Nursing of Abdominal Injury patient associated with the Coronavirus disease 2019

Abstract

Introduction: The incidence of abdominal injuries has kept increasing due to several incidents, e.g. using vehicles and physical attacks. Most of them are caused by penetrating wounds and mechanical injuries, resulting in hypovolemic shock and early death, including later death of intra-abdominal infections. Under the situation of the coronavirus disease 2019 (COVID-19) pandemic, ER nurses play a key role in close patient care from the first acceptance to prevent shock, abdominal pain, and hypoxia, ensuring preparation for emergency surgery and the control of the spread of Coronavirus as well as prevention.

Methods: One case study was selected from the medical records of treatment at ER, Saraburi Hospital.

Results: The case study was a Thai male, aged 43 years, coming to the hospital with the symptoms of abdominal discomfort and dyspnea 2 hours before coming to the hospital. He informed that he played with his friend. Then, he asked his friend to pump the air into a rubber tube, and blow it into his anus. After that, abdominal discomfort and dyspnea occurred. Therefore, he hurried to the community hospital. The physician examined his body and found hard stomach/abdomen, with rebound tenderness. He was suspected of hollow viscus organ perforation and was transferred to Saraburi hospital. The patient was a close contact to a person infected with the coronavirus disease 2019. However, the ATK result from the community hospital was negative, followed by RT-PCR for SAR-CoV2. Next, the patient was sent for film abdomen series. The result showed free air under the diaphragm. Therefore, OR emergency for exploratory laparotomy in parallel with simple exploratory laparotomy with peritoneal toilets and exteriorization of sigmoid wound was required. After using nursing process as a tool for his health condition assessment, followed by nursing diagnosis, planning, practices, as well as pre- and post-operative assessment, the patient recovered from the illness and was safe from the critical conditions. The hospital admission duration was a total of 14 days.

Conclusion: To take care of patients with abdominal injuries under the coronavirus disease 2019 pandemic, ER nurses must have knowledge, caring skills, nursing practices in compliance with patient care standards, and accurate as well as quick problem-solving. These will result in efficient patient care, high survival rate, and efficient the coronavirus disease 2019 control as well as spread prevention.