The Unseen Wound

In: Business and Management

Submitted By scarface31313
Words 3162
Pages 13
The Unseen Wound
Salvador Siegel
May 17, 2012
Rick De La Pena

The Unseen Wound
Many soldiers returning home from war have many obstacles to overcome both physical and mental. Most soldiers are not aware of a certain condition that they might have developed while deployed in a war zone. This condition is called Traumatic Brain Injury, also known as TBI. It is an injury that is not found on the outside of the body but rather internal, therefore it is called the Unseen Wound. Even though it’s unseen, TBI is real and affects a large percentage of veterans returning from war and test results show that an average of 46 percent of soldiers have TBI.
Traumatic brain injury, the signature wound of the Iraq and Afghanistan wars, is doubly cruel: it leaves many victims emotionally shattered and cognitively crippled. But because mild and moderate brain injuries do not show up on CT or other imaging devices, doctors and even family members are often skeptical that any real damage exists. TBI is real and affects a large percentage of veterans returning from war. “Consistent with the designation of TBI as one of the signature injuries of the war theaters in Iraq and Afghanistan, 46% of the returning veterans recruited for this project screened positive for a deployment-related TBI” (Morissette, Woodward, & Kimbrel, Meyer, Kruse, 2011, p. 346). I have deployed multiple times to Iraq and Afghanistan and have sustained injuries in result of Improvised Explosive Devices (IED’s) and mortar attacks. Shortly after returning home, my family and close friends noticed that I was no longer the same person. Even though my family and friends asked me to go see a doctor, I refused to go, I felt like there was nothing wrong with me. A few years after being discharged from the military, I started to notice the changes that my family and friends have been talking about. One…...

Similar Documents

Unseen Poetry Help.

...English Literature Unseen Poetry help. What does “Unseen” mean? It will be a poem you have probably never seen before You are being tested on your ability to “read and respond” thoughtfully You are thinking about what the writer is trying to say Every word of the poem will count The Question Write about the poem and its effect on you. You may wish to include some or all of these points: The poem’s content - what it is about The ideas the poet may have wanted us to think about The mood or atmosphere of a poem How it is written - words or phrases you find interesting, the way the poem is structured or organised Your response to the poem Context What it’s about What happens in each section Is there an order or sequence? Who’s speaking? Story or idea? Ideas What did the poet want us to think about? Is it a story or an idea or an expression of an emotion? Is there a message? Mood and atmosphere What is the tone of the poem? How does it make you feel as you read it? Think about the 5 senses Think about the setting How it is written? Don’t just list or spot techniques Pick out words or phrases that you find effective and try to say why Think about the sound and rhythm of the poem. Does it have a beat? Or is it disjointed? Look at repetition of sounds or words Your Responce It’s perfectly acceptable to say you find a poem confusing or misleading if you can explain why Try to be positive about some aspect of the poem or explain......

Words: 373 - Pages: 2

Wound Vac

...Project Title: Wound Vac Form Project Date: 02/01/2011 Department: P4 Nursing Contact Phone Number: 26650/6655 Team Contact Name: Evelyn Johnson and Tequicha Price E-mail address: 1. What is the project purpose, Aim statement? The purpose of this project is to keep log of all wound VAC’s that the unit has ordered as well as returned. 2. What are the main causes of the problem? Our unit manager had been notified that a wound VAC was discontinued on 10/02/2009 from a patient and now it was missing. So this meant that unless the equipment was found our unit will be charged for it.   3. What was the baseline level of performance? As of April 2012 the unit has not had any missing wound Vac since the project has started . We created a form to help keep track of all wound Vac that has been on the unit. Even if a surgical patient comes to the unit with a wound Vac we ensure that the unit clerk knows about the Vac and we begin to keep log of the Vac when it comes to the unit. 4. What was the solution? We have created a form that has to be faxed to PSPD when a wound VAC is needed and when the wound VAC is discontinued. 5. What was the measured improvement of the solution? The measurement of improvement has been great we have not no missing wound Vac since this project started. 6. How will the improvement be maintained and monitored over time? Since October 2009 the unit was charged for a wound Vac......

