Case Study Helicopter Retrieval To Small Regional Hospital Case Study

Case Study Helicopter Retrieval To Small Regional Hospital Case Study Case Study: Helicopter Retrieval To Small Regional Hospital â€" Case Study Example > The patient is not too sick to transfer, however the patient will require to be transported to the tertiary level hospital to receive the definitive management. In order to transport the patient, there will be need to provide the prehospital care to the patient which will be aimed at increasing chances of the patients survival before reaching the tertiary hospital for better management. The patient will be able to benefit from the prehospital management before he is transported to the hospital for the definitive management of myocardial ischaemia. The prehospital management of the patients condition(myocardial infarction) will be based on immediate offering of medical intervention since the loss of muscle cells starts to become irreversible in two hours after the infarction has occurred (Whitbread 2002,1967). The management will be aimed at the relieving of pain and the prevention of the occurrence of cardiac arrest. Early care of the patient will be much centered on the provision of reperfusion therapy to limit the infarct size and to prevent the extension as well as the expansion and treating of the immediate complications which include pump failure, shock and arrhythmias which are life threatening. The prevention of further infarction is also of importance and the reduction of the occlusion of the coronary artery on the myocardium. The initial diagnosis of myocardial infarction will be based on the chest pains, progressive dyspnea as well as the activation of the parasympathetic system which is characterized by the presence of hypotension (Bettencourt 2005, p. 874). Prehospital management of on the ground before the transportation of the patient will involve the relieving of pain. This will be done not only for humane reasons but because the pain will be associated with the sympathetic activation which will bring about the vasoconstriction which will eventually result in the increase of the amount of work of the heart. The pain will therefore be managed by the use of intravenous morphine. If the opioids fail to relive the pain, repeated doses will then be necessary or then the intravenous beta blockers or the nitrates will also be effective in the management of pain. Intramuscular injections should be avoided since their absorption will be unreliable and the site of injection might bleed when the patient will be offered the thrombolytic therapy. The antiemetics will be given concurrently with the Opioids. Opioids could induce respiratory depression, hypostatic hypotension and bradycardia or tachycardia and muscle spasm which might have the negative effects to the patient since they will aggravate the condition. Other risks of using the opioids would be the setting in of urinary incontinence (Bettencourt 2005, p. 874). Thrombolytic treatment is the cornerstone in the management of myocardial infarction. The aim of the therapy will be to complete and maintain the patency f the infacrted as well as the related arteries. The reperfu sion therapy will also go ahead to prevent the reduction of cardiac function as a result of the myocardium undergoing irreversible necrosis due to complete occlusion of the blood vessels. The management should begin immediately for this condition since the resultant ischemia will only be reversible within 3 to 6 hours. The choices of reperfusion therapies will range from the use of the percuteneuos transluminal coronary angioplasty, thrombolysis and coronary bypass graft surgery. The choice of the procedure to be used will be based on the patient’s condition, the location and the extent of the ischemic process. Coronary angioplasty in the first is divided into two, primary angioplasty and angioplasty which is combined with thrombolytic therapy. There will also be need to provide ventilation to the patient due to the saturation levels of oxygen in the blood being low. This should also be done because the patient is breathless and is having the features of heart failure or shock. T his will be aimed at addressing the need for perfusion of the various organs to prevent ischemia which would lead to necrosis on persisting. Thrombolytic therapy could lead to the patient developing hemorrhagic shock due to increased bleeding internally and this might affect the perfusion of various body organs and could result in end organ damage (McVaney 2005, p. 282).