The patient is a 35-year-old woman who was the driver in a high-speed motor vehicle crash. EMS reports that his vehicle was struck on the driver’s side by a truck and the victim had to be

The patient is a 35-year-old woman who was the driver in a high-speed motor vehicle crash. EMS reports that his vehicle was struck on the driver’s side by a truck and the victim had to be

extracted using the “jaws of life.” The patient was wearing a seatbelt, and he was unconscious when EMS arrived, but he has intermittently aroused reporting extreme pain in the chest and pelvis area. He arrives secured to a backboard with a C-collar in place. His breathing is uneven and becomes increasingly more labored as he is transferred to the ED stretcher. Vital signs are respirations 35/min; pulse 125/min; and blood pressure 86/40 mm Hg; cardiac monitor shows sinus tachycardia. The resuscitation team includes an ED health care provider, primary nurse, secondary nurse, respiratory therapist, and a UAP.

1. During the primary survey, what is the highest priorityintervention?

2. When assessing breathing during the primary survey, what is included in this assessment?

3. Discuss with a classmate several ways that assessment, interventions, and responsibilities could be divided between the primary and secondary nurse. (Use your critical thinking skills and discuss your answer with your instructor.)

4. What duties would be appropriate to delegate to the UAP?

5. What is the purpose of the secondary survey?

6. Why is the mechanism of injury (MOI) important in trauma cases? In the scenario above, speculate about the relationship of the mechanism of injury and the EMS report on thepatient’s complaints and injuries.

7. Using the concept of gas exchange, explain why the patient is likely to have a nasogastric tube. Using the concept of tissue perfusion, explain why a Foley catheter would be used for a patient with severe trauma.

8. When assessing the patient, you notice a strong odor of alcohol on his breath. The lab results indicate that his blood alcohol concentration (BAC) is 0.25 mg % (250 mg/dL). Your immediate concern for the patient is the possibility of
A. Respiratory arrest.
B. Vomiting with aspiration.
C. Onset of withdrawal symptoms.
D. A need for larger doses of analgesics.

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