Words: 345 - Pages: 2

Dm Wound Care

...Education on Wound Care for Diabetic Patients Education on Wound Care for Diabetic Patients Abstract Non-compliance of wound care management has increased the risk of infection and amputations. Diabetes wound care management is an important and fundamental aspect when it comes to diabetes teaching and education. Assessment of the feet daily and at a primary care office will provide information such as noncompliance, risks for neuropathy, peripheral vascular disease, macro-vascular disease, and possible amputation. Education provided by health care practitioners to the diabetic population will promote decrease in risk for further complications and the patient to be involved in their own care. Assessment, treatment, and education on wound care management with the involvement of the patient will increase the patient’s quality of life and be very beneficial to both the practitioner and the patient. Keywords: diabetic wound care management, diabetic ulcer care, outpatient diabetes management, diabetic care management Introduction Working in a primary care setting will involve a multitude of disease processes- diabetes mellitus being one of them. Diabetes is a disease that is characterized by high levels of blood glucose with a defect in insulin secretion and cell resistance. Without proper management, diabetes may lead to other issues in health. Examples of such, would be, delay in wound healing, leading to foot ulcerations, which thus increases the risk for......

Words: 5353 - Pages: 22

Wound Mnagement

...Wound Management                                                     1 What is a wound? A wound is defined as the disruption of the normal anatomical structure and function of tissue. Or it could be described more simply as any physical injury involving a break in the skin. A partial thickness injury would be one that is limited to the epidermis and superficially the dermis. There is no damage to the dermal blood vessels. A full thickness injury incorporates damage to the epidermis and dermis, with damage to the dermal blood vessels and deep tissue layers. Wounds can be acute or chronic. An acute wound can be an injury from surgery or trauma and would expect to heal in a month. A chronic wound would be one that shows no sign of healing after a month. This may be due to underlying disease such as diabetes mellitus or circulatory disorders. Some biomechanical abnormalities can slow the healing process. 2 What are the basics of wound care? Wounds should be kept 1, clean                           2, moist                                     3, well nourished (pressure needs to be kept off the wound) Careful observation is needed on removal of any dressings, and notes should be taken recording any the appearance, drainage, granulation and location of the wound. Records need to be made of any cleansing agents and debridement agents used. Also all dressings that are applied need to be listed. Wound cleaning and irrigation,                     The aims......

Words: 635 - Pages: 3

Deep Partial Thickness Wound

...left side of the chest. The wound is very painful, like most burn wounds. A wound of this nature extends deep into the second layer of skin and can quickly develop into a full thickness burn or third degree burn. The symptoms include skin that is red and white, not easily blanch able along with bloody blisters, which are often moist and painful. The Registered Nurse should assess and provide wound care including timely wound irrigation and dressing changes, along with monitoring for signs of infection. The primary goal is to promote healing, minimize further damage and prevent infection. If the patient’s wound is open, note its color. If the wound is red, that demonstrates healthy tissue regeneration. If the wound is yellow purulent drainage and slough (dead skin) are present. If the wound is black the presence of a thick, necrotic material called eschar is present which hinders healing and must be removed. If the wound is closed the skin edges should be well-approximated. Ultimately, the Registered Nurse is working towards a wound which is free of infection and, therefore, completely healed. When cleaning the wound area, the Registered Nurse should use asepsis/sterile technique so the wound is free of all microorganisms. When cleansing a wound, always start with the cleanest area; never return to an area you have previously cleaned. Be sure to discard cleansing swab after each horizontal or vertical stroke. The Registered nurse should moisten the wound bed prior to removal......

Words: 548 - Pages: 3

The Wound-Dresser

...The Wound-Dresser The Wound-Dresser By Walt Whitman 1819–1892 Walt Whitman The Wound-Dresser By Walt Whitman 1 An old man bending I come among new faces, Years looking backward resuming in answer to children, Come tell us old man, as from young men and maidens that love me, (Arous’d and angry, I’d thought to beat the alarum, and urge relentless war, But soon my fingers fail’d me, my face droop’d and I resign’d myself, To sit by the wounded and soothe them, or silently watch the dead;) Years hence of these scenes, of these furious passions, these chances, Of unsurpass’d heroes, (was one side so brave? the other was equally brave;) Now be witness again, paint the mightiest armies of earth, Of those armies so rapid so wondrous what saw you to tell us? What stays with you latest and deepest? of curious panics, Of hard-fought engagements or sieges tremendous what deepest remains? 2 O maidens and young men I love and that love me, What you ask of my days those the strangest and sudden your talking recalls, Soldier alert I arrive after a long march cover’d with sweat and dust, In the nick of time I come, plunge in the fight, loudly shout in the rush of successful charge, Enter the captur’d works—yet lo, like a swift running river they fade, Pass and are gone they fade—I dwell not on soldiers’ perils or soldiers’ joys, (Both I remember well—many of the hardships, few the joys, yet I was content.) But in......

