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Focus: Musculoskeletal and Neurological Systems

Patient Update


Mr. Gilbert Loeppky (or "Gil," as he prefers to be called) was admitted during the early evening to the Surgical Unit of Okla Trauma Center from the ER. As a victim in a motor vehicle accident that same day, Gil incurred a blunt force head injury and was unconscious at time of arrival at Okla Trauma; he gained consciousness approximately 2 hours after admission (see Chapter 4). Diagnostics determined that there was no internal hemorrhaging within the cranial cavity. However, Gil remains on close monitoring and is receiving neurovital sign checks every 30 minutes, a precautionary measure for all patients with head injuries. In addition, Gil suffered fractures and injuries to his right leg. Although he has yet to speak with a physician in any detail about these injuries, he knows that he is scheduled for surgery to repair them. Gil's parents, Pat and Pearl Loeppky are with him now, awaiting a visit from the surgeon.

In the midst of all of this trauma, Gil has become a new father. His wife, Glory gave birth to a little girl prematurely over at Fayette General Hospital, where she was admitted after the motor vehicle accident (see Chapter 8). Gil and Glory have spoken by telephone.


"Good evening, I'm Dr. Elaine Karras, orthopedic surgeon," announced a tall woman in light-blue scrubs as she strode confidently into Gil's room. She stretched out her hand to the patient and said, " Gilbert Lop… Lop-key, I presume?" She smiled.

Gil shook her hand and politely corrected her. "Lep-key. Gil Loeppky. Call me Gil. How do you do?" Gil replied in a raspy voice. "These are my parents," Gil added, nodding stiffly in their direction.

"Hello, I'm Pat Loeppky, and this is my wife, Pearl," Gil's father said as an introduction. The doctor shook hands with Pat and Pearl as well, and then she returned her attention to the patient.

"Well, Gil, as you know, you've broken a number of bones in your right leg. I'll be performing the surgery to repair them tomorrow afternoon around 5 pm. I wanted to pop in this evening before I go off duty to talk with you a bit and to answer any questions that you might have." Dr. Karras paused to wait for Gil to consider what she was saying.

Gil's mother interjected: "Tomorrow afternoon! Why so long? That sounds awful to make him wait in pain for so long!"

The surgeon explained that, because Gil had sustained a concussion, it was not wise to administer anesthetic medications to him until he had been monitored for neurological, cognitive, and vital signs over a period of at least 12 full hours. She said to Gil, "Although anesthesia is generally safe for someone who, like you, has had a moderate concussion, there are some risks involved as you emerge from it postoperatively. When you wake up, you might exhibit behaviors similar to ...

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