Nursing care for patient with thoracic spine injury S/P spine surgery with head injury hemopneumothorax & MDR : Case study

Abstract

The purpose of this case study was to study nursing of thoracic spine injury patients who received spine surgery. Case study: By studying at Male Surgical ward 1. Male Orthopedic ward And Surgical Intensive Care Unit (SICU) at Chaiyaphum Hospital The study started from 12 July - 6 September 2019. A Thai male aged 18 years, with significant symptoms, is driving the MC, falling by himself, with a torn wound on his face, numbness in both legs for 30 minutes. Fracture dislocate of T4-T5 + Complete cord injury + Mild HI moderate risk, accepted for treatment on 12 July 2019 at the Male Surgery ward 1 1 day and moved to the Male Orthopedic ward, 13 July 2019, undergoing surgery Decompressive laminectomy T2-T7 with pedicular screw with posterior lateral fusion, 15 July 2019. After surgery, move to receive further treatment at SICU On ET-Tube with Ventilator was able to wean out the ventilator on 16 July 2019. Moved back to the Male Orthopedic ward. While treating patients with pulmonary infection, Hemopneumothorax had ICD and complications caused by pressure ulcers, level 4, doctors performed surgery on Debridement on 29 August 2019. And sent a physical therapy consultant to prepare the Home programe until discharged on 6 September 2019, a total of 56 days of sleep. 

The results of the study showed that nursing problems were as follows. Crisis period, pre-operative  period , post-operative period, intensive care period, discharge plan period . From nursing problems at each stage lead to nursing plan nursing practice and nursing assessments that are in line with the problems and patients are planned for distribution in the form of D-METHOD. The multidisciplinary team is continually following home visits. Including a consultation system when patients and relatives encounter problems.