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• W1520683886 abstract "ABSTRACT Background Patients with severe, multiple, traumatic injuries are challenging to manage in critical care. Early identification of injuries and optimal resuscitation is essential for favourable outcomes. Trauma‐related haemorrhage can lead to the lethal triad of hypothermia, coagulopathy and acidosis. Many trauma patients require urgent haemorrhage control and structural fixation through operative intervention. However, metabolic derangement and cardiovascular instability may delay surgery, resulting in an ongoing cycle of deterioration. Damage control surgery ( DCS ) may be used as a temporizing measure until the patient is stabilized in critical care. The aim of this case study is to discuss the complex issues faced in the critical care management of a severely injured patient. Design We conducted a patient case study, with analysis of care using published evidence. The key terms used to search for evidence were trauma, injury, damage control surgery, spinal fixation, critical/intensive care and nurse. Results We report the care of a trauma patient with complex, conflicting injuries requiring management of the lethal triad and DCS . The delay in subsequent definitive repair of spinal column fractures provided many challenges for critical care nurses including restricted patient mobilization, positioning and pressure ulcer prevention. A review of contemporary evidence relating to DCS reveals that whilst this technique is used increasingly in trauma, the research focuses on single system injuries. Conclusion Evidence and guidelines are required to support DCS for critical care patients with multiple, conflicting injuries including spinal fractures. For patients with delayed surgical intervention, rotational bed therapy may assist critical care nurses in meeting needs." @default.
• W1520683886 created "2016-06-24" @default.
• W1520683886 creator A5014355572 @default.
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• W1520683886 date "2013-05-01" @default.
• W1520683886 modified "2023-10-03" @default.
• W1520683886 title "Nursing challenges with a severely injured patient in critical care" @default.
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• W1520683886 doi "https://doi.org/10.1111/nicc.12019" @default.
• W1520683886 hasPubMedId "https://pubmed.ncbi.nlm.nih.gov/23968442" @default.
• W1520683886 hasPublicationYear "2013" @default.
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