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Focus: Cardiovascular System and Urinary System


Patient Update

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You first met Mr. Zane Davis in the audio dialogue at the beginning of Chapter 2. A victim of a motor vehicle accident, Mr. Davis was attended to by an emergency medical technician (EMT) at the scene. At that time, Mr. Davis was ambulant, but he was also somewhat confused. Even so, Mr. Davis was able to tell EMT Manuel Orantes that he has a history of a "bad heart." His actual diagnosis was never made clear.

Mr. Davis is a 74-year-old married man. He, his wife Stevie-Rose Davis, and their grandson Clay Davis were all in the Davis's vehicle at the time of the accident. Mrs. Davis has been transported to Fayette General Hospital for assessment. Clay Davis, who is 7 years old, is expected to arrive at Okla Trauma Center shortly. Neither Mr. Davis nor the staff knows any of this yet.


En route to the hospital, Mr. Davis began to slur his words. He became increasingly confused, and he was unable to understand what was going on around him or what was being said to him. EMT Orantes immediately assessed the patient's neurological signs. During one test, Mr. Davis' ability to grip the EMT's hand on command was slow and uncoordinated. When he did take the EMT's hand, the strength of his grip was weak. Also during this time, Mr. Davis was incontinent of urine. Due to his age and the potential for elderly patients' health to deteriorate rapidly, he was brought to the Okla Trauma Center rather than to a general hospital as the EMT had originally planned.

Upon arrival at the trauma center, EMT Orantes advised the attending physician in the ER of the possibility of a transient ischemic attack and recounted the patient's symptoms to her. A CT scan and blood work were immediately ordered. The patient was attached to a 12-lead electrocardiogram and given oxygen by mask. The team proceeded with the immediate medical and neurological assessment of Mr. Davis's condition in preparation for his transport to Diagnostic Imaging for the CT. The laboratory had been notified of an incoming case, and a laboratory technician would soon arrive to take initial blood tests. The attending physician, Dr. Crowchild, also ordered a urinalysis to be done as soon as possible to rule out a possible urinary tract infection.

At the ER nursing station, a young woman in a white lab coat introduced herself and inquired about a patient. "Hi, I'm Tracey from the lab. I'm looking for a Mr. Zane Davis. Can you tell me where he is?"

Graciella, the medical assistant, looked up from the desk. "Sure," she replied. "Bed 3, over there. You might have to wait a minute, though. The treatment team is still working with him. I'm not sure if they want you first or a CT scan. Protocol says CT first. Just wait. I'll go ask."

"Okay," Tracey responded. Moments later, the ...

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