Nursing care for Multiple Trauma Patients with Hemothorax and Liver Injury: A Case Study

Abstract

Objectives: To study of nursing care for multiple trauma patients with hemothorax and liver injury

Methods: This is a study of nursing care of patients in the trauma surgery in Phaholpolpayuhasena Hospital: one multiple trauma patient with hemothorax and liver injury. Data was collected from medical records, interviews, and observation. Data was collected between July-October 2023. Data was analyzed to define nursing diagnosis, nursing practice, evaluation and summary.

Results: Thai male, age 27 years, diagnosed with fracture posterior left 6^th-8^thribs, left hemothorax, left diaphragmatic rupture, liver injury, fracture T12 with spinal cord injury. The patient received intercostals drainage of his left lung and underwent two surgeries: exploratory laparotomy with repair diaphragm and open reduction with pedicle screws     T10-L2. Nursing planning was divided into three phases including 1) preoperative phase: risk of shock from having bleeding within the abdominal cavity and pleura; the patient, and relatives worried and afraid of harm to his lives. 2) the first 24 hours after surgery phase: there is a risk of tissue depletion of oxygendue to gas exchange.Dropped from a pleural bleed and had surgery to repair his diaphragm. There is a chance of repeated bleeding. Repeated shock after surgery .This is because during surgery the patient was in shock from the  loss of a large amount ofblood and water and the patient was uncomfortable from the pain of the surgical woundand 24 hours after surgery receive continued care safely until sold back home. Including watching out for infections, Pain management, teaching  and guidance forphysical rehabitation. Total length of stay in hospital is 35 days.

Recommendations: For the treatment of multiple trauma patients, nurses play an important role in the care process that they should have competency in surgical nursing, understand the pathology, progression of disease, and its complications; and be able to assess multiple trauma patients in order to make a decision timely and define accurate and comprehensive nursing diagnosis that would improve a safety system for patients and thier quality of life.