Running head: Deteriorating Patient
The Deteriorating Patient
Student Name
University Name
Unit Name
The Deteriorating Patient:
Introduction
James "Jimmy" Parsons is a 26-year-old flight engineer who was admitted to the hospital in a senior dependent department about 46 hours ago. On Saturday night, he went out with friends to qua
el with a group of bars, while another group of men made rude remarks about Mr. Parsons' female acquaintances. In this qua
el, one of them was allegedly playing Mr. Parsons on his face, and as a result he lost consciousness, fell, and slammed into the back of his head on the sidewalk. After a
iving at the emergency department, he underwent an urgent CT scan of the
ain and found subdural hemo
hage with 1 cm midline shift and hemo
hage, and intra-operative bleeding. Codman's intracranial pressure monitoring device was placed to monitor ICP levels after surgery. In the evaluation of ED, Mr. Parson's blood alcohol concentration was improved, and his blood toxicology screening results showed that the illegal substance was negative. Immediately after surgery, he was considered stable. He was extubated about 6 hours ago and is now Hiflow nasal plug (HFNP).
Option 1: Traumatic Brain Injury
Discussion
Past Medical History
Type 1 diabetes, smokers (7-10 per day), social drinkers (6-10 beers on weekends), wisdom teeth extraction x 4 (2010). He lay on his back (30% on the bed), Codman's ICP monitors the in situ, GCS 10/15 (E3, V3, M4), the pupils are equal, responding to light and adaptability. There is visual evidence of the raccoon eye and the battle sign (on the right). Physical and psychological effects can be widespread in the injury of the injured
ain. Some signs or symptoms may appear immediately after a painful event, others may appear for days or weeks. Signs and symptoms of troubled
ain injury (TBI) are subtle in this case (Armstrong, 2018). TB symptoms can not appear until the day after the injury, or sometimes James may be able to work or act differently, but James may not appear to be hurt as it appears to be good. After TBI, any of the following symptoms may occur suddenly or worse, especially within the first 24 hours of infection, people should not immediately see medical professionals immediately.
Test Reports
ICP (mmHg) 10 12
Temperature (°C) 36.9 37.2
Breathing (
eathing / minutes)
18 (eupnic) 23 (increased work of
eathing, related to excitement)
Blood pressure and mean arterial pressure (MAP) (mmHg)
128/92(98)122/68(86)
Heart rate (beats/minutes)
87 96
SpO2 (Fio2) 97% (Fio2 30%, 30L high flow nasal congestion (HFNP))
96 (FiO2 30%, 30L, HFNP)
BGL 6 (2 units / hour of Actrapid infusion)
6.4 (2 units/hour of Actrapid infusion)
At 13:00, Mr. Parson's tachycardia was HR 118 with no obvious predisposing factors, and the 12-lead ECG confirmed that the rhythm was sinus tachycardia.
Pathological outcome
He lay on his back (30% on the bed), Codman's ICP monitors the in situ, GCS 10/15 (E3, V3, M4), the pupils are equal, responding to light and adaptability. There is visual evidence of the raccoon eye and the battle sign (on the right).
Critical plan of care
Between fifteen to 14 years of adult age, TBI is more in adult adults. It is also important to mention here that the receipt of a person's life with TBI, which has continued to be mobile, is reduced only after four to five years, but for those who have low mobility; Depending on the...