My coworker had an interesting patient last night which I had no answer for so here is the scenario any ideas?
Came in mental status change with normal lytes ? ??dt's, urine was positive barb benz. Put on ativan drip 10 and versed drip was I think 40mg and hour Still breathing believe it or not not vented. I guess the previous nurse took her off the the ativan drip and was told wean off the versed. was given dekanoate 250 at 2000 the versed was off by 12 and was on bipap at 11 the patient throughout the night became more somnolent the nurse was suction him nasopharyngeal but the patient kept on producing enormous secretions like flash pulmonary edema. Actually I did hear her suctioning through the night so i know she was on top of it I figured for good measure i would do the same when I went in there noticed no gag with suctioning and within 15 minutes same thing filled up like pulmopnary edema
Suction consistency white some clear almost like exudative stage ARDS not pink tinged
I recommended CXR, and ABG, Sugar and Lasix for good measure she called Dr an gave report next shift.
VS all seemed normal Sinus- HR 80's Afebrile BP 120's on 80's map 70's PP >50
02 sats on a venti 40% ->93% Breathing like he was acidotic to me. Urine output normal
Stat CXR-normal
Abg Slightly acidotic but a COPD patient Home O2 PO2 Normal base excess normal
RYNOBLASTER30
51 Posts
Maybe all he needed was a DNR order?