At Death’s Door

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Situation

Sophie, an 18-year-old female, had to be airlifted by the emergency response team after sustaining multiple injuries from a car crash.  She was unconscious and had unstable vital signs. Doctors also suspect that she had several fractures from the accident.

Dialogue

Physician:         Can you identify the patient?

Nurse:              The EMT handed me her driver’s license and it identified her as Sophie Turner, 18 years of age, from 14 E Stonybrook, Connecticut.

Physician:         Please give her Lactated Ringer’s solution to be infused rapidly via two large-bore peripheral intravenous catheters.

Nurse:              Blood pressure is dropping, oxygen saturation is at 90%, and respiratory rate at 7 breaths per minute.

Physician:         Let’s start the endotracheal intubation and place ventilatory monitoring and ECG leads. This patient is at death’s door. We will also conduct a fast abdominal sonogram to determine the extent of her chest or abdominal injury.

Nurse:              I already called the sonography department, doc.

Physician:         Once the procedure is done, you may wheel the patient to the ICU department.

Nurse:              That has been noted, we will transfer the patient after my call to the ICU department about this admission.

Vocabulary

At death’s door A near death experience
Airlift Transportation by air
EMT Emergency Medical Technician
Sustain an injury To suffer or have an injury
Fracture Another term for broken bone
Unconscious Not awake or responding to external stimuli
Infuse To let a fluid substance into a person’s vein
Large-bore intravenous catheter An intravenous line that delivers large amount of fluid
Oxygen saturation The amount of red blood cells (hemoglobin) that has oxygen
Endotracheal intubation Placement of tube through the windpipe or the mouth
Ventilatory Pertaining to something that helps circulate air
Sonogram The image produced during a sonography
Wheel To carry someone through something that has wheels

Analysis

  • When someone is at death’s door, he or she is very ill and almost dying.

Example: He was at death’s door after getting involved in a car accident, but the doctor revived him.

  • When someone or something has to be airlifted, the means of transportation is by air.

Example: The food supply was airlifted to reach the troop.

  • An Emergency Medical Technician or an EMT is a member of the healthcare team trained to respond during emergency. They are also called ambulance technicians in some countries.

Example: The EMTs responded quickly following the car crash.

  • If you sustained an injury, it means you had or suffered an injury after an accident.

Example: She sustained right leg fracture due to fall.

  • A broken bones or fracture can be caused by accidents. It may be due to sports, falls, or vehicular accidents.

Example: Kirsten sustained a fracture on the right arm from a fall.

  • A person becomes unconscious, meaning not awake and responsive to tactile (touch), verbal, and other form of stimulation usually because of an injury.

Example: He became unconscious immediately after getting into a collision with another car.

  • When you infuse something, usually in fluid form, you introduce fluid through a patient’s vein.

Example: Maria received medications via intravenous infusion.

  • A large-bore IV catheter usually utilizes large cannula that delivers large amount of fluids into the patient’s vein in the fastest way. This is used especially during emergencies.

Example: She lost lots of blood and they had to deliver fluids via large-bore IV catheter to prevent shock.

  • Oxygen saturation refers to the amount or fraction of hemoglobin or red blood cells that carry oxygen versus the total amount.

Example: Healthy individuals have an oxygen saturation of 94-100%.

  • A tube is usually inserted through the mouth during endotracheal intubation especially during emergency situations. The tube may also be inserted via the windpipe (trachea) or the nose.

Example: They had to do endotracheal intubation because her ventilation was impaired following an injury to her lungs.

  • Ventilation refers to the movement of air from one space to another. Anything that refers or pertains to ventilation is called ventilator.

Example: She couldn’t really breathe so she has to be assisted by a ventilatory device.

  • Sonography is commonly known as ultrasound. The image produced following this imaging test is called the sonogram.

Example: The sonogram revealed a tumor.

  • When you are being wheeled, you are carried or transported to another place via something that has a wheel.

Example: She was wheeled into the operating room per stretcher.

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