Septic Emboli Resulting From Severe Trauma: A Primer on Care

Trauma nursing requires specialized knowledge and skills. This article describes the case of a patient who was involved in a motor vehicle accident and presented to the emergency department with hypovolemic shock secondary to a splenic laceration. In the hospital, the patient experienced prolonged hypotension.

The patient sustained a variety of insults to the cardiovascular, respiratory, endocrine, and musculoskeletal systems. Microbiological data and laboratory test results did not reveal the defining characteristics of sepsis or systemic inflammatory response syndrome typical of trauma patients, making it challenging to identify the source of the sepsis.

The patient was diagnosed with nontraumatic cerebral septic emboli, a condition that is less common in trauma patients and more common in cases of endocarditis, septic thrombophlebitis, and central venous catheter infections. The condition has a 50% mortality rate if not detected promptly and appropriate treatment administered.

The patient survived the 4-week hospitalization owing to timely management of his conditions by the health care team and their persistence in identifying the cause of his atypical sepsis.

To provide adequate care to trauma patients, critical care nurses require specialized knowledge of this unique population. Trauma critical care nursing should involve hands-off communication, thoughtful review of laboratory test and imaging results, and engagement in interdisciplinary care rounds.