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and this is why they fit so well into the chosen time period. Ancient Egyptians practiced artistry decorated with different kinds of animals just like the Comb
and the statutes of the pharaoh were commonly made for their tombs.
Emergency Preparedness.
Emergency Preparedness
Question 1
Introduction
The rate of recurrence of major as well as unpleasant incidents seems to be on the increase in recent years. The occurrences have heightened the understanding of the devastating consequences of the various incidents on human lives. The abruptness as well as the magnitude of the incidents often renders regions affected by the natural catastrophes incapable of responding efficiently towards the emergencies due to the devastation getting beyond the capacity of the region’s resources (Peters et.al, 2004).
Many regions have had to handle relentless and unpredictable incidents that have often put the general public into a state of jeopardy. Such unpredictable events cause devastating impacts that spread on to the national economies of the affected nations. The results show in the large number of people dying as a result of loss of lives. Hundreds or thousands of people die and some injured while million others are rendered homeless in some cases. A number of affected regions also suffer from infrastructure damage leading to financial losses that are difficult to bear with.
Victoria has had a long history of incidents with a number of them being extremely destructive, and has come up with a capability of dealing with such incidents. A number of organizations within the community, together with the emergency service providers, play a significant role in this. Various activities of these organizations, both charitable and permanently staffed, require coordination to evade conflict, wastage, as well as gaps (Commonwealth of Australia, 2004).
How the Emergency Service Community is preparing for Incidents
The emergency management community deals with incidents of different sizes, from small to extremely large. Particularly, they deal with incidents involving more that one organization. Emergency management entails plans, structures and arrangements set up to bring collectively the normal actions of the government, charitable as well as private organizations in an all-inclusive and synchronized way to handle the whole range of emergency requirements, including prevention, response as well as recovery.
With major incidents occurring unexpectedly, they seem complex to distinguish from lesser to major occurrences at the initial stages. And with the usual experiences and the anticipations of the parties implicated, there may seem to be a difficulty in recognizing that a rising situation requires a reaction or response of a better order. For these reasons, the management plans to deal with major incidents are much similar to plans to deal with lesser or order occurrences, and are not a different set of plans set aside for a major incidents(Becker et.al.,2010).
In Victoria, there exist no rules and regulations or declarations needed to instigate or speed up the response as well as the recovery activities. The plans are therefore deliberated to allow for the situation to be evaluated, providing for a graduated marshalling in addition to the utilization of the resources meant to deal with such incidents, under structures established under the appropriate overall plan along with the participating organizations’ own plans (Emergency Response Plan 2009).
Victoria’s emergency services are tailored to handle various hazards with most emphasis put on obvious tragedies for instance fire outbreaks, floods as well as transport accidents. A number of such incidents are handled employing the emergency management plans and resources (Commonwealth of Australia, 2004).
These comprise of emergencies that has only been little or even no experience within the state of Victoria, such as terrorist incidents, earthquakes, animal disease emergencies as well as environmental emergencies. The management of such emergencies is often a collective responsibility linking many people as well as organizations within the community. It therefore does not just involve a section of the community working for the rest of the society, though a number of organizations do have expert roles.
Along with the emergency services, the government departments also have some part to play. The emergency response duty may act as a small part of their duty. The government has the duty of making arrangements for, as well as managing the costs of a health emergency occurrence. The government does this through the Emergency Management Act. The human service department has the duty of directing all the health in addition to the medical emergency responses and in this case developing, improving and maintaining the plan (IRFC, 2010).
Municipal councils too have important roles in emergency planning. All Victorian municipalities are charged with the health protection within their respective boundaries. The environmental officers within the respective municipalities are concerned with the emergency management preparation. They therefore provide public health advice in cases of emergencies. The emergency management arrangements of the municipalities include both the public health as well as the recovery response. These are connected into local public health as well as the recovery plans (Gabriel, 2008).
