![]() The interventional Radiologist attempts to place a Femoral guided catheter to provide thrombolysis of the pulmonary embolism, but is unsuccessful. CPR is initiated, and the patient is intubated. Scenario 5 Patient goes into electrical mechanical disassociation (EMD) with no palpable pulses. The nurse calls the Rapid Response team (RRT) to radiology stat, and tells the radiology tech to get the interventional radiologist. She tells the nurse she can't breathe, and becomes inconsolable. Vital signs are BP: 130/72, P: 92, R: 28, T: 99.1 F, 37.3 C, PaO2: 94 Scenario 4 As she is preparing to go into the CT scanner, Jody becomes very short of breath and panicked. The surgeon orders a D-dimer blood test, a computerized tomography pulmonary angiography (CTPA), and a ventilation-perfusion scan, a V/Q scan. The treatment does not relieve her shortness of breath, but her lungs are clear bilaterally. The surgeon is called, and he orders Respiratory Therapists to give a nebulizer, as he thinks it is probably her asthma. Her mother is very concerned and insist that they run more tests. Vital signs are BP 113/60 P 76 R 18 PaO2 96 T 99.1 F, 37.3 C Scenario 3 Jody is more awake, but has become anxious. The nurse explains that she is receiving Fentanyl for pain, and is not yet fully alert from the anesthesia. ![]() The patients mom is concerned that Jody does not seem herself, and is a little confused. Scenario 2 Jody's parents arrive and are visiting with her. The nurse is trying to get her to use her incentive spirometer. She has an 18-gauge IV Cath to left forearm that anesthesia started in the OR. Her VS are stable, and her Foley is draining clear urine. She has good sensation in her operative leg, and can wiggle her toes. They performed an open reduction internal fixation (ORIF) with two plates and eight screws. Jody Rush Scenario 1 Jody is back from the OR resting quietly. He's being admitted for pain control, close observation of his intralocular pressure, and head injury. He has a 20g SL to his right hand, that was started in the ER. His pain has been well controlled with IV morphine 4 mg, q3 hours. His visual acuity is diminished, and the whites of his eyes are hemorrhaged. There is significant edema and discoloration to the left side of his face, and his left eye is almost completely swollen shut. They were not concerned as his intraocular pressure was normal in the ER. The Maxillofacial surgeon was consulted, and they will see him this morning. He was unable to sleep later in the evening as the pain became worse, and his vision became more impaired. The patient stated that there was significant swelling, but his vision was fine, and the pain was controlled with beer and 800mg of Motrin. They applied some ice to his face, and he decided to go to the post game keg party instead of coming to the ER. Apparently he was pitching, and the batter hit a line drive hitting him in the right side of the face. He was hit in the left eye by a softball yesterday. Wight Goodman Wight Goodman, Patient was admitted to the floor last night from the ER for an orbital fracture. Patients affected extremity has normal pulses, and the capillary refill is less than 3 seconds. There was some concern that she may have sustained a head injury as she has an abrasion to her forehead, but she denies ever losing consciousness. We just received an order for a foley catheter. We were able to get her on a bed pan earlier, but it took a lot of work. She was on a ski trip with some of her friends from college her best friend has been camped out with her. Her parents are on their way they are flying in today. She has a history of exercise induced asthma, and uses a rescue inhaler, Albuterol. She was nauseated after her last Fentanyl dose, and the Dr. ![]() She has been in a lot of pain, and has been receiving 25 mcg IVP, q2 hours Fentanyl for pain. She is in a traction splint, and will be going for surgical repair today. Jody Rush Jody Rush, 20 y/o female, admitted for right femur fracture status post skiing accident.
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