A., Garg, V., & Balgir, R. S. (2019). A population-based cross-sectional study to determine the practices of breastfeeding among the lactating mothers of Patiala city. Journal of family medicine and primary care, 8(10), 3207–3213. https://doi.org/10.4103/jfmpc.jfmpc_549_19

• Taberna, A., Filatova, T., Roy, D., & Noll, B. (2020). Tracing resilience, social dynamics and behavioral change: a review of agent-based flood risk models. Socio-Environmental Systems Modelling.

• Zabler, S., Maisl, M., Hornberger, P., Hiller, J., Fella, C., & Hanke, R. (2021). X-ray imaging and computed tomography for engineering applications. tm-Technisches Messen, 88(4), 211-226. 

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