The patient died due to the crush syndrome, which was precipitated by the subsequent events of the crush injury. Johns tissues were subject to circumstances that led to damage and death of muscle tissues. For instance, he stuck in the crushing force for one hour before the first aid arrived, then a tourniquet was applied for another one hour to prevent loss of blood. The tissues after the tourniquet was applied were deprived oxygen and became ischemic due to the direct compression by the crush. The outcome was metabolic imbalance and subsequently the organ failure. The injury of muscles allows led to various mineral to leaking into the blood for instance potassium, creatine kinase, and myoglobin. In such cases, vital organs are at risk of failure, for example, the excessive amount of myoglobin passing through the kidneys is a risk factor for renal failure. The condition may also result to hyperkalemia which leads to dysrhythmias. Dysrhythmias affect the cardiac functioning which ultimately affects the brain. The patient died due to the crush syndrome and subsequent events.
During extrication, the patient is likely to experience a hypovolemic condition. In this case, a hypovolemic condition was caused by the hemorrhage since it took too long before he was received first aid. Following arrival to the emergency department, John was examined, and his condition was stabilized. The healthcare providers scheduled his case for amputation the next day. He was left overnight; meanwhile, other healthcare conditions, for instance, renal intoxication which leads to renal failure were not monitored. Once the blood has been intoxicated the other organs of the body are at risk of failure or malfunctioning, for instance, the brain which depends on nourishment from the blood. In such event, John was at the risk of dying, and without adequate monitoring, at night his condition became worse and succumbed.
John was a trauma patient, and this required the healthcare facility to place him under simultaneous monitoring and treatment. John was supposed to be put through the protocols of advanced life support instead of the basic life support. After running the ECG test, the levels of hyperkalemia were established, and the doctors should have been keen in managing phosphorus, potassium, and calcium.
The doctors should have performed a urinalysis especially after noting the change of color of the patients urine. Detecting the myoglobin in the blood would have alerted them to started mechanism to restore balance to prevent renal failure. Kidney failure led to the intoxication of the blood which contributed to johns death.
I recommend that that for the prevention of a quick progression from a crush injury to a crush syndrome, the first aider could have established intravenous access before extrication. To control renal failure as they left the patient unmonitored all night, the doctors would have infused John using normal saline. In patients like John it so important to prevent the risk of rhabdomyolysis by avoiding fluids with potassium. The receiving trauma department should be provided with the ECG results to initiate the proper life-saving protocols.
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