Multiple stab wounds: a short-term respiratory case study

Respiratory management is a role that is of paramount importance to intensive care nurses. Proactive nursing allows a nurse to have a positive effect on a patient's condition by actively improving the patient's status and setting priorities of care, avoiding deterioration wherever possible. In this account of the respiratory management of a patient who has sustained bilateral pneumothoraces following multiple stab wounds to the chest and back, the physiological assessment of the patient is described and a proactive respiratory plan of care is formed. Anatomy, physiology and pathophysiology in relation to pneumothoraces, metabolic acidosis and magnesium links with functional residual capacity are addressed. The potential risk of Adult Respiratory Distress Syndrome (ARDS) following direct and indirect lung injury is discussed. Recent research into ventilation modes and into areas of nursing practice relating to respiratory management are also considered.