Situation in hospital - what do u do

[Promethean]

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"Inspect fundi"

Lol

I did think that sounded a bit ambitious for any rapid response I'd ever seen, but if you can work it in, that does sound like a reasonable quick screen for ICP. If you have your equipment on you, it shouldn't take but a sec.

 

[762513]

Idk how ABGs are drawn in your facility, but you could order a VBG and check for hypercapnea.

 

[cbrons]

I did think that sounded a bit ambitious for any rapid response I'd ever seen, but if you can work it in, that does sound like a reasonable quick screen for ICP. If you have your equipment on you, it shouldn't take but a sec.

If you carry one of these around

 

[jdh71]

I did think that sounded a bit ambitious for any rapid response I'd ever seen, but if you can work it in, that does sound like a reasonable quick screen for ICP. If you have your equipment on you, it shouldn't take but a sec.

It's stupid. You never "work in" a fundus exam in an unresponsive patient. If you think you may need to scan the head you scan it.

In a smoker on O's and narcs, the biggest bang for the buck after the narcan is a vbg. Hypercapnea doesn't respond to narcan. And any other lab abnormality bad enough to cause unresponsiveness is much less likely and would show up much more aggressively acute.

The problem with these questions is you need years of experience to really approach them properly in a practical manner.

 

[jdh71]

If you carry one of these around

I have EXACTLY two on hand, in my pocket at all times!! Just in case I need to check the fundus of an unresponsive patient.

 

[762513]

It's stupid. You never "work in" a fundus exam in an unresponsive patient. If you think you may need to scan the head you scan it.

In a smoker on O's and narcs, the biggest bang for the buck after the narcan is a vbg. Hypercapnea doesn't respond to narcan. And any other lab abnormality bad enough to cause unresponsiveness is much less likely and would show up much more aggressively acute.

The problem with these questions is you need years of experience to really approach them properly in a practical manner.

Wait... was the nurse right? Shhhh don't tell the med students.

 

[762513]

It sounds like hypercapnea, if so, you want to draw an ABG and check code status. Depending on the patients stated wishes. Get them to the ICU. Place a nasal airway and a rolled up blanket behind their upprr shoulders to have the weight of their head keep their airway open by extending their neck. Place soft wrist restraints and a bipap mask. I'm just a nurse but there... I just solved hypercapnea. Done it a dozen times.

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