Page 286 - Critical Care Nursing Demystified

Chapter 6 CARE OF THE TRAUMATIZED PATIENT 271

posterior parts of the body for injury. A more focused, thorough assess-
ment of the area of pain or obvious deformity is conducted. An in-depth
patient history is obtained as further information is forthcoming from
the family and the EMS team as to the specifics of the trauma, medical
history, and whether drugs and/or alcohol were involved. Diagnostic
studies such as x-rays, CAT scans, EKG, hemoglobin, and hematocrit are
performed. A chemistry profile and arterial blood gases are ordered and
completed.
The most common type of shock is hypovolemic. Instances of hemor-
rhage must be identified and corrected with blood products to replace
intravascular volume and the oxygen-carrying capacity of the blood. Fluid
replacement is needed in the form of lactated Ringer’s solution, which are
crystalloids, or plasma and albumin, which are colloids. Intravenous fluids
can be warmed and utilized along with warming blankets to correct and
prevent hypothermia. Urinary catheters are inserted to monitor hydration
levels through urinary output.

5. Definitive care – Specific injuries are taken care of during this phase such
as surgical interventions, suturing of lacerations, jaw wiring, reduction of
fractures, and cast applications. Downloaded by [ Faculty of Nursing, Chiangmai University 5.62.158.117] at [07/18/16]. Copyright © McGraw-Hill Global Education Holdings, LLC. Not to be redistributed or modified in any way without permission.
6. Critical care – Seriously or critically ill patients are cared for postopera-
tively or directly admitted from the emergency room to the critical care
unit as needed for intensive follow-through care.

Medications Used in Trauma Care

5 Spinal Cord Injury (SCI)

Medication Action Nursing Actions
Histamine-2 Reduces ulcer formation 1. Usually administered IV
antagonists from traumatic stress
Methylpredni- Suppresses the inflam- 1. Assess patient for adrenal
solone matory response by insufficiency
decreasing spinal cord 2. Monitor I and O
edema
3. Assess for headache or
change in LOC
4. Monitor for signs/symptoms
of infection

(Continued )