Evidence Based Practice Diagnostic Testing for Small Bowel Obstruction
Last week, I had a 57 year old female who was admitted from the ED with severe abdominal pain. The physician ordered a CT of the Abdomen and it showed a small bowel obstruction. Early diagnosis of a small bowel obstruction is critical in preventing complications such as strangulation or perforation. In the past, plain x-ray films was used to diagnose SBO with a 20-52% accuracy. In 46 cases they performed a plain x-ray and CT on each case, the results show that CT was 100% accurate and showed all complete obstructions that lead to a more immediate surgery. My client in the past had a hysterectomy that lead to adhesions in the small intestines. The surgeon performed a lysis on the bowel adhesion, which relieved her abdominal pain and allowed her to have a bowel movement. The client stated she felt a lot better and was grateful that they found out what was wrong with her.
Diagnostic Performance of CT in the Detection of Intestinal Ischemia Associated With Small-Bowel Obstruction Using Maximal Attenuation of Region of Interest Am. J. Roentgenol. April 1, 2010 194:957-
CT of small-bowel obstruction: value in establishing the diagnosis and determining the degree and cause. D Frager, S W Medwid, J W Baer, B Mollinelli and M Friedman JR January 1994 vol. 162 no. 1 37-41
The Other End of the Stethoscope
After reading the chapters in the book, it really made me think about what it would be like to be a patient and what I would want from my caregiver. You don’t want them too professional where they don’t seem human and not enough where they seem incompetent. It seems like a hard median that each caregiver will have to develop on their own. Even though we talk about therapeutic communication and what we should and shouldn’t say sometimes going with human instinct is best and treating each patient individualized. I want to personally work on being more “human” and to be the caregiver that individual needs.
Last week, I had a 57 year old female who was admitted from the ED with severe abdominal pain. The physician ordered a CT of the Abdomen and it showed a small bowel obstruction. Early diagnosis of a small bowel obstruction is critical in preventing complications such as strangulation or perforation. In the past, plain x-ray films was used to diagnose SBO with a 20-52% accuracy. In 46 cases they performed a plain x-ray and CT on each case, the results show that CT was 100% accurate and showed all complete obstructions that lead to a more immediate surgery. My client in the past had a hysterectomy that lead to adhesions in the small intestines. The surgeon performed a lysis on the bowel adhesion, which relieved her abdominal pain and allowed her to have a bowel movement. The client stated she felt a lot better and was grateful that they found out what was wrong with her.
Diagnostic Performance of CT in the Detection of Intestinal Ischemia Associated With Small-Bowel Obstruction Using Maximal Attenuation of Region of Interest Am. J. Roentgenol. April 1, 2010 194:957-
CT of small-bowel obstruction: value in establishing the diagnosis and determining the degree and cause. D Frager, S W Medwid, J W Baer, B Mollinelli and M Friedman JR January 1994 vol. 162 no. 1 37-41
The Other End of the Stethoscope
After reading the chapters in the book, it really made me think about what it would be like to be a patient and what I would want from my caregiver. You don’t want them too professional where they don’t seem human and not enough where they seem incompetent. It seems like a hard median that each caregiver will have to develop on their own. Even though we talk about therapeutic communication and what we should and shouldn’t say sometimes going with human instinct is best and treating each patient individualized. I want to personally work on being more “human” and to be the caregiver that individual needs.