Answer to each classmate
4 sentences per each classmate response is fine.
one reference per each classmate response.
case 1
The practitioner is working in the emergency room when a young woman comes in with a man who appears to be a much older boyfriend. The woman appears young but states that she is 22 years old. Despite cool weather, the woman is dressed in shorts and a t-shirt with a sweatshirt. The man stays close to her in the examination room and answers most of the questions for her. When she does respond, her answers are short and vague, with the boyfriend elaborating on her responses. There seems to be tension between the two, and the man is harsh with the woman.
The woman has a large laceration on her upper thigh, which she says she received a week ago due to falling. The wound appears red and inflamed, and has greenish yellow drainage seeping from the lower aspect. The entire anterior surface of the thigh appears swollen and red, is warm to the touch, and is painful. The wound edges are not approximated, and it appears to be a partial thickness wound about 10 cm in length. The wound appears painful, but the woman is guarded in her answers to questions about pain. The woman has a temperature of 100.5F, heart rate of 92 bpm, respirations of 24 breaths per minute, and blood pressure 110/60. As the practitioner, you sense something is off between the woman and the man, who will not leave her side.
Further examination reveals bruising on both thighs and arms, all in various stages of healing. The woman has a few minor lacerations on her forearm, which are healing. While reviewing the wounds, you are reminded of a recent in-service on human trafficking. During the in-service, you reviewed the article Red Flags: Identifying Sex Trafficking Victims in the ED found at this website: http://epmonthly.com/article/red-flags-identifying-sex-trafficking-victims-in-the-ed/. Participants were also directed to the National Human Trafficking Hotline found at https://humantraffickinghotline.org/. Remembering these resources, you feel concerned for the womans well-being.
class mate 1
What treatment should be provided to the wound?
The laceration should be irrigated with an antibiotic solution prior to any attempts to closure. Further an assessment of possible debridement of any tissue that would impede the healing process should be removed. I would prescribe Keflex 500mg every 12 hours for a period of 3-4 days.
classmate 2
What signs suggest that this may be an abuse and human trafficking situation?
Signs recognized on human trafficking victims include submissive and fearful (lack of eye contact) body language, an inability or unwillingness to speak to people when approached, and signs of physical abuse. In addition, victims may present with sexually transmitted infections, malnourishment, and psychological trauma (Dois, et al., 2019).
case 2
A 3-year-old girl arrives at the clinic accompanied by her parents. The family has a dog that bit the girl, and she has bite wounds on her hand and ear. The ear is torn, but it is not actively bleeding. The hand has three puncture wounds in the soft tissue, none of which are actively bleeding. However, bruising is noted on the hand around the area of the puncture wounds. The parents report that the bite occurred within the last 45 minutes.
classmate 3
What patient education should be included?
In order to prevent dog bites, the children should be educated on staying away from strange dogs, not allowed to play with dogs unless supervised by an adult, and taught not to disturb a dog while it is sleeping or eating. The parents should teach the children how to behave with their own dog, keep dogs with a known history of aggressive behavior out of households with children, train dogs properly, avoid aggressive play with dogs, and keep vaccines up to date.
classmate 4
How should the wounds be managed?
Analgesia should be given, and the wound should be cleaned with mild soap and water, or Betadine. Bite wounds of the hand should not be sutured. Wounds should have gauze and bandages (Dunphy, 2019).
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