Street Drugs and Brain Aneurysms

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Specializes in Home Health.

i know that members are not allowed to give medical advice…but…i think this should be ok.

what would you do?

a 20 y/o male enters the er by ambulance. he is alert x3 but can only write his answers (

ex. you ask for his to tell you his name and he writes it down). if your questions are yes/no type questions he will node to answer. a family member is in the ambulance with the patient and stated that he is a drug user, clean for a few months, and this was his first time using drugs since being clean. the family member states the patient smoked maujauna (only), stated something was not right about the drug, vomited in the bathroom, and then passed out. the family member then states that the patient is very open about his drug use and is being honest about recent drug use. at that time ems was called. ems backed the information stated. the drug screen is + for meth, maujauna, coke, and a depressant.

you examine the patient, the doc is informed, and he is tied to the bed due to combative behavior. the next day the family states the patient is “talking funny” (ex. he recognizes family members but when he tries to say their names it is very difficult for his to form the words) and his right grip strength is weaker than his left grip strength. the family also states that the right side of his face is “sagging” and he is drooling for the right side of his mouth. also, the patient’s right eye is a little droopy.

would you ask the doc if he wants a ct or would you contribute it to withdrawals?

i'm currently a nursing student and observed this case. i'm know i'm missing plenty of details but from i understand the patient's family is attempting to sue because the patient had a fatal brain aneurysm.

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Any neuro changes should be reported to the M.D. as soon as possible, then let the doc be the doc and the nurse be the nurse.

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Specializes in Cardiac Telemetry, ED.

We're not allowed to give legal advice either.

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Specializes in ICU.

the doc should definitely be taking care of this one.

Not giving advice here,, just an experience.

Had a 20 something patient one time, dropped off at a fire station passed out. Later we found out he had some "bad meth". It was an aneurysm. It really messed this guy up. He eventually went home, but not the same,, not at all. Meth is very very dangerous.

Edit: Let me just add that this is a time where a nurses advocacy and documentation skills should be used very wisely.

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Specializes in Home Health.

Thanks. I just wanted to know how the family could take leagal. Virgo_RN, sorry I'm not trying to legal advice. I just thought that this was scary. I could be that nurse one day. Unlike most student nurses, who fear of killing someone or giving the wrong medication, I fear some one taking legal action against me. It was a mad house. People yelling at the nurse telling her " we will have your job". It really freaked me out!

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Specializes in ICU.

It was a mad house when the patient died? Sometimes this happens,, even when everything is done correctly. How do you know they didn't scan this patient? Did they tell you? How long did it take from admission to death? There are several factors here.

Sometimes families get angry when their loved ones die,, and they lash out to the nearest person.

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This is typical for this type of family. They accept no responsibility. Never mind their son & brother was a druggie which contributed to his death. No, it must be someone else's fault. Maybe the doc will give it to them straight with no sugary coating.

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Specializes in ICU, Telemetry.

I've had pts (a lot of crack in our area) who come in with a EF of 10-15% at the age of 25, just from their drug use. I had a pt, frequent flyer, always pos for coke. They're whining because "nobody's nice to me" (we wouldn't let him go outside to smoke, and get more crack, which he'd had a history of doing). I finally told the person, "you see us as people who aren't nice to you because we don't enable your addiction. We see you as someone we're going to be zipping into a body bag unless you decide to stop the crack." He didn't, and had a massive MI about 3 months ago and died at 29. The family went crazy and sued the doc for "misdiagnosing his heart condition." Luckily, he'd decided to take his business up the road when that happened, so it's not us getting sued. When my charge nurse told me the pt wouldn't be coming back and why, the first thing I felt was relief. The pt was a druggie, but his family were druggies and members of the local "gun and knife club." I was worried if the pt died at our facility, they'd come in and shoot whoever they felt responsible....instead of realizing the pt made his decision every time he did crack.

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Specializes in Home Health/PD.

I was taught brain aneurysms were there from birth. So one way that the aneurysm could have ruptured could have been from the drug use. just my :twocents:

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