What would you do for a patient who was a hemodialysis patient, tended to run SBP in the 100's, but was still a/o X 3 with a SBP like the high 60's to low 70's, who also was in ST w/ (very) frequent PACs vs. MAT (per the doc's notes).
Full code, of course.
Had HD that morning and a colonoscopy in the afternoon, was actually GIVEN fluids at HD. Was taken off Cardizem gtt toward the end of HD when HR was being maintained around 110's & BP dropped to 60's. Maintained LOC just fine also.
Anyhow, later that night, was unable to give po Cardizem, so of course, the HR popped back up again and the BP hung around the 70's systolic.
We worried that if she crashed on our floor, help would get there too late and that she needed titration of a gtt and closer monitoring, so we transferred to CCU.
But that only made me start wondering. What would you do for this patient? Would this patient be a candidate for pressors if she's in renal failure? What sort of treatments would you see her get on your unit?
What could we have done better? I kept feeling like we were missing something, but I didn't feel safe to do anything differently, given we were on a regular tele floor.
