Care Of The Patient With Multi System Organ Failure

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Saint Anselm College
Manchester, NH

NU 450: Senior Synthesis

Name: Christina Delaney Preceptorship Faculty: Welch

Critical Care Case Study: Care of the patient with multi-system organ failure
Allen Hale, 27 years old, was admitted to the ED of a community hospital after running a red light in his car and colliding with another car. The patient was intubated in the field. A left pleural chest tube was placed in the ED. He also has a visibly fractured left femur. A total body CT scan reveals a left parietal subdural hematoma and a flail chest with L pneumothorax and pulmonary contusions. He has no intra-abdominal issues.
Since Allen arrived in the ED, he has been responding to noxious stimuli only. His blood alcohol level was 200 mg/dl (0.2% weight/volume) and there was indication of marijuana on his toxicology screen. The health care team was unable to determine if he had a durable power of attorney or any family who could make a decision for him. He needs to go emergently to the OR. How should the healthcare team proceed prior to surgery?
1. List 3 rationales for proceeding with surgical intervention with an individual who may be unable to give fully informed consent.
a. The patient is unconscious and the probability of harm with out the procedure is greater than the risk of harm from the procedure itself
b. Irreversible harm or death can occur if the procedure is delayed in emergent situations
c. When there is no family of the patient around to act for
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