Use Of A Tourniquet Is An Effective Means Of Arresting Lives Threatening External Hemorrhage From A Limb Injury

During the first week of our new nurses in a surgical ward, I was supervising one of the supernumerary nurses. We were looking after a thirty-nine year old woman, Ms LC, who had undergone a laparoscopic peritonectomy. We had to start her on a negative pressure wound therapy dressing or NPWT; as suggested by wound clinical nurse consultant and the doctors during their ward round, since this would allow the fast healing of her wound.

Pressure ulcers are one of the most common problems health care facilities often face which causes pain and discomfort for the patient, cost effective to manage and impacts negatively on the hospital (Pieper, Langemo, & Cuddigan, 2009; Padula et al., 2011). The development of pressure ulcers occur when there is injury to the skin or tissue usually over bony prominences such as the coccyx, sacrum or heels from the increase of pressure and shear. This injury will compromise blood flow and result in ischemia due to lack of oxygen being delivered (Gyawali et al., 2011). Patients such as those who are critically ill or bed bounded are at high risk of developing pressure ulcers (O'Brien et

Jane presented with a wound to her lower left leg which, following a holistic assessment (appendix 2), was diagnosed as a venous leg ulcer. The assessment was conducted in accordance with Local PCT Leg Ulcer Guidelines (appendix 3) as well as RCN Guidelines (RCN 2006) to rule out other possible aetiology such as arterial ulceration, diabetes or malignancy (Moloney and Grace 2004). Although traditionally considered uncommon, recent studies suggest that malignant ulcers are more prevalent than previously thought (Miller et al 2003, Taylor 1998) therefore even though initial assessment suggests an uncomplicated venous ulcer, if Jane’s wound fails to heal following appropriate treatment then specialist advice will be sought. Between 17% and 65% of people with a leg ulcer experience severe or continuous pain with a major impact on quality of life (Briggs and Nelson, 2003) and effective pain relief is important to maximise quality of life, to enable mobilisation and improve appetite to facilitate wound healing. Fortunately, Jane experienced no pain from the leg ulcer prior to or at the time of assessment. However, careful review and monitoring of any pain will be important throughout the treatment process as the first line of treatment for uncomplicated venous leg ulcers are compression systems (RCN 2006) and although compression counteracts the harmful effects of venous hypertension and

It required considerable surgical skill. Resection also carried a high risk of profuse bleeding and infection. Successful resections allowed the patient to keep the limb, although it was limp and useful to merely “fill a sleeve”. An amputation was a surgery where a circular cut was made completely around the limb, the bone was sawed through and the blood vessels and arteries were sewn shut. To prevent future pain, the nerves were pulled out as far as possible, cut, and released to retract away from the end of the stump. Clippers and a rasp were used to smooth the end of the exposed bone. Sometimes the raw and bloody stump was left untreated to heal gradually, sometimes the excess skin was pulled down and sewn over the wound. Speed was essential to lessen blood loss and prevent shock. An amputation at the knee was expected to take 3 minutes. It was also the most common civil war surgical procedure.

A full assessment of the wound should be carried out prior to selection of dressings. Any allergies should also be noted. The wound should be traced, photographed and measured providing data for comparison throughout the treatment. Consent should be gained prior to photographing the wound and the patient should not be identifiable from the photograph (Benbow 2004). All information should be documented in patients’ records, using the wound assessment tool. The pressure sore was identified as grade two

“At some point, you just pull off the band-aid and it hurts. But then its over and it hurts, but then its over and you’re relieved”. – John Green. The adhesive bandage, or now known under its commercial name the band-aid is a invention discovered by Earle Dickinson in the 1920s made form gauze and plastic to heal minor wounds.

