Scenario: At work, you are called to give care for a co-worker who has fallen from an 8-foot ladder. As you arrive, you see the injured person lying on the ground. They are crying and moaning in pain. A bystander says that the person landed on their back. The injured person has not moved from this position. The person says that they have tingling and numbness in their legs and feet and pain in their back. The person also has a 2-inch laceration on the side of their head. You want to help. Describe the immediate steps that you should take in responding to the emergency to determine what your plan of care should be.

Explanation:

In the case given, this person is conscious and oriented and complains of pain on back, tingling and numbness in the legs and feet which could be sign of spinal cord injury. On the side of head, he also has laceration and bleeding .

The first priority should be given to the suspected spinal injury.

1. I would ask the person to stay still and try not to move or sit because he has symptoms suggestive of spinal cord injury.

2. I would also call for emergency team response.

3. I would apply pressure on the bleeding wound on the head so as to minimize the bleeding.

4. I would check  for signs of fracture in other parts of body, and try to immobilize the part with splint if suspected for fracture.

5. I would monitor the person closely for any signs of confusion or shock. then reassure the patient till the ambulance arrives.

6. Should in case the patient stop breathing or loose pulse, I would start Cardiopulmonary resuscitation (CPR) immediately.

PLAN OF CARE

1. For risk of trauma related to weakness of body part secondary to spinal cord damage.

   This is to maintain proper body alignment and posture so as  to prevent further damage to the spinal cord.

 Another aspect is administering bed rest , this is very important

 I would also ask assistance while handling the patient. I would use logrolling technique while moving the patient.

2.For  Impaired physical mobility related to neuromuscular impairment.

I would do the following:

   Assess the  mobility level, motor function.

   Check for impairment level and take action to prevent contractures ad foot drop.

   consider range of motion exercises

3. For acute pain related to physical injury.

I would do the following:

  Assess the pain level by using pain scale.

   Provide comfortable position, hot or cold applications.

   As ordered, administer pain medications  .

   Teach relaxation techniques to deviate mind.

4. For risk of impaired skin integrity related to immobilization, decreased sensory perception and decreased peripheral circulation.

I would do the following:

   Assess the skin for signs like redness, selling, warm especially on pressure areas and bony prominence.

   keep skin dry and clean and avoid wrinkles on bed covering.