CANCER

Carotid rupture management for Head and Neck cancer patient in Terminal care

[Name of Student]

Carotid rupture management for Head and Neck cancer patient in Terminal care

Introduction

I work in an oncology ward (in a hospital) for different type of cancer patients including head and neck cancers. After a recent incidence of carotid rupture on a patient with metastatic laryngeal cancer, I realized that there were no clear instructions and guidelines were available for staff to follow. To provide the quality care to patient and family, I will make a guideline and clear instructions for staffs for the management for carotid blowout in terminal care.

The paper will also present a brief overview of the epidemiology, risk factors, presenting signs and symptoms and staging of my chosen tumour type as well as service improvement suggestions and recommendations for changes to current practice.

Epidemiology of Head and Neck cancer

With an estimate, in 2008 was 16 000 A new cases per year, cancers of the upper aero digestive tract (UADT) are at fifth among the most common cancers in France. These cancers are predominantly male (80% of new cases are men) (Sessions, 2005, 115-1402). In 2007, nearly 60 000 patients were ALD for head and neck cancer. Mortality is estimated at about 5000 patients per year. Head and neck cancer include a wide variety of tumours. The circumstances of diagnosis, the initial assessment, management and monitoring these cancers are themselves driven by topography and histology of the tumour in question.

The rupture of the internal carotid artery was a very frequent complication of head and neck cancers. The main causes were the post-surgical infection, rupture of the ligatures, post-radiation necrosis and of course complete tumour invasion. Since the progress of surgery and radiotherapy, these complications are rare(Desai, 2008, 2187). It never occurs on mucous membranes or intact skin. There is usually a wound infection or tumour, exhibition or necrosis of a vessel with small haemorrhages revealing called sentinels. Prophylactic ligation of the carotid artery can avoid massive bleeding, with the possible risk of underlying cerebral ischemia. It avoids the urgency of ligation at the time of massive haemorrhage.

This cataclysmic haemorrhage is a terrifying event for the patient, his family, but also a caregiver unprepared. When the event is expected and no deterrent ligation is possible, the therapeutic approach should be prepared including the sedative, and hypnotic injection at the onset of bleeding and the cataclysmic thick compresses necessary to hide bleeding the patient and his family. Treatment consists of compression of the bleeding vessel and sedation of the patient. Death occurs within minutes. In rare cases where bleeding occurs at an earlier than expected time, by the end of the first treatment or before an effective rescue therapy, we may use the internal carotid artery ligation in an emergency with risk of cerebrovascular complications (Steiner, 1993, 116).

Risk Factors

In most cases, the exact cause of tumour in head and neck cancer remain unknown. New research is continually conducted in order to learn more about the causes of ...