Words: 1508 - Pages: 7


...Review SKIN FUNCTION AND WOUND HEALING PHYSIOLOGY John Timmons is Clinical Manager, Wounds UK and Tissue Viabiliy Nurse, Aberdeen Regular evaluation and the setting of goals is essential to monitor the progress of the patient and their wound.To do this, is important to understand the physiology of the skin and the way normal wound healing progresses in order to plan and provide effective wound management. This article describes the structure and function of the skin and outlines the four normal phases of healing. Wound healing is an exciting and continually developing field, with new technologies and research playing a large part in improving the quality of patient care. The role of the nurse in wound care is all encompassing, stretching from the initial assessment of the wound and the patient, to making the correct decisions about treatment and beyond. Regular evaluation, and the setting of goals is essential to monitor the progress of the patient and the wound. To do this, a baseline knowledge of the functions and anatomy of the skin and wound healing physiology is required. Figure 1. When the skin is breached, it is important to close the defect as quickly as possible, thereby preventing infection from occurring. vital substances (Graham-Brown and Burns, 1998). the nerve endings present in the skin allow the body to detect pain, and changes in temperature, touch and pressure. 8Sensation: Functions of the skin The skin, often referred to as the largest......

Words: 3757 - Pages: 16

Wound Care Education

...Wound Care Education Abstract The purpose of this paper is to identify a patient health issue that would benefit from patient education. During the clinical rotation at Jackson South the group identified a need in wound care especially for patients with other underlying health issues such as diabetes. A large percentage of patients had wounds that would require patients to properly care for them once discharged. The group identified a lack of patient knowledge on how to care for these wounds and decided to develop a patient education pamphlet to teach patients how to care for wounds while not in a hospital setting. The group identified one particular patient that had insufficient knowledge in self-care. Wound Care J.G. is a 65-year-old male patient with a history of a cerebrovascular accident, hypertension, diabetes and multiple pressure ulcers. The patient was admitted to Jackson South Community Hospital with multiple wounds for suspected infection. He currently has two pressure ulcers present. One is a stage IV ulcer located at his right hip and the other is a stage III ulcer located on the heel of his right foot. He is scheduled for a CAT scan to rule out any collections in the hip and medical management of the wounds will be continued. Factors that contributed to the development of these ulcers were his lack of sensation due to his diabetes and being bed bound. He is alert and oriented and is in no acute distress. He currently lives with his only daughter, who......

Words: 749 - Pages: 3

Wound Care and Nutritiun

...Dietary Protein Increase and the Promotion of Wound Healing in Diabetic Adult Patients Dietary Protein Increase and the Promotion of Wound Healing in Diabetic Adult Patients Introduction There are approximately 23 million people diagnosed with diabetes in the U.S. (American Diabetes Association, 2012) and this population continues to grow. There are multiple complications associated with diabetes. One major and expensive complication is diabetic wounds. The cost of care in the U.S. alone for this population is approximately $245 Billion annually. (American Diabetes Association, 2012) Proper wound care is an essential step in the wound healing process, however,wound care alone is not sufficient. Nutritional status is extremely important in wound healing. Diabetic patients need to be educated and assessed for protein-energy malnutrition (PEM) as the body’s nutritional needs significantly increase during the wound healing process (Demling, 2009). Supplementation (especially protein) and the importance of it for wound healing need to be discussed with the patient. Without all the necessary interventions applied the process of wound healing can be lengthy and may lead to infection, excessive hospitalization and potential amputations. Understanding the body’s nutritional needs and how the body uses protein in the repair process is imperative. The recommendation for the amount of protein supplementation is between 0.8grams/kilogram to 1.2 grams/kilogram and is based on......

