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Give a short answer essay, based on a clinical case study about a deteriorating patient.
Stage 1: Mr Jones, a 66 year old male, was scheduled for theatre at 8am for an internal fixation of his femur. Prior to surgery a peri-operative assessment was carried out by the anaesthetist and surgeon to ensure he was fit enough to undergo surgery. Mr Jones was prepared for operating theatre and a pre-operative checklist was completed. Mr Jones was transferred to the operating theatre where he underwent surgery without complications and was transferred to the recovery unit prior to returning to the High Dependency unit (HDU) Mr Jones’s observations in the recovery unit were as follows:
Stage 4: You note that Mr Jones’s condition has deteriorated over the 30 minutes upon return to the HDU and you call for an Emergency reponse and review (MET). The Medical Emergency team arrive and request that Mr Jones receives 500mL of Normal saline stat. and inform you that he is in Hypovoleamic shock! Mr Jones has the bolus of Normal saline and his obervations are as follows:
• Outline your systematic assessment of Mr Jones upon his return to HDU (Stage 4 of this case study)