The credibility as well as the reputation of various bodies towards the disasters is mainly influenced by their perceptions towards their reactions on the event of the crisis. The organization and communication involved towards the disasters in reaction to such crisis rapidly brings out the main challenge. A more open and consistent communication is employed throughout the system in order to come up with a successful crisis communication process.
Other than the Victorian State emergency plans there are also response plans at the regional levels. The Victoria state emergency plan comes up with the emergency response coordination plans in addition to setting out the roles of the chief agencies involved in the response. A number of public as well as private agencies, or some section of organizations, have key roles to play towards the response plan (Commonwealth of Australia, 2004).
Other organizations such as the municipal councils are called upon to offer support during specific events. Emergency responses are normally established on various arrangements which are applicable all the times and they operate whenever there is an emergency. Responsibilities normally lies initially at the municipal level with support coming from the regional or the state level if need be.
Incident controls are left with the control agencies which are mainly responsible for reacting to particular emergencies. Support agencies on the other hand offer services, personnel, as well as materials to assist control agencies and other affected persons. Response agencies in this case are vested with the role of controlling and supporting agencies with regards to a particular emergency. This always entails a collective responsibility where agencies and resources are brought together to enable a well-organized response towards the emergencies (Sinha, 2008).
These unpredictable events have enlightened many organizations to consider an in depth analysis of their preparedness on how to handle such events. As a result of this enlighten, many programmes have therefore been established so as to enhance the public safety in the event of such emergencies. The significant role of effective management systems is therefore increasingly acquiring recognition in the disaster emergency management.
There also exists various recovery processes in place established by the various bodies involved. These are often in place and meant to assist those who are affected by various emergencies so that they area able to acquire a proper as well as an efficient level of operating. This process involves efforts between all the levels of the government, on-government agencies, community, as well as the private sector considering various factors such as:
the recovery of essential infrastructure
environment rehabilitation
the regeneration of the affected community’s economy
the emotional, social, as well as the physical wellbeing of the affected individuals and community
During the recovery process, the governments as well as the community often have plans set in place in order to assist the affected persons and the community to recover back to a healthy, secure, and functioning environment. There is also state as well as regional recovery managing commissions. Regional recovery management comes up with agency responsibilities as well as coordinating plans that are applicable to the respective region, with detailed resource listings as well as contact details (Commonwealth of Australia, 2004).
Moreover, they depict plans for the establishment as well as support of the community recovery teams. Recovery within the Victoria state is often managed at a level that is nearest to those affected, which might or might not be situated within the municipal district. The activities are planned to start immediately following the impacts of an occurrence, and carry out at the same the time with the responsive actions.
Recovery is often managed within the municipal level and done by the council, and in most cases with the participation with the community recovery commissions which combine both government as well as non-government agencies’ works taking into account the community’s needs throughout the recovery process. The various committees are normally chaired by the council personnel. The department of human services works as the directing agent on recovery as stipulated by section 17b (1) of the Act (Eburn, 2005).
There is therefore a multi organization structure for emergency planning, which facilitate the implementation of the roles as well as the responsibilities, and the capability to acclimatize to different situations within an organized framework. Some of these are legislated whereas others have been formed through agreements.
Benefits in the preparations and delivery of service to the affected community in cases of disasters
Promoting a stern review on the past incidents’ management practices
A number of benefits have accompanied the various preparations towards the delivery of service to the affected community during disasters. This has been able to promote a stern review on the past incidents’ management practices as well as considerations of a broad range of non-structural approaches employed initially.
The change in emphasis in disaster management and preparedness programmes, from non- structural to structural procedures in a number of Victoria’s incidents of essential management has helped to improve the preparedness approach (Sinha, 2008).
