assignment
At the scene: Around 11:00 PM: Matthew Smith, a 25-year-old male driver, was involved in a car collision. During the winter storm, he lost control and hit a power pole. The mechanism of injury was a front impact at 70km/hr. The front part of the car was severely damaged, and the front window was smashed. Matthew was restrained by a seatbelt, and the airbag was deployed. Due to the nature of the collision, there was a prolonged extrication time during which he was exposed to rain. At the scene, the ambulance crew noted Matthew was conscious, GCS 14 (E=3, V= 5, M=6) eyes open to voice. He presented with labored breathing, RR 22, SpO2 97%, on RA, BP 100/60mmHg, HR 93 bpm, T 35.3°C. On chest and abdominal inspection, a seat belt sign was noted crossing from the R shoulder down to the R chest and at the level of the anterior-superior iliac spine. The paramedics applied cervical collar and spinal precautions, inserted a gauge 16 IV access placed in the R cubital fossa, Hartman’s fluid was started, and Matthew was transferred to ED urgently. In ED: At 11:45 PM: Matthew was brought in by ambulance, he was triaged to the resuscitation bay. The trauma team transferred Matthew to the hospital bed, received handover from the paramedics and started the primary survey. On admission, Matthew was able to answer questions, and no blood in the mouth or airway obstruction was noted. The airway team removed the cervical collar and examined Matthew’s neck, head, and spine. There is no evidence of spinal and head injury, and spinal precautions were ceased. On chest auscultation: normal breath sounds bilaterally, RR 22, SpO2 96% on RA. The seatbelt sign was noted crossing from the R shoulder down to the R chest and extensive bruising at the level of the anterior-superior iliac spine. Matthew also presented two minor wounds, abrasions in the R shoulder and R arm. On abdominal palpation, he presented abdominal guarding pain 6/10 and distension. Cardiac monitoring showing sinus tachycardia, HR 126; BP 88/60 mmHg; peripheries were cool and capillary refill was 3 seconds, 16 IV access placed in the R cubital fossa is patent, received 500 ml Hartman’s fluid bolus by the paramedics. Matthew’s GGS 14 (E=3, V5, M=6) eyes open to voice; BGL 5.0 mmol/L. T 35°C. As the primary survey is underway, the trauma leader is starting the priority interventions to manage Matthew’s case. He states he weighs approximately 105 kg, and he is 1.75 m tall. Past medical history: Matthew is allergic to penicillin. The team has not yet performed full medical history. Next of kin, Matthew’s parents have been notified and are on their way into ED. address the following sections: 1. Patient situation. (a) patient identification (b) patient's situation leading to the current presentation and the timeframe of the events(c) patient's medical background (d) provide critical observations done during the pre‐hospital and triage 2. Collect cues. outlining the most recent and relevant patient assessment findings, including the time using A-E assessment tool. Also, provide normal range values with in text referencing. 3. Process information. analyze the cues (collected in section 2) and distinguish between the relevant and irrelevant information. Cluster cues together and identify relationships between them. Match the clustered clues with the relevant patient situation and describe the underlying pathophysiology of the patient's condition. 4. Identify critical problems. priorities three (3) relevant and time‐critical actual nursing diagnosis for the patient. 5. Identify interventions. present two time‐critical interventions for each identified critical problem (6 in total). Time‐critical interventions are actions that would assist in preventing the deterioration in the patient's condition. The interventions need to state what needs to be done, how this will be done, when and how often it will be done. 6. Explain the rationale behind the interventions. explain why the interventions are indicated and how they will prevent the patient's deterioration. The rationale for the interventions must be explained and supported by the underlying pathophysiology and the evidence‐based literature. 7. Detail the outcomes for each intervention The outcomes include ranges, values, measures, and behaviors (e.g., BP, HR, urine output and pain level) to guide whether the interventions improved the patient's condition. 8. Reference List APA 7 referencing