Question

The patient is a 37-year-old man 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.

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.

Answer 1

Insertion of nasogastric tube directly impacts the respiratory system. While inserting the nasogastric tube the ventilation can be affected. When this is interrupted the diffusion of the oxygenated gas is stopped and perfusion to the cells is stoped causing hypoxia . Unconsciousness can affect this process and increase risk for aspirations,bleeding ,injury in the respiratory tract.In order to prevent aspirations because of injury in the chest, the patient will be in need of nasogastric tube.

Severe trauma can affect the tissue perfusion. The renal perfusion can be interupted resulting in alterations in elimination naturally and thus affecting its perfusion.Similarly the tissue perfusion is affected when the central nervous system is affected in a motor vehicle accident. Hence in order to drain urine Foley's catheter would be used for patient in severe trauma.