It is in this perspective that emergency preparedness management provides a way to think about as well as planning structures towards emergency management. The emergency preparedness framework facilitates
a concentration on risks involving the connections between the various hazards and the communities and not only hazards
development of a number of inventive approaches towards secure programs through risk reduction by changing either the possibility of emergencies or the potential results
the involvement of a number of people as well as professions other than just the emergency services to enhance safety along with sustainability
Cost/Economic benefits
Economic benefits are also accrued as a result of disaster preparedness. For instance, the economic benefits that come from fire disaster management attempts are replicated in the economic, environmental in addition to the social damage avoided during incidents of bushfires. It is normally predictable that if the preparedness level is highly undertaken then the damage becomes lower and in this case more benefits to the society (Handmer et.al, 2008).
The gains therefore goes up as efforts increases too although at a declining rate. The management cost however increases with further management efforts but an increasing rate. The various approaches employed are also useful as they capitulate the same result towards identifying economically effective and most favorable management problems (Handmer et.al, 2008).
Risk analysis and best measures
The appropriate disaster management decisions are very crucial to analyzing the risks involved as well as working towards the best measures. These are largely improved through information integration. They bring out familiarity of both the short and long term impacts of such disasters. For instance to understand the impacts of floods and to make appropriate plans requires significant analysis of relevant data such as soil characteristics, topography, population, vegetation, settlements, transportation, socio-economic as well as the materials (Handmer et.al., 2008).
This is because this information is acquired from different sources and therefore problematic to many vulnerable regions to collect them together. They are also play a significant role in developing preliminary information in order to come up with the disaster management system. Such type of information may be categorized into various related categories depending on the short and long term requirements. These include:
Pre-disaster activities: These involves researching and analyzing in order to enhance the already available knowledge base, risk evaluation, prevention, mitigation and disaster state of readiness.
Post-disaster activities: This involves responding to the crisis after the event of a disaster, making rehabilitations as well as doing reconstruction.
All these are done through the analysis on the pre-disaster on the affected region and the risks. The same applies on the post-disaster data concerning the impacts on the affected region and the available resources to encounter such disasters. In most cases the information requirements of disaster managers go beyond those of other organizations and in this case the data may already be stored somewhere else. At the national level normally are databases for a number of roles.
The implications to the delivery of normal services
Over the recent years disaster management has changed from being exclusively the task of conservators and continuation managers to presently being a corporate apprehension; this shows a positive result. It is also interesting to observe that although there exists a number of approaches to respond to the disasters, there exists also a higher level of uniformity within the organizations as to how the various disasters are managed as well as being dealt with (Gabriel, 2008).
The various incidents at the Victoria state, both small and huge, demonstrate that they are neither unyielding nor generally predictable in their outcomes; and in most cases things are not what are expected. It is therefore of great significance that the concerned bodies in Victoria focus their efforts on the outcomes rather than the causes. There is need for the managers to be familiar that handling disasters is more of an innovative process, and that there is no exactly an accurate way. And by coming up with a clear framework awareness of concepts and principles which allow the managers to handle the unexpected are developed (Hughes et.al, 2009).
There is an urgent need to come up with mechanisms consisting of many partnering groups for instance NGOs and communities around working in the affected areas. They should always be able to move on doing the process of monitoring and coming up with detailed, up-to date and relevant information from the affected persons. This however requires a lot of resources since they need transportation to the various locations of the affected areas. The data collected from such activities can be of significant role in the future assessment of such risks.
In each of the regions affected, there is an urgent need to employ the use of the media particularly the internet in order to combine the relevant actions with the rehabilitation programs going on. The appropriate resources, funds as well as other personnel also be directed on those actions so that the needs of the affected people along with the resources from well wishers and the skills and services of other experts could be put together. This would allow for on time and appropriate aid to many communities and households that were not assisted by either the management of their respective regions or NGOS (Eburn, 2005).
The management of the affected regions should also conduct vulnerability evaluations for the sake of preparedness, planning, risk reduction and risk analysis and do the facilitation as well along with the assistance of other autonomous organizations. Conducting vulnerability evaluations will be of significant role from various aspects. This will be able to strengthen the preparedness plans. This can also help in the reduction alternatives and population resettlement strategies depending on areas of disaster vulnerability. This should be done after the relocation of new infrastructures to safer areas.
