Calling all adult ICU nurses!! Stat please!

  1. you nurses with experience with stroke victims, please, please tell me what you can!

    i'm a nicu nurse--- i'm at a complete loss.

    my stepmother in new mexico (i'm in alabama) just called my sister (in georgia) who called me on my cell phone to let us know our dad has suffered a stroke and they are moving him to intensive care very shortly. he fell monday and hit his head on a rock in a mountain stream... didn't go to the doctor. thursday when checking his sugar (insulin diabetic) he didn't return from the bedroom. his wife checked on him and found him rather confused. thought it was his sugar. they went to the hospital. very soon he became weak on his left side. he's progressed to the point where he can't talk but can understand things being said to him and answers with "uh huh or unh unh", barely moves his left arm and leg by himself.

    the worst part is that because of the subdural hematoma they cannot give him blood thinners as a treatment for the stroke.

    dad is 69 years old. his dad died at 57 of a cerebral aneurysm.

    my sister is a rn too and has adult intensive care experience. she is going to wait a couple of hours for the icu to get dad settled into his new bed and for their shift change to occur and then call to ask them, "if it was your dad and you were on the other side of the country, would you hop on an airplane right now or wait to see what transpires?" and hopefully they will be able to give some feedback.

    i just hate it that they can't give him the blood thinners!

    any thoughts on the subject would be very, very appreciated!
    Last edit by Anaclaire on Sep 6, '02
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  2. 12 Comments

  3. by   911fltrn
    Anacaire, As im sure your aware heparin and bleeding are incompatible. My reccomendation is to get on a plane. I will pray for you and your dad!
  4. by   hoolahan
    Ana,

    It sounds as if it is actually the pressure of the hematoma increasing his intracranial pressure, and causing his symptoms and not a clot-related stroke.

    He needs a neurosurgery consult STAT!! He should have the hematom aevacuated before any more bleeding causes the brain to herniate through the foramen magnum, the opening at the base of the skull for the spinal cord.

    I would call the physician's answering service and ask them to page the doctor covering to return your call as you are a nurse in another state and want to know if a neurosurgery consult has been done, and if not demand that one be done stat, and/or your dad be transferred to a facility with a trauma center, who will have round-the-clock access to on-call neurosurgeon's. If acted upon quickly, relieving the pressure should reverse the symptoms.

    I do not mean to alarm you, but I wouldn't get on the plane just yet, see what's happeneing via phone, and get the ball rolloinf so that if you decide you do need to be there, progress is being made. Too often I have seen consults held off d/t the weekend. As a professional courtesy, they should accomodate you, if for no other reason.

    When it is your family, be assertive and persistent, don't settle!
  5. by   jode
    Get on the plane......there are too many variables here. Go.
  6. by   Carleigh
    AnaClaire,

    Wish I could help but I'm new to nursing. Just wanted to say that I pray your Dad will get better. This has to be so hard for you with him being out-of-state. I hope you get the answers you need. As for going out there, it depends on your circumstances. Since he is in ICU, if you can arrange to go, I would if I were you. But don't feel guilty if your situation doesn't make it possible for you to go. Good luck and let us know how things work out.
  7. by   renerian
    Hop the next plane honey...................................I would if it was my dad. Both my parents are deceased. They were when I was 42.

    renerian
  8. by   Anaclaire
    Thank you all SOOOOOOO much for your immediate and heartfelt responses to my request for information!!!

    Hoolahan, what wonderful diagnostic skills you have! I called my stepmother right away to see if a neurosurgical consult has been done. She said they've had that done and three "checks" have established that the subdural hematoma is not the cause of this stroke. It felt soooo good to be able to call and find out about that... thanks to you!!!

    I suppose we will be buying airline tickets! The consenses dictates and I appreciate all of you for your help and generous spirits!!!

    :kiss :kiss :kiss

    With love to all,
    Anaclaire
  9. by   Anaclaire
    And thank you for the prayers!!! Keep 'em coming if you can!!!
  10. by   lisamcrn
    I am praying for your father and your family.
  11. by   hoolahan
    I'm glad I could help. I just hope he has a speedy and complete recovery. I am glad you could make sense of it w all the typos too, sorry!!

    I will keep him in my prayers. In the meantime... www.stroke.org

    www.ninds.nih.gov
    www.strokeassociation.org
    www.strokefamily.org
    www.americanheart.org

    Just to get you started... Keeping you all in my prayers.
  12. by   bestblondRN
    Anaclaire,

    This sounds more like a hemorrhagic stroke, not an embolic stroke. Regardless, get your patootie on the next plane to see him. He will definitely need a neurosurgeon to evacuate the hematoma. The longer it goes, the more likely he is to have residual neuro deficits. Don't settle for less than that, and push to have him transferred to a tertiary center if need be. Good luck and my thoughts and prayers are with you and your family!
  13. by   stressedlpn
    Get on the plane now. I'll be praying
  14. by   traumaRUs
    As someone who lost my father recently from a stroke - get on the plane. You just never know. Prayers and cyber-hugs!!

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