Exciting Emergency Department Scenario: Knife Handle Protruding from Abdomen
What should be the nurse's priority when assessing a patient with a knife handle protruding from the abdomen in the emergency department?
a. Remove the knife and assess the wound.
b. Determine the presence of Rovsing sign.
c. Check for circulation and tissue perfusion.
d. Insert a urinary catheter and assess for hematuria.
Answer:
In an emergency involving a penetrating wound in the abdomen, the priority is to assess the patient's overall state and determine the extent of the injury by checking for circulation and tissue perfusion.
When faced with a critical situation like a knife handle protruding from the abdomen, it is crucial for the healthcare provider, in this case, the nurse, to prioritize the assessment of circulation and tissue perfusion. This ensures that the vital blood flow and oxygen supply to the tissues are maintained adequately.
The immediate concern is not to remove the knife from the wound, as doing so could lead to further damage or severe bleeding. In such cases, it is best to leave the knife in place and manage the situation surgically in a controlled environment.
Checking for the presence of Rovsing sign, used to diagnose appendicitis, is not relevant in this context of a penetrating abdominal injury. Inserting a urinary catheter and assessing for hematuria is also not the immediate priority, even though it may indicate urinary tract damage.
By focusing on assessing circulation and tissue perfusion first, the nurse can better understand the patient's overall condition and make informed decisions regarding further treatment and intervention.