Internal Code: 1HBDD
Case Study: Jane Gill was a 37 year old female married to Tom, a 38 year old engineer. They had two children, Hamish 5 and Fletcher 6. The Gill family had only moved to Tasmania from central New South Wales two months ago following a new job offer for Tom. All their family reside on the mainland and they had not made many friends.
Jane was driving back home to a coastal town in her minivan after doing her grocery shopping when she was involved in a high speed, head on MVA with a drunk driver named John.
When the ambulance arrived at the scene Jane was trapped in her minivan. Jane was conscious with a GCS of 13, pulse rate of 130 and BP of 90/50. Jane was complaining of bilateral leg pain and abdominal pain. Paramedics fitted a rigid collar, inserted a 16 gauge cannula, rapidly infused 2000ml of Hartmann’s solution and administered 5mg of morphine IV in 1 mg increments. After a difficult extrication, Jane was removed from her minivan by paramedics and fire service 30 minutes later.
Jane suffered compound # of Lt and Rt femurs, # Rt tibia and fibula and # Lt tibia. Jane was transferred to the Emergency Department of the LGH. Jane was also complaining of abdominal pain. On route the ambulance service contacted Tom on his mobile phone. Tom was picking up his children from school. He was informed that Jane had been involved in a MVA and was asked to come to the Emergency Department. Shortly after Jane arrived at LGH, John, the drunk driver from the other vehicle, arrived in the emergency department.
On arrival Jane’s condition had deteriorated: BP 80/45, Pulse 140, GCS 11 still conscious and cooperative. Jane was still complaining of abdominal pain 9/10, and her abdomen was visibly distended.
Once in the resuscitation bay, Jane had a cardiac arrest. Jane was connected to a cardiac monitor and CPR commenced. Adrenaline was administered IV whilst Jane was in asystole. Emergency department doctors and nursing staff attempted to resuscitate Jane without success.
Tom and the children arrived shortly after Jane died. Tom was frantic and approached you wanting to know where Jane was. The children wanted to see their mother to make sure she was alright
As a RN you will be exposed to death and the dying process. In many cases you may have little control over the process but you will have some control over how individuals and their families approach the issues of loss, death and grief. You will also have some control over how individuals and their families cope with sudden or impending death.
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