There is also an urgent need for the emergency department to enhance data base management through relevant information gathering on the victims of the disaster as well as their subsequent needs, for instance, those of figures of the survivors and missing persons. It is however a fact that the process of accounting for missing persons is often difficult task, imprecise counts will seriously affect the scale of resources directed to affected persons. The victims in this case should be involved in gathering and ascertaining the truth of the data (Commonwealth of Australia, 2004).
Relying upon the officials and other observers can affect the credibility of the resulting data. The emergency department should also come up support facilities within the respective regions of the affected regions. These would serve as an advisory back up on disaster rehabilitation giving relevant advice and training within the respective nations to enhance the arrangements between the bodies involved. It will be also of great significance if a disaster risk management program is designed and put into use in accordance to priority basis so as to come up with the capacity involving the government and the society in general to put down the risks and enhance development gains.
In all the affected regions of Victoria State there is also an urgent need to bring all the people so that are able to organize them and formulate their personal decisions on their own short and long term goals. In most cases they are supposed to work as a group so that they are able to acquire permanent housing in regions where they are able to regain their former livelihood. This could possibly be areas that are not very vulnerable to such disasters. In all the affected regions of Victoria State the approach and priorities in managing the disasters should in most cases given advance evaluation of the concerned risks (IRFC, 2010).
Thereafter the institutional and legal systems should be empowered to combat disaster risk management. Great disaster preparedness and planning and reduction actions including training and capacity building should also be strengthened. This should be applied in order to come up with a strategy with regards to the extent of vulnerability and the risk frequencies of particular regions of the affected nations. Disasters are not a common occurrence and designing a disaster risk management for disaster risk is simply not cost effective. The strategy should therefore be designed on the basis of the vulnerability assessment (Emergency Management Manual, 2003).
Conclusion
Just like any development process, the directions delineated possibly will not all bring out enhanced future safety for all communities as well as more efficient and competent multiagency planning course of action. Change at all times requires an avoidance of the common previous practice (Gabriel, 2008).
Nonetheless, if the challenges of discovery are taken up by the various emergency service providers, their experiences will be crucial in the development as well as the improvement of the future with regards to emergency preparedness. Prevention of disasters or the reduction of their harshness is an important concern in emergency management, together with response and recovery. Emergency Risk Management, a focused application of risk management, is the main tool for working towards achieving the expected objectives.
References
Emergency Response Plan
Becker, V, etal. (2010). Emergency Planning and Community Right-To-Know Act: A Status of State Actions, National Governors’ Association.
Commonwealth of Australia. (2004). Natural Disasters in Australia: Reforming Mitigation, Relief and Recovery, Retrieved on September 7 from HYPERLINK “http://www.ga.gov.au/hazards/management/preparedness.jsp”http://www.ga.gov.au/hazards/management/preparedness.jsp
Commonwealth of Australia. (2009). Victorian Bushfires -.
Eburn, M. (2005). Emergency Law: Rights, Liabilities, and Duties of Emergency Workers and Volunteers. Federation Press.
Emergency Response Plan.(2009). Victoria Emergency Management Department:
Emergency Management Manual Victoria.(2003). Emergency Risk Management and Mitigation in Victoria.
Emergency Management Manual Victoria,(2010). State and Regional Emergency Management Planning.
Gabriel, P. (2003). The Development of Municipal Emergency Management Planning in Victoria Australia. The Australian Journal of Emergency Management.18 ( 2).
Hughes, R & Mercer, D.(2009). Planning to Reduce Risk: The Wildfire Management Overlay in Victoria, Australia.
Handmer, J & Hayness ,K. (2008). Community Bushfire Safety, Csiro Publishing.
International Federation of Red Cross and Red Crescent Societies (IRFC).( 2010).Legal Preparedness for International Disaster Response in Australia: Laws, Policies, Planning, and Practices.
