Critical Care Experience Report ( Micu )

The author read Mrs. X’s medical notes prior to their initial consultation to afford herself the knowledge she required should she need to prescribe for her when fully qualified. It was evident from reading her medical notes that there were a few considerations to take note of before commencing any treatment, such as her medical history, drug history and allergies. Her past medical history consisted of Type 2 diabetes mellitus, which was diet controlled, hypertension, hypercholesterolaemia, neuropathy, rheumatoid arthritis and raynauds syndrome.

2/10/2016, 1600, Vital Signs: BP 140/85 P132 RR32 Temp 102.2 SpO2 85% on 2 liter by nasal cannula. Jacquline Catanzaro is 45 years old female on disability admitted to Medical Unit Hospital. Sister with patient. Reason to admit is can’t breathe. Diagnosis is 30 year of asthma exacerbation, psychiatric schizophrenia, obesity, pneumonia and herniated disc. Smokes 40 packs year. Drinks 2 pots of coffee a day. Drinks 3 beers each day. Frequency ED visits and hospitalization dependence on rescue inhaler. Patient refuses wear nasal cannula because of worry that it contains poison. Patient has a long history of stopping taking psychiatric medication and asthma medications. Patient has isolated herself from others. Sister is only caregiver. Neuro

The patient is a 72-year-old female who arrived to the emergency department in cardiac arrest. Emergency medical services reports the patient was last seen eating breakfast at her nursing home and was found an hour later face down and unresponsive. After it was determined the patient was in asystole, an intravenous catheter was started and two rounds of Epinephrine was administered. Upon arrival to the emergency department the patient had pulseless electrical activity with sinus tachycardia on the monitor. Airway management was in process with a bag valve mask on 100% oxygen and chest compressions in progress. After intubation and stabilization the

A (assessment): Ms. O’Reilly’s vital signs are temperature of 37.5 C, pulse of 112, blood pressure of 102/52, and respirations of 24. Her respirations are still deep but have a regular rhythm. She has a CBS of 8.1 and regular insulin running as per orders. The lab work shows uncompensated metabolic acidosis with no hypoxia. Ms. O’Reilly’s neurological status has improved with a GSC of 13. Her dehydration is being treated with NS containing 40mEQ KCL/L running at 200ml/hr and potassium levels maintained at 4.

According to the provider, the claimant's cough has been improved. His review of systems was positive for fatigue, malaise, sleep difficulty, shortness of breath, wheezes, and a cough. His blood pressure was 115/71 mmHg and his BMI was 30.35 kg/m2. The physical examination revealed wheezes. Clonazepam was prescribed for agitation. Atorvastatin, Nystatin, Citalopram, and a probiotic were prescribed. Continued use of Aspirin and a regular inhaler were suggested. Further, a follow-up visit with Endocrinology, Cardiology, and Pulmonology. As it relates to a spot in his lung, a repeat CT scan was recommended. The bronchial washes were negative for

Her drug screen showed positive benzodiazepines and blood alcohol was negative. Troponins were negative. Also, her initial work up showed acute kidney injury with a creatinine of 1.84, and potassium of 5.8. Her chest x-ray showed small amount of infiltrate in the right lower lobe. The CT scan of the head did not show any acute changes. The abdominal CT scan showed constipation and 6 mm opacity in her bladder. She had an electroencephalogram (EEG) which revealed diffuse generalized nonspecific encephalopathy. In addition, there was slowing of the left hemisphere consistent with left intracerebral lesion. The assessment diagnoses were acute respiratory failure (ABG of 87.287, pCO2 of 45.2, pO2 of 380 and biacarbonate of 20 on vent settings), altered mental status, attempted suicide, infectious process, medication use, hyperglycemic nonketotic, and less likely cerebrovascular accident given that her CT scan of the head was normal. She was admitted to the Intensive Care Unit under the care of Dr. Modupe Kehinde. She was intubated for airway protection and remained intubated until 5/23/2016 (7 days). She was on ventilator and was given nutritional support

(Medical Law and Ethics, 2009 Chap. 6 Pg. 216) No, there isn’t any legally recognizable injury to the patient. None of these accorded the patient suffered cardiac arrest and died. The patient would have to seek recovery or compensation but in this case the patients family has filed a wrongful death suit.

