00:00Case report, Nelson Mandela, Emergency Admission and Treatment Protocol.
00:06Patient, Mr. Nelson Mandela.
00:09Age, 94.
00:10Date of admission, a fictional date.
00:13Hospital, Pretoria, Central Medical Hospital, Medical Record,
00:18Numman, PCM, Mazira, Zoals, 1, Tuzwon, Wives, Emergency Admission.
00:24And initial assessment, Mr. Nelson Mandela was received in the emergency room
00:29at 08.40, Oz, following a severe traumatic episode,
00:35he was non-responsive and bleeding from the forehead.
00:38Triage nurse, Ms. Lydia Mokoena, RN,
00:43immediately initiated the Advanced Trauma Life Support, ATLS Protocol.
00:49Attending emergency physician, Dr. Johan Bautha,
00:52emergency medicine specialist.
00:55Initial, diagnostics ordered, MRI brain to assess for intracranial haemorrhage or neoplasms,
01:06CT scan, head and chest to evaluate head trauma and thoracic integrity,
01:13abdominal ultrasound, rule out internal bleeding,
01:16digital x-ray, chest and extremities.
01:22All diagnostics were performed within the first hour of arrival.
01:26First aid was administered, including haemostatic bandaging and IV fluids,
01:33ringers lactate.
01:34Diagnostic findings, MRI, brain, presence of a midline shifting tumour in the left temporal lobe,
01:433.6 Kim diameter, CT scan, no acute haemorrhage, tumour, visible,
01:50ultrasound and x-ray, normal abdominal and skeletal profile,
01:55cardiac status, later evaluation,
01:57severe aortic valve stenosis, with reduced or an ejection fraction,
02:03EF, 32%,
02:04neurosurgical intervention,
02:07lead neurosurgeon,
02:09Dr. Nkosazana Dlamini,
02:11MBCHB,
02:12FCS Neuro,
02:14anaesthesiologist,
02:16Dr. Frederick Lau,
02:18scrub nurse,
02:19Ms. Sibongjiel Kumalo,
02:21procedure,
02:22left temporal craniotomy and tumour resection,
02:25duration,
02:275 hours,
02:28outcome,
02:29tumour successfully excised,
02:31specimen sent to pathology,
02:34patient shifted,
02:35to recovery room,
02:371,
02:38post neurosurgical monitoring,
02:41intensivist,
02:43Dr. Andrew Matlala,
02:46patient was under observation in a special post-off suite,
02:50on day 2,
02:52cardiac irregularities were noted,
02:54ECG and ecocardiogram,
02:57confirmed severe aortic valve pathology,
03:00cardiac surgical procedure,
03:02lead cardiac surgeon,
03:04Dr. Aisha Khan,
03:06MBBS,
03:07FRCS CTV,
03:09cardiologist,
03:10Dr. Sibisiso Malongo,
03:12perfusionist,
03:13Mr. Daniel Botha,
03:15anaesthesia team,
03:17Dr. Rachel,
03:18Stein and team,
03:20procedure,
03:20open heart surgery,
03:23aortic valve replacement,
03:25duration,
03:266 hours,
03:28post-surgery care,
03:29shifted to recovery room 2,
03:32then moved to ICU,
03:33bed 4 intensive care,
03:35unit monitoring,
03:36chief ICU nurse,
03:38Ms. Tendiwe Mbatha,
03:40assigned nurses,
03:4124-7,
03:42nurse Peter Moyo,
03:45RN,
03:45nurse Linda Masuku,
03:47RN,
03:48nurse Claire Van Royen,
03:50RN,
03:51nurse Sifo Dladla,
03:52RN,
03:53vital parameters monitored continuously,
03:55IV fluids,
03:57vasopressors,
03:58antibiotics,
03:59and high flow oxygen were administered.
04:03Multiple IV drips and antibiotic regimens were rotated due to poor initial response.
04:11Complication management, despite optimal medical care, Mr. Mandela exhibited delayed recovery.
04:19A multidisciplinary board meeting was held by Dr. Aisha Khan, cardiothoracic surgery,
04:25Dr. Nkosazanad Lamini, neurosurgery,
04:29Dr. Mlongo, cardiology,
04:33Dr. Matlala, intensive care,
04:36Dr. Ruth Zulu, hematology,
04:39findings, hemoglobin,
04:41levels critically low,
04:43immediate blood transfusion protocol,
04:46initiated,
04:476 units of packed RBCs,
04:50transfused over 48 hours,
04:52public response and security measures,
04:55during ICU stay,
04:58large crowds of supporters,
05:00estimated over 2 million,
05:02gathered outside the hospital.
05:05Hospital administration,
05:07led by Mr. Themba Radevi,
05:09requested
05:09law enforcement intervention for crowd control.
05:14SAPS was deployed for
05:15public order and perimeter security.
05:18Final recovery and discharge.
05:21On day 21 post-admission,
05:23clinical signs stabilised.
05:26He was shifted to a general award for rehabilitation.
05:31After a total of 30 days in the hospital,
05:34vitals normalised,
05:35neurostatus,
05:37alert and oriented,
05:39cardiac status,
05:41stable,
05:41hospital EF 55% discharge summary prepared,
05:46by Dr. Andrew Matlala.
05:48Transportation.
05:50Patient was discharged in a fully equipped hospital ambulance.
05:55Before leaving,
05:56Mr. Mandela expressed deep gratitude
05:58gratitude to the entire medical team,
06:01thanking each department
06:02for their relentless care
06:04and dedication.
06:06If he not given a special medical,
06:09care with transfusion of more blood bags,
06:12and
06:12intravenous drip in his vein.
06:17recovery of Mandela
06:20was nearly very difficult.
06:23This case highlights
06:24the complexity of managing
06:25multi-organ critical conditions,
06:29including neuro-oncology,
06:31cardiothoracic emergencies,
06:33and post-op ICU care
06:35in a geriatric patient.
06:38The interdisciplinary coordination
06:39and critical decision-making
06:42were pivotal in Mr. Mandela's
06:45survival and recovery.
06:46After recovery
06:48and able to walk on his feet,
06:51Mr. Nelson Mandela
06:52thanked the team of doctors of the hospital
06:55and went away
06:56on an ambulance
06:58especially arranged for him
07:00by the hospital administration.
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