Peters, E & Mc Entire, D, 2004, Emergency Management in Australia: An Innovative, Progressive, and Committed Sector.
Sinha, P.C .(2008) .Wind and Water Driven Disasters: Encyclopedia of Disaster Management Series. Anmol Publications.
Emergency Nursing Essay
Emergency Nursing Essay
Student Name:
University:
Subject:
Instructor:
October 10, 2013.
EMERGENCY NURSING CASESTUDY
Ryan should be in triage 2. This is because of the fact that patients in this cadre are critically ill and therefore demand medical attention within 10 minutes or else their situation will degenerate into more complicated forms (Berman and Kozier 2008, p.22). In most cases, these patients are normally brought to medical facilities by emergency ambulances. In Ryan’s case, he is complaining of chest pains and has become notably shorter of breath and distressed on route. From these observations among others, it can be suspected that Ryan may be having a right sided haemothorax (Eastman and Minei 2009). Also, Ryan should be in this triage because of the mere fact that he got retrieved from the accident scene by the Emergency Ambulance team half an hour after the accident had occurred and from this, he could be deep pain hence necessitating the need for immediate medical; attention without fail.
Kragh, Walters and Baer (2008) observe that haemothorax can degenerate into a situation where the accumulation of blood will start to exert pressure on mediastinum and trachea. This will strain the volume of blood that the ventricles of the heart are able to fill. Subsequently, this will further affect the trachea deviating to the unaffected part. This is what explains why Ryan should be in triage 2 where he is guaranteed medical attention at most within 10 minutes.
Priorities for care for Ryan
From the information given about Ryan’s situation, the first priority will be containing the chest pain, stabilizing breathing ability and nursing any injury sustained in the accident both seen and unseen (O’Shea 2011, p. 21).
According to Emergency Nurses Association (2008) chest pain and breathing inabilities could be a result of haemothorax which is right sided. Because of the dire dangers of these condition posses to the patient, immediate and decisive measures are needed that they can be limited and thus saving the already threatened life of the patient. First, it will be very prudent to remove the part that that causes bleeding and drain any blood and air that is in the thoracic cavity and the chest area. This is accomplished through the process of inserting a thoracostomy tube into the chest cavity and thus resulting in the expansion of the lungs thus preventing further bleeding.
While executing the above process, the danger of blood clogging in the tube is eminent. Therefore, to achieve effective and intended results for Ryan, better and effective drainage tubes are a necessity when draining the blood and air that might be in the chest cavity.
As earlier stated, the priority for Ryan’s treatment is to get him stable, stop any internal bleeding and drain blood and air from the bleeding and drain blood and air from the pleural cavity and also examine his entire body to establish whether there could be other hidden injuries that can pose a danger to hi healing process or at worse even his life.
A chest tube shall be inserted through the wall of the chest and made to drain the blood which is a result of draining and also air that could be in this cavity.
In situations where haemothorax may be complex and established that a tube alone cannot mitigate the oozing blood, thorascomy or surgery option may be explored. This will be administered with the sole intention of controlling and deterring the bleeding that could potentially worsen the situation. Therefore, for him to regain the lost blood that is highly needed for his recovery, proper diet especially on green vegetables and any other food that is rich in minerals is a must.
From the description of the whole accident that Ryan got involved in, it was a grisly scenario that must have left him in a shock. Therefore, Ryan also needs some professional counseling that will accompany other therapies so that he can regain his usual self. Though the time that the counseling can be done may be in contention, but it is a necessity for him to receive it and the earlier this therapy can be administered to him the quicker.
According to Blackbourne (2008), another priority of care for Ryan shall be identifying the genesis of the haemothorax and treating it. In Ryan’s case of accident, a tube is what is needed though surgical operation can be explored in situations of further complications. Ryan’s quick recovery can also be a top priority for the nurses attending to him. This can be achieved through a careful and systematic approach that can hasten his healing process without necessarily compromising its quality.
