Experience at the ER today, did I do this wrong? (long)

[GeauxNursing]

Got a called from SIL today that my hubby's dad was EMS-ed from Wal-Mart to a local ER because he passed out. I headed over there and met her, we waited outside the room while they were trying to I guess get him situated and stuff. He was combative, got some Ativan. He was alert but disoriented. His tone was kind of flat, i guess.

He had a seizure at the Wal-Mart Neighborhood market and someone called 911. So here we are. We just sit with him in the ER room, he keeps repeating the same questions every 2 minutes or so, and when we answer them (about what happened to him) he just looks so incredulous, like what?? really?

Anyways, he bit his tongue pretty bad, bruised his knees, his nose was bleeding a bit and he had bumped the back of his head. I'll add here that his only medical history is the 5-bypass he had a couple years ago. Non-diabetic. He is 63 and quite spry, maybe a bit overweight.

They take him for a CT of his head. Being a relatively new nurse, my mind is racing! Blood pressure something? Heart attack? Stroke? Little bit later they are speculating about probably being a seizure and all the labs are WNL and his tongue being all chewed up and Let's see what the CT says.

Dr. comes in a little bit later and says well we think you had a seizure blah blah. CT looks normal, but we're having a good thorough look at it. We'll let you know. Mentions something about clots or possibly a tumor, we just don't know.

The nurse comes in later and starts a drip of fosphenytoin. Explains what it is, what it does. My FIL is alert, calm, still kind of monotone. Just sort of detached, I guess. I'm texting with my mom through all this, she's been a nurse forever and she's my go-to lady. She is worried about microclots that maybe the CT won't pick up.

As about 45 minutes pass, he gets his drip, he rests. I'm wondering why he hasn't been moved to a room yet, the doctor didn't come back yet...

Next thing you know, the nurse comes back and says he's ready to go! Pulls his IV out, with no FREAKING gloves on, gives him a rx for phenytoin TID and some lortab, and tells him to get to his doctor. My SIL signs the discharge paper (I guess? Not sure what it was) and then we're alone.

Okay, so I get him to a standing position and we slowly walk down the hall, only to find out he's getting light-headed. So I dart into the wheelchair bay and grab one, while he almost falls over! Get him home, reclined in his lazyboy, and he starts to act somewhat better, so I relieved, but still obviously very worried.

My questions are:

-should I have pushed for an MRI? an admit for observation?

-shouldn't he have been more closely watched on the new medication?

-since they couldn't rule anything out, shouldn't they have explored the possibilities? what if it is a clot?

-was it enough to just tell him to 'get to his doctor'? why didn't he get seen by a neurologist there?

-why didn't the doc ever come back? And why didn't it occur to me to ask for him?

-and why did our nurse suck so much? no gloves, no discharge education, it didn't even occur to her to offer a wheelchair? What if he really had fallen?

So what now? I'm worried, the FIL says he's not afraid because he doesn't know what it is, so why be worried? My SIL and hubs I guess don't know how serious it can be. Am I over reacting?

thanks!

[GilaRRT]

This is something best discussed with the PCP and among the family. We cannot really give medical advice so you walk a fine line with this question. Good luck.

[Meriwhen, ASN, BSN, MSN, RN]

I hope everything's all right with your FIL. As far as what to do, the only advice I can give is to echo GilaRN's. Best of luck.

[sirI, MSN, APRN, NP]

That was an experience. I truly hope that all is o.k. with him. But, we cannot possibly begin to speculate about what should or should not be done.

Please stay in contact with him, back to the ED if need be and stay in close contact with his Health Care Provider. We hope this all resolves w/o any further problems.