Driving Can Be Dangerous to Your Health by Phil Stephens

Part III—The Hospital

John pulled up in front of the hospital and opened the back door of his car. He saw Dave holding a bloody tissue as they picked up his wife and carried her into the Emergency Room. The nurse saw the two men holding the older woman and the blood on the tissue, and ushered them into a cubicle.

The nurse put a clip on Barbara’s finger and turned on the heart monitor. The two men could hear the fast beeping sounds and saw “95 bpm” appear in the lower right corner next to the heart icon. The nurse started an IV, and took Barbara’s blood pressure (90/58). Finally, she put a plastic ring around Barbara’s head and a tube up each nostril.

“What’s that for?” asked John, concerned for his wife.

“It’s called a nasal cannula. It’s used to administer oxygen, should the doctor decide that it’s necessary.”

The nurse stepped back when the doctor entered the cubicle and she began to examine Barbara. John told her about the asthma attack that afternoon, and the second unusual attack that had happened in the last hour.

“Did your wife complain of chest pain?”

“Yes, she said that it was in her chest, neck and left arm. I thought that she was having a heart attack.”

“That is possible,” continued the doctor. “Are your wife’s legs usually swollen?”

John explained that his wife’s legs often swelled when they took road trips because they were in the habit of driving long distances without stopping. The doctor frowned at John.

“Did you notice that the swelling is worse in her right leg?”

“No doctor,” replied John. “But her right hip was replaced about six months ago.”

“Your wife had major surgery, and you drove how far?”

“That was my fault,” said Barbara. “My granddaughter was born around the time I had my hip surgery, and I wanted so desperately to see her.”

“If my initial prognosis is correct,” the doctor continued, “you may be staying here for a few days.” She reached down and turned on the flow of oxygen through the nasal cannula, and made notes on a chart.

“An orderly will take you to your room. I’ll schedule you for some tests.”

The bed was pushed out of the cubicle and John went to follow. The doctor turned to John and continued, “Perhaps you should go to Admissions while we get your wife settled in. I am afraid there’s a mountain of paperwork waiting for you.”

Questions

1. Is Barbara’s heart rate normal?
2. Is Barbara’s blood pressure normal?
3. What can you conclude from these two observations?
4. What two parameters are responsible for creating the movement (filtration and reabsorption) of fluid across the capillary wall?
5. Draw a diagram of a capillary and label arteriole at one end and venule at the other. With pressure on the vertical axis, draw two lines to show how the two parameters (Question #4) vary along the length of the capillary?
6. Why does a lack of movement create swelling in Barbara’s legs?
7. Why is swelling restricted to her legs? Why didn’t her arms swell?
8. If you were the doctor, what tests would you perform?

Copyright © 1999–2009 by the National Center for Case Study Teaching in Science.  Please see our usage guidelines, which outline our policy concerning permissible reproduction of this work.