I have a patient who has a history of a cardiac arrest in our unit 6 months ago. I got her back from that and she has been doing well....until today. At the end of her run she began to call out a PCT's name. She seemed agitated (she only speaks Russian so its hard to know whats going on with her most of the time) so we began to rinse her back fearing that her pressure was dropping. The last pressure we got was 101/42 at 1300. By 1303 she began yelling this PCT's name kind of rhythmically while throwing her head back. At this point she was fully rinsed back but was not focusing and was thrashing about in the chair. As her pressure was normal for her before rinseback my guess is it was not a hypotensive seizure. I was unable to get anymore vitals on her as she was moving around too violently. Here are the different things I saw from her in the five minutes before the ambulance arrived.
1) no response to my voice or commands,
2) jerking back and forth from body fully extended to body pulled up in fetal position (no it did not resemble a grand mal seizure)
3) cyanosis that was getting worse with every minute
4) not diaphoretic
5) some right sided facial contortion (mouth pulling down on right side) with each time the body extended
6) each time the arm on the left extended, wrist turned in with fingers facing toward forearm as if posturing
7) blood glucose 112
The paramedics said they were going to sedate her in the ambulance, and when I called the ER to check on her status, they said she was sitting up calmly in a chair
She has an extensive cardiac history including CHF, the previously mentioned cardiac arrest, and a fib, is not diabetic, is in her 70's, currently has staph bacteremia
I'm driving myself crazy trying to figure out what was going on and how she could be okay so soon after....and get this....my wonderful NP sat in the back office and listened. When I asked why he didn't come out and help me assess the situation he said "oh, you're a good nurse. you can handle anything, I'm never worried when you're here" Gee thanks, but no thanks! could've used some help!
Anyone have any ideas as to what was happening?