All over the world, with every new war breaking out, new medical innovations came with it. With each fatal injury incurred on soldiers it was up to surgeons to come up with effective solutions. According to most experts at the time of WW11 stopping the bleeding was in quote "the most vital step" to buy time for the soldier to recuperate and survive, better limb amputation methods led to significantly decreased deaths because of shock or bleeding out. Even today, in specific times in particular during the Afghan war, American medics brought into life new clotting agents that gave the injured more time to get full treatment at a hospital. Another tool that at first was frowned upon by medics

The ulnar or medial collateral ligament is one of two ligaments that is a part of the elbow joint, running along the medial side of the arm and acts as the connection between the distal portion of the humerus to the proximal portion of the ulna. The ulnar collateral ligament is largely responsible for the stability and use of the elbow as well as assisting in the flexing and extending of the arm. The ulnar collateral ligament can become overly damaged in a few different ways, such as a broken arm where the broken fragment of bone severs the ligament, or a severe impact or collision that causes the ligament to stretch beyond its elastic capabilities, leading to a sprain or even a tear. While this type of traumatic injury is highly possible, the most common

Tie the tourniquet around the patient’s arm at about 7 to 10 cm above the venipuncture site.

The article discusses the importance of leadership and teamwork in trauma and resuscitation. It describe how leadership and leadership styles affect patient care, and looks into figuring out how to train future physician leaders. The article states that “according to the Centers for Disease Control and Prevention, unintentional injury remains the leading cause of death in people under 44 years of age and the fifth overall cause of death in the United States.” Furthermore, stating that the lack of proper leadership contributes to this cause. An example used in the article to describe a common seen lack in leadership was an ER physician and a Trauma physician working parallel of each other trying to execute their own plan. Although it may seem

According to the reporter (father), the mother (Joanne) would beat Claude with an extension cord, and burn him. She last beat him with an extension cord on last Monday, and he had/has bruises on his back. Claude was recently burned (the week of intake) with a cigarette under both of his eyes. The reporter did not know the reason Joanne would do this, but she does it often. Joanne would take him to Dr. Warrington in Clarksdale, MS, and would say that another children done it to him. Claude has scratches in his face, and the reporter thinks he is going to go blind soon because Joanne keeps beating him in his eyes. Whenever she gets into it with her boyfriend (Leroy), she would take the anger and pressure off on Claude and Jeremiah. The reporter

In 1920, Earle Dickson made an invention that would change every parent's, child's and chef's life; the band-aid. Earle's wife was a bit of a klutz and she frequently burned or cut herself while cooking. One day after an especially bad cut, a lightbulb went off in his head. He had a brilliant idea. He cut patches of gauze and applied them to strips of adhesive tape, which he then covered with the fabric crinoline. Dickson worked at Johnson & Johnson, and he thought that everyone there would be impressed with his new invention. Sure enough, when he pitched the idea, his boss loved it. For almost 100 years his invention has helped millions of people, and most importantly me.

There has always been a need for constant innovation in the healthcare industry. A novel invention at its inception, the liquid bandage is “a colorless adherent material that can be sprayed or painted directly on a wound.” They work by sealing off the affected area from the outside until it has fully healed, when it slips off. The time it takes for healing or time it takes before slipping off depends on the type or make of the liquid bandage. The key advantage of the liquid bandage is the ability to apply the product in situations where traditional bandages have been proven ineffective and lackluster, such as on rough parts of the body or under water. However, this innovation has not resulted in plastic or paper bandages being considered as

There are bound to be some differences including better conditions. Nevertheless, the raft that Louie and his friends lived on for over 35 days, was poorly stocked. In different circumstances, if their friend, Mac, hadn’t ate their food supply, they still had both rafts, and if their raft was stocked properly, they might’ve been able to live in better conditions on the raft, and if not in better conditions than longer. Another reason, that there would be some differences would be because of the different time period and development in technology. They are bound to have new rafts that would be far superior and of finer quality than those of the past. As to Louie and his friends being found by the American’s sooner than the opposing side, we

A.D.Van Velzen et al (2005) conducted an experiment to compare the outcome of early treatment using elastic bandaging and rigid dressing and it was found that rigid dressing can reduce the risk of knee flexion contracture. In the research, the subjects were divided into three groups: (i) traditional elastic bandaging (ii) immediate fitting method and (iii) delayed fitting method. In the first condition, the stump of the subject was covered with a dressing bandage. Elastic bandaging was started once the wound has healed and after the removal of stitches. The subject was fitted with a regular prosthesis once the stump edema has minimized. It takes few months from amputation to the delivery of prosthesis. Before the subject gets any prosthesis, he/she was trained to walk by using air splints or