From the observation, Ryan has also sustained bruises especially the one that could have been caused by a safety belt. Such bruises if left unattended could also be a source of discomfort to Ryan who is also reeling from chest pain, breathing problems and even shock form the accident. Therefore, an emergency way of dressing such bruises can also be another priority Ryan also complains of nausea. This could be that when the TV flow. IV flow is higher chances are very high that the patient will vomit. Therefore in Ryan’s case it could be better if the IV flow can be adjusted so that he doesn’t vomit. This will further weaken him (Emergency Nurses Association 2010).
If an operation has been carried on Ryan or the point at which the drainage tube was inserted must be dressed. The dressing should be conducted to prevent any infection to the wound (Sinn 010, p. 17). The material chosen for such dressing should be of quality so as to promote faster healing
Also, another priority for Ryan will be the dressing on the wound that ought to be changed when: the wound is not dry and intact. This situation can be attributed to; symptoms of infection or any other worrying tendency like, example redness of the wound, swelling or discharges or no evidence for routine wound dressing after every three to seven days (O’Shea 2011).
It must also be emphasized that dressing of wound should be done carefully and in the right way to avoid further complications from the wound which can affect his recovery path.
Finally, the health priorities for a patient like Ryan can be many. However, compromises have to be made so as to ensure that the primary priorities for such patients are first addressed before other issues are dealt with. All these measures will be aimed at promoting his healing process while at the same time deterring the possibility of further complications from his conditions.
Pathophysiological Events and Nursing Considerations:
Hamathorax is contained first by removing the part that causes bleeding and draining any blood that might be in the thoracic cavity (Hewson, Poulakis, Jarman, Kerr, McMaster, Goodge, and Silk 2011). Through the process of tube thoracostomy, blood in the cavity is drained. This is done through the insertion of a chest tube thus subsequently, affecting the lung to expand hence stopping the bleeding. To prevent chest clogging or occlusion which potentially can lead to further complications like crippling effective drainage of the space in the pleural cavity, better performing chest tubes are a must.
Large diameter tubes or more than one tube are normally used with an intention of limiting clogging potentials and should clogging be detected, the patient always must transferred to a theatre with an intention of opening up the chest through a surgical process in order to get rid of pleural cavity clot.
Tambimuttu, Hawley and Marshall (2012) state that in an event that the clot persists in the chest tube that is being used to drain the blood and any air from the chest cavity, or in the pleural cavity, Thrombolytic agents are applied to break this up. Though this can be an effective way of dealing with blood clogging, it does pose a risk in that it can result in increased bleeding as a result of the thrombolytic agent that makes blood less thick thus causing over bleeding
In circumstances as listed below surgical operations shall be explored so as to reverse the trend of blood being less thick. These circumstances are;
First, if there is continued bleeding from the chest, a condition that can be explained a 150-200 ML/h for two to 4 hours
Secondly, if back to back blood transfusion is needed so that to maintain the haemodynamic stability in the body.
When draining blood and air from patients with a coagulopathy, great care and attention must be paid.
This caliber of patients includes those patients who are normally administered with anticoagulation therapies whenever need arises. At this stage, it must be noted that needle aspiration are not applied in an event where clotting deficiencies are prevalent. Instead, tube thorascomy is applied with a capability of visualizing and managing any bleeding from the chest wall. Out of necessity for patients who are in need of extended anticoagulant medication, such treatment mode can be re-continued after 8-12 hours after the thoracostomy has been done.
With the completion of tube thorascomy process, repeated chest radiographs should follow immediately. This will aid in the observation of the chest tube position hence assisting in observing how the exercise of evacuating the haemothorax from the chest cavity has been done. It may show other intrathoracic pathology that had been obstructed by the haemothorax.
Normally, a chest tube is placed to a water seal when the lung has been fully expanded through radiography. The drainage of fluid is usually less than 50ml within 4 hours and in these circumstances, residual air leak is limited.