Words: 1974 - Pages: 8

Journal of Wound

...Journal of Wound, Ostomy and Continence Nursing In the article Combined Negative Pressure wound therapy and ultrasonic MIST therapy for open surgical Wounds: A Case Series, is a detailed summary about four different case studies that underwent colorectal surgical procedure, and healed through secondary intention. Secondary intention is when a wound is left open and allowed to close by epithelialization and contraction. Surgical wounds left to heal by secondary intention are at a greater risk for developing infections, increased hospital stay, incur greater hospital costs, higher readmission, and patient morbidity. This Journal looks into two new developments for open wound treatments. The first new treatment is non-contact low frequency therapy (NCLPU) that uses cavitation and acoustic microstreaming. Cavitation is the formation and vibration of microscopic bubbles whose movement promote changes in cellular activity. Acoustic microstreaming is the movement of fluids in and around cells by the physical force of sound waves resulting in increased protein synthesis and increased permeability of the cell membranes and vascular walls. The second new development is combined negative pressure wound therapy (NPTWT), a vacuum source creating continuous or intermittent negative pressure inside the wound to remove fluid, exudates and infectious material promoting wound healing, closure and the reduction of edema. With the reduction of edema improved tissue perfusion, delivery of......

Words: 699 - Pages: 3

Wound and Skin Case Study

...Nurs 2820 Skin Integrity and Wound Care Student: Navjot Kaur Case Study Dale Gordon has been a client in the ICU for 6 days after developing complications after open heart surgery. He is an 82-year-old African American who is disoriented to place and time. He lives with his daughter Claudia in her home. Claudia and her two brothers visit Mr. Gordon daily since he has been hospitalized. Mr. Gordon has not been eating well since the surgery and has lost 3 pounds. Mr. Gordon has type 2 diabetes and is on oral antihyperglycemic medication. Before he came to the hospital, Mr. Gordon was able to only ambulate for short distances. He has orders to get up in a chair twice a day. Joan, a student nurse, is caring for Mr. Gordon this morning. She has reviewed his medical record and is now ready to start caring for him. 1. Joan assesses Mr. Gordon using the Braden Scale and determines that his score is 12. What does this score indicate about Mr. Gordon’s pressure ulcer risk? Explain what the Braden score is. * Mr. Gordon has a high risk of developing a pressure ulcer because his score is a 12 on the Branden Scale. The lower the score on the Branden Scale (6-23) the higher the risk of developing a pressure ulcer. The Branden Scale is used to determine any limitations with a patient’s sensory perception, activity, nutrition, moisture, and mobility. 2. Joan is assessing Mr. Gordon’s skin and notices that he has a 3 cm blister and a shallow crater on his buttock. Mr.......

Words: 543 - Pages: 3

Wound Care

...his name. During the time in the PACU, Lori monitors respiratory status closely due to what factors? Select all that apply. A. Anesthesia can have a depressing effect on respirations. B. Mr. Baker has a history of smoking. C. Mr. Baker has an abdominal incision. D. All of the above. Lori is developing Mr. Baker’s care plan and adds the nursing diagnosis potential for infection. Why would Mr. Baker be at high risk for developing an infection? Answer: Rationale: Mr. Baker’s nurse asks Lori to apply a thromboembolic device (TED) hose and a sequential compression device (SCD) on him. What is the purpose of each device? A. To prevent thrombus and emboli B. To promote respirations C. To promote pain relief D. To promote wound healing E. All of the above The nurse is precepting a student nurse and explains that perioperative nursing care occurs A. Before, during, and after surgery. B. In preadmission testing. C. During the surgical procedure. D. In the postanesthesia care unit. The nurse is caring for a patient who is scheduled to undergo a surgical procedure. The nurse is completing an assessment and reviews the patient’s laboratory tests and allergies. In which perioperative nursing phase would this work be completed? A. Perioperative B. Preoperative C. Intraoperative D. Postoperative The nurse is caring for a patient in the postanesthesia care unit. The patient has developed profuse bleeding from the surgical......

