Case Study 2

BIOL 2010: A Case Study in Osmosis

Carol had butterflies in her stomach as she checked her appearance in the mirror hanging in the staff lounge. Her long hair was neatly pulled up in a ponytail and her nurses’ scrubs were clean and pressed. She exited the staff lounge and entered the hustle and bustle of County Hospital’s ER to begin her first shift as an RN. The first few hours of her shift passed slowly as Carol mostly checked vital signs and listened to patients complain about various aches, pains, coughs, and sniffles. She realized that the attending physician, Dr. Greene, wanted to start her out slowly, so she could get accustomed to working in the busy ER. Carol knew, though, that the paramedics could bring in a trauma patient at any time.

After her lunch break, Carol didn’t have to wait long for her first trauma patient. The paramedics burst in through the swinging double-doors of the ambulance bay wheeling in a young man on a gurney. Edward, a veteran EMT, recited the vital signs to Carol and Dr. Greene as they helped push the gurney into the trauma room, “18-year-old male, GSW to the right abdomen, heart rate 92, respiratory rate 22, blood pressure 95/65, no loss of consciousness.” Carol’s breath caught in her throat a bit. She knew that gunshot wounds were sometimes the most difficult traumas to handle and it was her first one!

Once inside the trauma room, Dr. Greene began his initial assessment of the patient, while Carol busied herself with the things she knew would be needed. She attached a pulse-ox monitor to the patient’s index finger so Dr. Greene could keep an eye on the O2 levels in the patient’s blood, and she inserted a Foley catheter so the patient’s urine output could be monitored.

After finishing her initial duties, Carol heard Dr. Greene saying, “It looks like the bullet missed the liver and kidney, but it may have severed an artery. That’s probably why his BP is a bit low. Carol, grab a liter of saline and start a fast IV drip … we...