The patient is a 53-year-old African American female who was recently hospitalized from 1/19 -1/22, had a complete workup for seizure disorder, was discharged home and she represented to the ED several times on the 23rd complaining of seizures. She present after having a single isolated seizure which lasted 20 minutes witnessed by her family. She also presented earlier in the evening of the previous evening because she continued to have seizures. She is a history of CVA, hypertension, bipolar disorder. The patient has required intubation in the past. Her laboratory work is essentially unremarkable, phosphatase of 26, AST of 72 and ALT of 75. Dilantin levels are not reported at this point. The case was discussed with Dr. Amr Kahf. I

My patient Mary Ramussen came to the clinic for dental hygiene services. She is a 66 year old lady taking several medications. All of her vitals were within normal limits at her visit. Vitals are very important to take because a patient may not have any symptoms. Medications can have many contraindications, adverse reactions, or an interaction with other medications. It is important to have knowledge of medications and how to avoid adverse reactions or toxicity. Some medications can interact with local anesthetic with vasoconstrictors and cause effects on the heart. Knowing all medications that a patient is taking is important for knowing what over-the-counter medications to recommend post treatment. Some medications

This paper will specifically focus on a case involving an intellectually disabled adult female who was reported to be experiencing sudden onset shortness of breath. Upon arrival of EMS, the patient’s caretaker escorted the responding personnel to a back room where the patient was sitting upright in bed and appearing cyanotic throughout the face. Upon initial assessment, it was determined that the patient was both pulseless and apneic indicating the need to begin immediate resuscitation efforts. This patient was transported under the strong suspicion that she was suffering from a pulmonary embolism which resulted in cardiac arrest. Care of this patient was transferred at the hospital where resuscitation efforts were continued by emergency room staff with no success. The ultimate goal of this report is to discuss the pulmonary circuit as well as the implications of impaired circulation within the lungs. This case study also aims to identify key clinical findings of pulmonary embolisms and signs of deterioration in an effort to help improve prehospital recognition within the EMS community.

Patient C.Z. was a 64 year old female who presented to the Emergency Department (ED) with acute chronic heart failure (CHF). Prior to her arrival, the patient had been seen by her primary care provider (PCP) for a routine visit. Due to the patient’s poor status, the PCP sent her to the emergency department (ED) of Christiana Hospital. Upon arrival to the ED, the patient’s chief complaint was difficulty breathing; this was evidenced by the patient stating she could not breathe. As part of her treatment plan for CHF, patient C.Z. explained she had been prescribed 40 milligrams (mg) of furosemide (lasix) to relieve symptoms related to hypervolemia which often accompanies CHF; her presenting condition corroborated that the prescribed lasix had

On Monday, November 11, 2015, a 79-year-old female was brought to the emergency department (ED) of Fairview Southdale via ambulance for myocardial infarction (MI). A few hours prior to the ambulance arriving, the patient was experiencing chest discomfort, shortness of breath, and upper abdominal pain. At that time, she called her son who then went to her house to check on her. Her son made the decision to call 911. Minutes after the paramedics arrived, the patient went into cardiac arrest. The patient had previously expressed to her family that she wanted to be “do not resuscitate” (DNR) to her family, however, upon cardiac arrest her son told the paramedics that he wanted all measured taken to resuscitate her. Cardiopulmonary resuscitation (CPR) was initiated with a Lucas device and the patient was deemed rapid transport. In route to the ED, the patient was in ventricular tachycardia and ventricular fibrillation. An automated external defibrillators (AED) was used to shock her 3 times in route and 1 dose of epinephrine was given. She was intubated with a 7.0mm endotracheal tube (ETT) to protect her

The patient was on hydromorphone for his abdominal pain due to liver disease, deferoxamine mesylate to treat secondary hemosiderosis, insulin due to diabetes mellitus, folates for sickle cell anemia, sertraline for possibly depression due to the hepatitis C, lansoprazole for stomach acid balance, promethazine for pain, and digoxin for cardiomyopathy.

The research question addressed in the research summary table is: “What is the prevalence of adults admitted to an intensive care unit (ICU) who suffered from post-traumatic stress disorder (PTSD) post discharge from the ICU?

81 y.o. female, admitted for hypertension and has a history of dementia. The woman was experiencing severe hypertension when she checked her blood pressure and her daughter immediately took her to the emergency department (ED). In the ED, she was given IV hydralazine and was also had a brain CT scan to rule out stroke. The patient was stable and on her bed with the lights off on arrival to the unit. She remained on the med-surg cardiac floor for continued management of her blood