There could be circumstances where a chest tube ought to be clamped. After the realization that air or liquid collection is absent through conducting follow up observation by use of radiography, the tube is removed. Also it is important that radiography is done after the removal of the tube to be certain of the absence complications should drainage be incomplete as shown by radiograph studies after the removal of thorascomy chest tube, a second tube should be done through the use of video-assisted surgery. (V.A.T) and a further operation conducted to completely drain the pleural cavity.
According to Blackbourne (2008) research has shown that 70-78% of patients with traumatic haemothorax usually get successful treatment through the use of theroscomy chest tube and therefore such patients demand no further therapies apart from one to three follow up chest radiographs within a span of 2-5 weeks to be certain of absence of intrathoracic collections that can degenerate to further complications.
Additional chest radiographs may be necessitated by the prevalence of other intrathoracic pathology besides other symptoms. Extended treatment will be dictated by the extent other injuries.
Research has shown that nearly 20% of the individuals who have undergone tube thorascoscomy will register amount of clot in their thoracic space (Eastman and Minei 2009). Although this is a grey area on what ought to be done, a number of opinions have been fronted on the best way of addressing this. These opinions do range from the follow ups after the initial process to evacuations through surgical methods.
Video- aided surgery (VAT) has tended to be the modern trend of addressing this medical malady. According to Manlulu, Lee, Thung, Wong, Yim (2012, p. 14), in some cases, it is administered within 7 to 8 days after the initial injury whereas others perform it within 2-3 days after retained clot has been noted in the chest cavity.
In situations where VAT is applied, one- lung ventilation is not a necessity. Instead one lumen tube is used to aid in ventilation during the whole process of operating the chest cavity.
Should cardiac, injury be noted, thoracotomy process should be reverted to and with speed so that further complications can be avoided.
The decision to employ VAT when dealing with retained clot is performed by the need to reducing the number of individuals who develops empyema and fabrothorax.
This process besides adding operative way of managing a patient, it does also provide an almost occurrence treatment mechanisms and decreasing the number of days that a patient needs to stay in the hospital unlike other methods.
Manlulu et al, (2012) further note that after thorascomy or VAT on those patients that generally like other patients because of diminished risks chest tubes is removed when drainage is about 25-50 ml.
After the removal of the chest tube, chest radiographs are taken to be sure that the healing process is on course as intended and no further complications are noted and if any, adequate measures are taken. Additionally, chest x-ray films can be obtained to enhance proper view and understanding of the whole healing process.
Haemothorax as a result of injury to the chest can be very tricky when handling it. It is therefore important that patients suffering from haemothorax when being treated are handled with utmost care.
This is what calls for utmost pathophysiological process and nursing consideration so that they can well be treated and timely healed where more than one treatment and timely healed. However, in some situations like retained, clotting where more than one treatment option exists, there ought to be an open approach to such an issue. This can be addressed through a more researched and a well versed option instead of applying options whose efficacy has not been tasted. In away, this will be a necessity since the issue at hand is the life of a human being that is hanging on balance and must be treated at all cost with utmost care.
Nursing management program for Ryan comprising relevant ED pathways and pharmacological management in ED:
It is apparent that Ryan is in a sorry health state and thus in dire need of emergency nursing measures. These measures will be directed to cardiopulmonary stabilization with an intention of limiting ventilator time and deterring sit upright unless other injuries hampers this position. Oxygen will be administered in order to give the patient breathing stability and air way should be released together with the breathing (Australasian College of Emergency Medicine 2011).
Because of Ryan’s conditions like, chest pain notably breath shortness, chest pain among conditions, there will be urgent need for his upright chest radiographs to be obtained so as to ascertain the extent of injuries to the chest and any other vital organs of the body. The aim of this is to establish the extent of the injuries and the most appropriate treatment to be adopted when treating the patient (Curtis and Ramsden 2011).
