TRAUMATIC HEAD INJURY

Traumatic Head Injury



Traumatic Head Injury

Introduction

For the purpose of this assignment and patient confidentiality, I will call my patient Mr. Smith, in keeping with the Nursing and Midwifery Council's (NMC) guidelines, as stated in the 'Code of Conduct' (NMC 2008, Pp. 4-9), which state that all nurses should maintain confidentiality. Reflection helps in professional development, which reveals knowledge and skills essential to everyday practice and expose areas for further development. Reflection is a process of organised thinking. It analyses and evaluates the learning process, which develops skills with practice. Reflection significantly analyses practice to reveal fundamental influences, rationale and knowledge (Taylor 2000, Pp. 17-56).

Discussion

Mr Smith arrived in the ED I work in brought in by the ambulance crew. I got the hand over from ambulance crew, which was vague, but stated that the patient (Mr. Smith) had been found on the floor, unconscious and smelt strongly of alcohol. On his arrival to the ED, the patient was very abusive and uncooperative. On primary survey, I noticed minor lacerations on the back of his head which was not actively bleeding. Mr. Smith was unable to give the history of events that led to his being in an ED but according to the London Ambulance Service (LAS) someone had called an ambulance after finding him unconscious. Initially, he was unresponsive and then had been abusive to the LAS crew. On initial assessment in the Accident and Emergency (A&E), the patient was alert but incredibly abusive and uncooperative, refusing all initial treatment and interventions. After settling down, Mr. Smith allowed me to do his observations, insert a cannula and take some bloods for investigation and to obtain an electrocardiogram (ECG). I also changed him into a hospital gown. I used the ABCDE tool for the assessment as per Advanced Trauma Life Support (ATLS) guidelines (Resuscitation Council 2011, Pp. 1-2), and I was satisfied that Mr. Smith showed no life threatening injuries. The ABCDE assessment is as follows: A- airway, B- breathing, C- circulation, D- disability, E- exposure.

Reflection on the Actions

Reflecting on my actions, I felt that had we delayed more, or had I not escalated my concerns, the patient might have deteriorated further. My knowledge, which I got from my trauma course, coupled with my experience helped me to recognise the patient's deterioration in my secondary survey, which might have saved his life. I feel I acted correctly in insisting that more needed to be done for the patient than the close monitoring I was required to do as per doctor's recommendations (Craig 2011, Pp. 63-109). I can only speculate in what might have happened had I not insisted that more needed to be done and had not gone to the Sister in Charge. The patient might also have been transferred to the other hospital earlier had the CT scan been done earlier, but I felt good that, at least, I had recognized the situation, and raised my concerns. It has taught me that my own professional abilities have a ...