Words: 3306 - Pages: 14

Wound Soap Note Example

...ulcer on sacrum. Removed wound dressing. There was 5% of thin serosanguineous drainage on ABD dressing. There was 20% of thin serosanguineous drainage on 4x4s. There was 50%of thin serosanguineous drainage on the kerlix super sponges. No unusual odor noted. Irrigated wound with NS, fluid returned clear. Obtained wound culture, sent to lab. Wound measured 10cm x 7.7cm. In the wound bed there was slough from 11 o’clock to 1 o’clock position and from 4 o’clock to 5 o’clock position. Slough making up 20% of wound bed. 80% of wound bed was granulation tissue. Bone was showing in the middle of wound. No redness or edema noted. No ecchymosis noted. Wound not approximated. Applied sterile wet-to-dry dressing. Patient tolerated procedure well. No signs of facial grimacing or guarding during procedure. -------------------------------------------------------------------------------------------------------------------------A: Impaired skin integrity related to physical immobility as evidenced by stage four pressure ulcer on sacrum. ------------------------------------------------------------------------------------------------------------------------------P: The nurse will reposition patient q2h to prevent further skin breakdown. The nurse will assess the wound daily for redness, swelling, warmth, pain and other signs of infection. Patient’s continence status will be monitored. The nurse will assess the client’s nutritional status and encourage fluids to help promote wound healing. The......

Words: 305 - Pages: 2

Unseen Response to 'Lament'

...Unseen Analysis on the poem ‘Lament’ The poem ‘Lament’ can be seen as a series of things, which the poet is grieving for as a result of the destruction of war. The poem begins every stanza with the word “For” in order to suggest all the things, which the poet thinks the reader should feel sorrowful towards. The poem has a regular structure and comprises seven stanzas, all of which are three lines long. This regular structure allows the poet to explore specific things, in each stanza, which he believes are being impact upon by the destruction of war and the pollution it causes. Each line of the poem is end stopped and this disciplined form can be seen as paradoxical with the almost dystopian level of destruction, which is being described. The first stanza of the poem begins with the word “For,” in order to suggest the things, which the poet believes the reader should be lamenting for. The use of the present participle of the word “pulsing,” conveys to the reader a sense of the desperation of the turtle, by suggesting the energy with which it searches for a breeding ground. The personification of the word “burden,” suggests the distressing reality of the experience for the turtle, as she searches for a breading ground. The visual image of eggs laid in their “nest of sickness,” conveys a juxtaposition in the vitality and life fullness suggested by “eggs,” in contrast with the word “sickness,” which alludes to the unhealthiness of the turtle’s environment. Structurally...

Words: 1475 - Pages: 6


...Wound V.A.C. – KCI Protocol Emergency General Surgery Service Vanderbilt University Medical Center 10 / 2004 Contributors: Sarah Debelak, APRN-BC Amanda Estapa, APRN-BC Ashlee Piercey, APRN-BC Dr. Jose Diaz, Jr., M.D. STATEMENT OF PURPOSE: POLICY: Define process for implementation, application, and management of negative pressure therapy The Wound V.A.C. will be provided to patients based on physician order PROCEDURES: I. Indications for V.A.C. Therapy A. For patients who would benefit from sub atmospheric (negative) pressure therapy for promotion of wound healing B. For patients who would benefit from drainage and removal of infectious material or other fluids from wounds under the influence of continuous and/or intermittent sub atmospheric pressure C. Types of wounds indicated: 1. Chronic Wounds including Diabetic Ulcers/Pressure Ulcers 2. Acute / Traumatic 3. Subacute Wounds (non-healing surgical wounds) . 4. Dehisced Wounds 5. Partial-Thickness Burns 6. Flaps 7. Grafts Contraindications for V.A.C. Therapy A. Patients with: 1. Grossly Contaminated Wounds 2. Malignancy in the Wound 3. Untreated Osteomyelitis 4. Non-enteric and Unexplored Fistula 5. Necrotic Tissue with Eschar Present B. Do NOT place V.A.C. GranuFoam (Black sponge) over exposed blood vessels or organs. May use VersaFoam (White) or petroleum-based gauze over exposed blood vessels or organs at base of wound with overlaying GranuFoam. Obtaining Equipment and Supplies A. Order the Wound V.A.C. from......

Words: 2502 - Pages: 11