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A 65-year-old male was brought by the rescue squad to the emergency room after being found comatose on the floor of his garage at the bottom of a 15-ft ladder. He was intubated at the scene for airway protection and remains unresponsive. Past medical history is unknown as a neighbor found the patient; however, the neighbor notes alcohol intake of unknown frequency or quantity. Computed tomography scan (CT scan) imaging of his cervical spine was negative but brain imaging showed diffuse, traumatic subarachnoid hemorrhage; small right-sided epidural hematoma (EDH); and large left subdural hematoma (SDH) with subsequent tentorial herniation. The left-sided SDH was evacuated and a hemicraniectomy was performed to minimize the mass effect of the cerebral edema. The patient was admitted to the neurocritical care unit (NCCU) for proper management and treatment. Foley catheter in place with clear yellow urine. Urinary output is within normal range. The patient initially regained some movement in the left upper and the left lower extremities postoperatively. But noticed of an acute loss of his left- sided motor function, right eye deviation, and in coma.

A 65-year-old male was brought by the rescue squad to the emergency room after being found comatose on the floor of his garage at the bottom of a 15-ft ladder. He was intubated at the scene for airway protection and remains unresponsive. Past medical history is unknown as a neighbor found the patient; however, the neighbor notes alcohol intake of unknown frequency or quantity. Computed tomography scan (CT scan) imaging of his cervical spine was negative but brain imaging showed diffuse, traumatic subarachnoid hemorrhage; small right-sided epidural hematoma (EDH); and large left subdural hematoma (SDH) with subsequent tentorial herniation. The left-sided SDH was evacuated and a hemicraniectomy was performed to minimize the mass effect of the cerebral edema. The patient was admitted to the neurocritical care unit (NCCU) for proper management and treatment. Foley catheter in place with clear yellow urine. Urinary output is within normal range. The patient initially regained some movement in the left upper and the left lower extremities postoperatively. But noticed of an acute loss of his left- sided motor function, right eye deviation, and in coma.

Phlebotomy Essentials
Phlebotomy Essentials
6th Edition
ISBN:9781451194524
Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)
Chapter1: Phlebotomy: Past And Present And The Healthcare Setting
Section: Chapter Questions
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TRAUMATIC BRAIN INJURY CASE SCENARIO

1. Discuss the disease or the condition on the case presented, that includes the definition, epidemiology, signs and symptoms, treatment and management. (please include a lot and important information thank you so much)

2. Create 2 NCP based on the given case scenario that needs to be prioritized. Thank you!

Subjective Data: Unable to obtain due to coma Objective Data: • Vital signs: Temperature - 97.6°F, heart rate 105 beats per minute; systolic blood pressure 148 mm Hg; mean arterial pressure 80 mm Hg; oxygen saturation 98% on 40% oxygen; respiratory rate is 18 breaths per minute with a set ventilator rate of 12 breaths/minute. • Intracranial pressure is 18 mm Hg with a cerebral perfusion pressure of 70 mm Hg. • The intraventricular catheter is leveled at 10 mm Hg and is actively draining clear cerebral spinal fluid. A normal intracranial pressure waveform is noted. • Medications: Normal Saline Solution at 75 mL/hour. Nicardipine IV infusion 5mg/hr. Propofol infusion has been off, and Fentanyl was given 6hrs ago. • Laboratory findings: sodium 142 mEq/L, blood urea nitrogen 8 mg/dL, creatinine 0.7 mg/dL, glucose 105 mmol/L, white blood cell count 11,000 cells/mL, hemoglobin 11 g/dL, platelets 205,000/µL, urinalysis and toxicology screen are both negative. Diagnostic Findings: • Immediate radiographic, diagnostic testing with a non-contrast CT scan of head. • MRI – few days after - showed severe diffuse axonal injury (DAI)
Transcribed Image Text:Subjective Data: Unable to obtain due to coma Objective Data: • Vital signs: Temperature - 97.6°F, heart rate 105 beats per minute; systolic blood pressure 148 mm Hg; mean arterial pressure 80 mm Hg; oxygen saturation 98% on 40% oxygen; respiratory rate is 18 breaths per minute with a set ventilator rate of 12 breaths/minute. • Intracranial pressure is 18 mm Hg with a cerebral perfusion pressure of 70 mm Hg. • The intraventricular catheter is leveled at 10 mm Hg and is actively draining clear cerebral spinal fluid. A normal intracranial pressure waveform is noted. • Medications: Normal Saline Solution at 75 mL/hour. Nicardipine IV infusion 5mg/hr. Propofol infusion has been off, and Fentanyl was given 6hrs ago. • Laboratory findings: sodium 142 mEq/L, blood urea nitrogen 8 mg/dL, creatinine 0.7 mg/dL, glucose 105 mmol/L, white blood cell count 11,000 cells/mL, hemoglobin 11 g/dL, platelets 205,000/µL, urinalysis and toxicology screen are both negative. Diagnostic Findings: • Immediate radiographic, diagnostic testing with a non-contrast CT scan of head. • MRI – few days after - showed severe diffuse axonal injury (DAI)
A 65-year-old male was brought by the rescue squad to the emergency room after being found comatose on the floor of his garage at the bottom of a 15-ft ladder. He was intubated at the scene for airway protection and remains unresponsive. Past medical history is unknown as a neighbor found the patient; however, the neighbor notes alcohol intake of unknown frequency or quantity. Computed tomography scan (CT scan) imaging of his cervical spine was negative but brain imaging showed diffuse, traumatic subarachnoid hemorrhage; small right-sided epidural hematoma (EDH); and large left subdural hematoma (SDH) with subsequent tentorial herniation. The left-sided SDH was evacuated and a hemicraniectomy was performed to minimize the mass effect of the cerebral edema. The patient was admitted to the neurocritical care unit (NCCU) for proper management and treatment. Foley catheter in place with clear yellow urine. Urinary output is within normal range. The patient initially regained some movement in the left upper and the left lower extremities postoperatively. But noticed of an acute loss of his left- sided motor function, right eye deviation, and in coma.
Transcribed Image Text:A 65-year-old male was brought by the rescue squad to the emergency room after being found comatose on the floor of his garage at the bottom of a 15-ft ladder. He was intubated at the scene for airway protection and remains unresponsive. Past medical history is unknown as a neighbor found the patient; however, the neighbor notes alcohol intake of unknown frequency or quantity. Computed tomography scan (CT scan) imaging of his cervical spine was negative but brain imaging showed diffuse, traumatic subarachnoid hemorrhage; small right-sided epidural hematoma (EDH); and large left subdural hematoma (SDH) with subsequent tentorial herniation. The left-sided SDH was evacuated and a hemicraniectomy was performed to minimize the mass effect of the cerebral edema. The patient was admitted to the neurocritical care unit (NCCU) for proper management and treatment. Foley catheter in place with clear yellow urine. Urinary output is within normal range. The patient initially regained some movement in the left upper and the left lower extremities postoperatively. But noticed of an acute loss of his left- sided motor function, right eye deviation, and in coma.
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