A Challenge in the Diagnosis and Evaluation of a Patient

Subject: Diagnostics
Pages: 2
Words: 346
Reading time:
2 min

There was a case during my practice when the medical team faced challenges in evaluation, diagnosis, and management. The patient fell off the dirt bike from the fifteen-foot wall and felt pain in the elbow; however, he could work for the rest of the day after the injury. The next morning, he felt the highest rate of pain. Therefore he came into the emergency department. The patient had the PMHx of hemophilia A (<1% factor VIII) and the inability to move the left elbow. He also stated that his hemophilia therapy includes Xyntha as the most effective control medicine for him. Hemophilia A with factor VIII is a severe type of disease when the development of alloantibodies against it is challenging.

Any intervention had to consider that the patient must not receive any infection, and his blood had to be continuously monitored. Treatment for such patients requires an interprofessional approach and the participation of multidisciplinary teams. The nurse practitioner of the trauma medical team was my mentor, so I was part of this brigade as well. My role as a student was to observe everything and carefully listen to the patient’s complaints. The patient’s management was challenging for us because we had to consider the patient’s disease, which is not related to traumatology. The hematology team joined us to consult and gave us recommendations throughout the treatment.

Another difficulty was to set the diagnosis, and the team came to several variations like elbow sprain and dislocation, olecranon bursitis, and compartment syndrome. The orthopedic team was called as they were more capable of evaluating the patient’s injury and complying with hemophilia A. The multidisciplinary teams concluded to avoid orthopedics intervention and provide the patient with proper pain management. The collaboration felt satisfying because if the trauma team had to make decisions on their own, severe consequences like blood infection could appear for the patient. Moreover, the hematology team considered the ethical principle of autonomy for the patient and provided the proper treatment with Xyntha he preferred.