oa Professional Nursing Today - Improving the quality of care - learning through case studies
Compartment syndrome : quality of care
Sipho was 26 months old when he was admitted with a history of having had diarrhoea for four days. He was severely dehydrated and pyrexial. He was assessed and two unsuccessful attempts made to establish a peripheral intra-venous line. The medical officer then commenced an intra-osseous line in the right tibia. Two hours later intravenous access was obtained by means of a cut-down and the intra-osseous line was removed. At this time Sipho's right foot was swollen and mottled. Sixteen hours later the medical officer observed that the right lower limb was more tense and swollen and could not detect a pulse in Sipho's right foot. He was sent to theater for a fasciotomy but, by the time he arrived, the orthopaedic surgeon decided that the limb was gangrenous and performed a below knee amputation. Sipho remained ill and had a wound infection but was discharged home after three weeks. His mother has indicated she intends to take legal action against the hospital.
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