Unit 1 Case study 2011

Unit 1 Case study 2011 - Micro 310: Unit 1 Case Study Due...

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Micro 310: Unit 1 Case Study Due Monday Sept 19 at 5PM You are to work on this case independently. You must write/type your responses in your own words. You may use your book, on-line sources or class notes. You may not use your class mates. If any questions are unclear, please send me and e-mail and I will clarify the point if possible Brian * is a 33 year old man seen in the emergency room of a small local Kansas hospital. He is oriented, but agitated, and states that he has just been bitten by a rock rattlesnake. You are the ER doctor on duty, but are not aware of any rattlesnakes in the area. Upon further questioning, you note that there is a reddish bruising mark on the right hand (see figure 1) and it is swollen so you mark the hand (2048) to indicate the time and margin of swelling. You also place the hand on a cold pack of ice to slow the blood flow and inflammation. You take vitals and find elevated respiration and heartbeat, but attribute it to the patients concern over the bite and urgency that something be done quickly. A brief history from the patient reveals that he owns seven “pet” rock rattlesnakes Crotalus lepidus that were collected by his father who had a masters degree in herpetology. Upon the death of his father 7 years ago, Brian inherited the snakes and has been caring for them ever since. Brian stated that he felt comfortable with the rattlesnakes as he often went out “collecting” snakes with his father when he was a teenager. He usually used a hose to water the snakes, but had been in a hurry and put water in the cage using a cup. One of the snakes was closer than he realized. After taking the history, you note that the swelling and redness is progressing up the arm. You do not have any anti-venom in your pharmacy, so you decide to ship Brian to the closest large regional hospital in Wichita Kansas. You call ahead to check that they have anti-venom on hand. They state that they have CroFab and will prepare it to administer upon Brian’s arrival. You find out later from the brother of a friend (aren’t small towns great!), that Brian is given 10 vials of CroFab before the swelling stops, and kept overnight. He releases himself against the doctors orders so he can meet his friends in Kansas City to watch a Royals game. His arm is still swollen to his shoulder and he can’t bend it. So he drinks his beer with his left hand. At 48 hr and 96 hours the swelling is noticeably reduced, but some inflammation is still present. POST SCRIPT: Brian is currently back at work as a chemist in a pharmaceutical plant and has given his
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Unit 1 Case study 2011 - Micro 310: Unit 1 Case Study Due...

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