Question

Scenario # 7 There has been a car accident and the driver if the car was brought to PRU. She has been stabilized in the emergency department; however, transferring her to another facility 40 miles to ICU away would not be appropriate in her health status for her injuries would not sustain life. The patient has to be placed in ICU in the next 1-2 hours. The night supervisory gains composure and describes the status of patients occupying the 4 ICU beds. Patient A- A 59 year old female, comatose, stroke victim who had been in ICU for 33 days; uncertain prognosis; retired, with no family Patient B- 2- week old premature male, has Down's syndrome and has been in ICU since birth; hospital has brought a legal action to permit surgery to repair a duodenal atresia, a procedure the parents had not permitted; family in adjacent city. Patient C- 35 year old male who underwent emergency appendectomy, developed severe wound infection and septicemia, source of infection is unknown; because of previous anaphylactic shock in reaction to antibiotics; requires ICU care; bachelor; aged mother in city. Patient D- 13 year old female undergoing chemotherapy for leukemia with an experimental drug; has been in remission three times in the past; close monitoring of the experimental protocol and potential reaction to drug requires ICU care; family in city. New Patient- 24 year old patient; college honor student in physics. scholarship winner; pregnant; engaged; no family known.

The supervisor ended the brief description by asking, "What should I do?"

Randall has to make a decision.

1. What should Randall do? Why is your choice the best answer? Support your thoughts.

2. What steps should be taken in reaching a decision?

3. Describe a means to avoid a similar problem in the future and how to deal with issues as they arise. (Adding additional ICU beds is not a budgetary or space option)

Write a 1 page report: 1” margins, single-spaced, 12-point font, Word document format (.doc or .docx)

Describe your facility

Describe your staff

Explain any legal or ethical issues of the situation

Explain your management style/theory

Discuss cultural issues that the situation presents

Explain budgetary plans or concerns

Explain credentialing or accreditation issues the situation present

Describe your response to the situation

PLEASE DON'T COPY AND PASTE FROM OTHER ANSWERS DO IT IN YOUR OWN WORDS

Answer 1

1. Randall can make a decision to shift the new patient, 24- female who is pregnant to a ward or even labour ward and occupy the new patient in that bed.
a pregnant woman is of course a venerable patient but she can be taken care of in the labour ward , and compared to other patients who need icu care it is better to shift the pregnant woman.
2. the steps that should be taken is to evaluate patients and see who needs the care the most. And who needs it the last of course every patient in the icu are sick. But if there is any chance of shifting the patient to an order place and taking a patient who needs more care than it has to be done.
3. to avoid similar problems, firstly the EMERGENCY DEPARTMENT should be made more equippable and only Patients who need utmost care needs to be sent to the icu , and also patients once stable should be moved to the wards.