Cervical Spine Injury - Essay Example

?Essays in Health Sciences and Medicine Part one Cervical spine injury is defined as a post traumatic injury to the cervical spine that results in the displacement of the vertebra. They have various classifications and these depend on location, mechanism of injury, relative stability, fracture type and presence of neurological involvement (Timothy, 2004, p. 2). Cervical spine injuries are recognized in the pre- hospital setting and there are a few methods of management that have been put forward as important in addressing these injuries. In these types of injuries it is common to find two situations: one where the patient is complaining of neck pain and thus can alert rescuers and second where the patient remains unconscious and cannot alert rescuers and this puts them in a vulnerable position (Timothy, 2004, p. 2). The latter could lead to an impairment of the neurological function by pathological motion of the cervical vertebra. The pre-hospital management in the first instance would be the immobilization of the cervical spine to prevent undue movement in the extraction process (Bronwyne, 2007, p.88). The spinal immobilization devices that are used by the rescuers consist of a hard collar with supports on either side of the head and the patient lying on a spine board with the head strapped on the board with the neck in a neutral position. High cervical spinal cord injuries are prone to airway compromise and this necessitates for respiratory support measures (Timothy, 2004, p. 2). Part two Shift work has been cited by many researchers as a cause of many problems to people engaged in activities that extend beyond the normal day. There are many professions that embrace the aspect of shift work and emergency response service is among them. The ambulance staff faces both health problems and social problems as a result of the effects of shift work. There are many strategies that have been proposed to address this but the problem still persists (Parkes, 2005, pp.2-8). Shift work has been linked to a variety of problems on ambulance staff. The first problem is that of disruption of the circadian rhythms and this has led to sleep/wake disturbances, desyncronization of internal processes and increased susceptibility to diseases (Parkes, 2005, pp.2-8). The second is that it has also led to disturbed socio-temporal patterns and this has resulted from atypical work hours that lead to many family problems such as divorces, reduced family support as the individual is most of the time away from the home and stress as a result of fatigue. (Parkes, 2005, pp.2-8). The third effect is unfavorable changes in health behaviors where individuals have been seen to start smoking, there is poor diet and irregular meals. Another problem that has been cited as a result of sleep loss and fatigue is the impairment of cognitive performance and this is especially true for tasks that require high concentration and decision making and this has led to accidents and injuries to patients being rescued (Pisarski, Bohle, & Callan, 2002, pp. 119-126). Part three Sepsis is a condition that occurs in which the body tries to fight a severe infection that has spread in the bloodstream. Septic patients have low blood pressure which leads to poor circulation of blood in the body and lack of perfusion of important tissues and organs. It can be caused by the body’s own defense system or from toxic substances from bacteria, viruses or fungi. Various people are at risk of developing sepsis and these include people with AIDS, young babies whose immune system is still undeveloped and the elderly (Collop, 2006). Ambulance staff plays a big role in the recognition and care of patients with sepsis. Many emergency responses have shown that the ambulance staff has contributed a lot to the early recognition and treatment of sepsis. A tool has been identified to help in the identification of sepsis and this is called the “sepsis six” tool. First the patient is assessed for temperature, heart rate, respiratory rate, mental status and glucose level. If these are found to be above or below normal levels the patient has signs and symptoms of infection. Then patient history is assessed to find out if it is a new infection. If the results are positive for new infection the patient has sepsis. The patient is then assessed for other new conditions such as blood pressure, oxygen saturation, passing of urine and lactate. If the result is positive then the patient has severe sepsis if no the patient has sepsis but no organ dysfunction (Robson, Nutbeam, & daniels, 2009, p. 535-536). Part four The accident and emergency handover is an important part in the operations of ambulance personnel. It ensures the continuity of care and patient safety. This process facilitates the transfer of pre-hospital information from the ambulance staff to the hospital staff and therefore helps in the quick provision of medical care to patients. It is also important because it enables the ambulance staff to quickly respond to other emergencies that await them. This necessitates for the process to be swift and efficient (Thakore & Morrison, 2001). The handover process has been cited by many as ineffective. This is because of the delays that are experienced in the process of handing over the patients to the A&E department. Delays occur due to the complexity of the handover process especially where new systems or data terminals are involved (WAO, 2009). Thus makes patient to wait for long before they are transferred to hospital care. A second problem that has been cited is the lack of formal training in giving a handover. Many hospitals have no guidelines for the handover process and many do not train their emergency response teams on how to go about it. A third problem that has been identified is distraction by the medical staff to immediately start assessing the patient. Many fail to get pre-hospital information and this pose safety concerns for the patient (Thakore & Morrison, 2001,pp. 295). Part five Hypoglycemia occurs as a result of a relative excess of insulin in the blood and results in low blood glucose levels. It has been established that this level that causes or produces symptoms of hypoglycemia varies from person to person and also varies in the same person under different circumstances (Metchich, Petit, & Inzucchi, 2002). There are several factors that put people at risk of hypoglycemic episode. These include a mismatch in the timing, amount and type of insulin and carbohydrate intake; under nutrition, renal, failure, liver disorders etc. other people at risk also include those who take a lot of alcohol. Hypoglycemia is divided into three categories: reactive, drug induced and fasting. Reactive occurs after four hours after eating and glucose levels rise too rapidly making the body to over excrete insulin that drives glucose from blood. Drug induced is as a result of drugs that are used to treat diabetes. Fasting hypoglycemia occurs after long periods between meals or strenuous exercises (Tomky, 2005, pp. 42-44). Glucose is the preferred treatment for hypoglycemia. Glucagon is used to treat severe hypoglycemic reactions due to insulin especially where oral intake of glucose is not possible. It is ineffective in patients who have been fasting or who have a long history of hypoglycemia. Glucagon acts through the release of glucose from glycogen stores (Miralles, Lodha, & Perlman, 2002, p. 1003). List of References Bronwyne, C. (2007). Suspected cervical spine injury. Nursing (Jenkintown, Pa), 37(3): 88. Collop, K. T. (2006, October 1). Recognition, Prevention And Management Of Sepsis. Retrieved December 1, 2011, from EMS world: http://www.emsworld.com/article/10322364/recognition-prevention-and-management-of-sepsis Metchich, L., Petit, W., & Inzucchi, S. (2002). The most common type of hypoglycemia is insulin-induced hypoglycemia in diabetes. American Journal of Medicine, 113 : 317–323. Miralles, R. E., Lodha, A., & Perlman, M. ( 2002). Experience With Intravenous Glucagon Infusions as Treatment for Resistant Neonatal Hypoglycemia. Arch Pediatr Adolesc Med, 156:999-1004. Parkes, K. R. (2005). shiftwork and health. Retrieved December 1, 2011, from Oxford University: http://psyweb.psy.ox.ac.uk/stressgroup/shiftchapter%25.pdf Pisarski, A., Bohle, P., & Callan, V. J. (2002). Extended shifts in ambulance work:Influences on health. Stress and Health, 18: 119-126. Robson, W., Nutbeam, T., & daniels, R. (2009). Sepsis: a need for prehospital intervention. Emergency Medical journal, 26(7): 535-538. Thakore, S., & Morrison, W. (2001). A survey of the perceived quality of patient handover by ambulance staff in the resucitation room. Emrgency Medical Journal, 18: 293-296. Timothy, J. (2004). Cervical Spine Injuries. Current orthopaedics, 18(1): 1-16. Tomky, D. (2005). Detection, Prevention, and Treatment of Hypoglycemia in the Hospital. Diabete spectrum, 18(1):39-44. WAO. (2009, April 23). Improvements needed in A&E patient handovers. Retrieved Decemeber 1, 2011, from Wales Audit Office: http://www.wao.gov.uk/pressreleases_2577.asp Read More