Case Scenario: Acute Care

Mrs. Fox, a 40-year-old wife and mother of 2, was involved in a massive motor vehicle accident on the Sawmill Parkway in which her car struck the center divider and flipped twice.  A good Samaritan immediately dialed 911.  First responders found the patient unconscious with severe injuries but were able to safely transport her to St. John’s Riverside Hospital.  Upon arrival at the emergency department, Mrs. Fox was immediately triaged and the following impairments were found:  blunt force trauma to the head, open fracture to the right leg, possible closed fracture to the right wrist/forearm, and internal bleeding to the upper right abdominal quadrant (possibly from the liver).  Hospital staff was able to contact the patient’s next of kin (family) to inform them of her condition.

Mrs. Fox was stabilized, imaging and tests were ordered/performed, and medically necessary surgical intervention was carried out.  The patient was transferred to the ICU of the hospital as she continued to fluctuate in and out of consciousness and had difficulty breathing without the use of a respirator.

Within a week, the patient fully regained consciousness, was able to breathe on her own, and was determined to be safe enough to be transferred to the general inpatient floor of the hospital.  It was determined that Mrs. Fox had sustained a traumatic brain injury predominately affecting sensation and motor function to the right side of her body.  She was placed on a restrictive diet and prescribed medication to treat her healing liver as well as diuretics to decrease the fluid compressing her brain.  A pin was placed in the patient’s right wrist to fixate the fractured scaphoid bone.  The right tibia was fixated with an intramedullary rod and pins. Neurovascular structures were repaired to the best of the surgeon’s ability; however, the prognosis of her right leg was undetermined based on the severity of damage.  

Based on the case scenario above, answer the following questions:

1.  Of the health professionals discussed thus far, which may be involved in Mrs. Fox’s care?

2.  What would be the role of each provider?

3.  Why might providers need to communicate with one and other specific to this case?

4.  How might they communicate?

5.  What other healthcare team members, not yet discussed, might be involved and what would be their roles?