An extensive evaluation of the chest ought to be done to establish whether tension pneumothorax is prevalent and if so, appropriate measure adopted. To be sure of this, needle decompression of tension pneumothorax shall be used. If it is confirmed, emergency measures shall be undertaken to diffuse it otherwise it can lead to worse oxygen shortages and very low pressure of the blood subsequently resulting to sequelae ( a condition that is a result of trauma or injury) which can actually cause death (Tambimuttu, Hawle and Marshall 2012).
Given that Ryan has exhibited respiratory complication, a thorascomy shall be needed. As explained earlier, thorascomy involve insertion of chest to be to the chest cavity so as to draining any blood that might be in the thoracic cavity. The tube inserted will affect the lungs to expand thus preventing further bleeding.
If it is established that Ryan has sustained bruises especially the one caused by a seat belt, measures like application of liniment shall be undertaken so as to alleviate any pain caused by such bruises that results from accident.
If needed be strong pain killers can be administered so as to mitigate discomfort to Ryan who is also suffering from haemothorax (Australasian College of Emergency Medicine 2011).
Ryan is in pain majority form the chest and through needs emergency pharmacological management in the emergency department so as to alienate this significant pain management aspects have been derived so as to assist patients like Ryan who are in dire need of them.
A number of tests must be done on Ryan to establish the extent of the injury to his chest haemothorax (Eastman and Minei 2009). These tests include chest X- rays, Chest X-rays CT scans, pleural fluid analysis and thoracentesis
Emergency measures must therefore be undertaken on realizing that included Ryan is suffering from the already suspected haemothorax. The major target fro such treatment will be to make him (Ryan) stable hinder further internal bleeding and also getting rid of the blood and air that might be in pleural cavity.
A chest tube will have to be inserted to the chest cavity through the wall with a sole purpose of draining blood and air in this space.
If it is found out that the haemothorax is advanced, a surgical method (thorascomy) will have to be applied so as to aid in controlling further bleeding. There is a likelihood of blood in the chest cavity to thicken because of activation of clothing cascade.
Blood thickening will lead to clots in the pleural cavity resulting to chest tube occlusion. Subsequently, this will effect inhibition of proper drainage of the pleural fluid. Therefore, effective working chest tubes are needed in order to limit the clogging potential and its related complications.
Ryan must be administered with 100% oxygen through non-re breathen mask. This shall aid him in breathing having been noted to have breathing complication (Curtis and Ramsden 2011).
Another emergency response that Ryan desperately née is the completed examination of his body to be sure that all injuries sustained in the accident are attended.
It appeared that Ryan is only complaining of chest pain and that there are no other physical injuries , But a thorough examination of his entire body is a necessity otherwise if this is overlooked , a serious health issue could be underway that can greatly affected his healing process or even his health
Another emergency that might be needed for Ryan’s the use thrombolytic agents. These are used in situation where there are blood cloths. They are therefore used to diffuse clots in tubes or when such clots emerge in the pleural cavity. However, such procedure in risky because of the potential of leading to increased bleeding
In case bleeding persists, surgical operation will be a necessity especially if it has been caused by aorta rapture.
In summary pneumothorax is a bit common in trauma patients and therefore being able to promptly recognize the clinical aspect and also being able to aggressively care for the patient is of utmost importance. Therefore emergency departments (EDs) must have the necessary manpower with the best equipments so as to be able to fix such life threatening issues otherwise if left unattended; the life of a patient can be lost.
References
Australian College of Emergency Medicine 2010, The Australian Triage Scale. Carlton Vic.: Publisher.
Australasian College of Emergency Medicine 2011. Guidelines for implementation of the Australasian Triage Scale in Emergency Departments. Carlton Vic: Australasian College of Emergency Medicine.
Berman S and Kozier E 2008, Fundamentals of Nursing, Concepts, Processes and Practice. 8th Ed. Pearson, Prentice-Hall.
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