Sure signs your pt. is sick

GilaRRT · Aug 1, 2009

Actually, CPR means the patient is dead.

FlyingScot, RN · Aug 1, 2009

Actually, CPR means the patient is dead.

:lol_hitti

Altra, BSN, RN · Aug 1, 2009

I'm very aware people use the ER as their personal clinic and source for narcotics. I think these things are their own form of sickness too. What I was asking was what the OP mean by "sick". I merely wanted clarification.

To clarify ...

The average person at home who doesn't feel like his/her normal self -- nasal congestion, cough, mild fever, diarrhea, constipation, minor boo boo, generalized pain after an accidental fall, etc. etc. etc. -- might state that they are "sick". It's a phrase we all use to some degree or another.

Then, there's "sick" according to an acute care nurse's definition ... and more specifically, "sick" as in emergently sick, meaning that action must be taken now.

Even dramatic unpleasant symptoms -- vomiting, diarrhea, non-arterial bleeding from a minor wound, for example -- are not necessarily evidence that a person is acutely or emergently sick. (despite the protests from concerned family members :wink2: )

Some examples ...

The 20-year old with no comorbidities who has n/v/d x 6 hours, temp of 100.8 and no abd pain other than cramping before/during episodes of diarrhea ... is most likely not sick.

The 15-month old who is pale, quiet, and doesn't protest the rectal temp check ... is likely SICK.

The 60-year old female who c/o "stiffness" in her left shoulder and "I got a little short of breath when I walked in here from the parking lot" ... may be having an MI and therefore SICK.

The weekend warrior who wore proper gear and a helmet but nonetheless skidded and had his bike fall on him while offroading ... no loss of consciousness, no vomiting, just generalized pain worse in right knee ... is not sick.

The weekend warrior who takes Coumadin, fell off a ladder while cleaning his house gutters striking his head on the gable on the way down, "not sure if I got knocked out or not" and has vomited twice and ... is SICK until CT scan rules out possibility of CHI.

GleeGum, BSN, RN · Aug 2, 2009

Had a patient once that came in with AMS by EMS. He's yelling "HELP ME, HELP ME!" and violently moving around, then had a period of calm, then go back to yelling and getting violent. We get him on the monitor. 3rd degree HB, got paced and transfered to Cardiac ICU. Talk about someone knowing he is going to die.

mmutk, BSN, RN, EMT-I · Aug 2, 2009

Color is usually a good sign if a patient is really SICK.

You know the one's i'm talking about when you see em you just

get a little kick in your step...

I let the bodies do the talking for the patients, that's an easy way

to see who's sick.

loricatus · Aug 2, 2009

If your pt looks healthy as a horse, but is anxious and says, ''I'm gonna die" they to me are the sickest person in the hospital and you better get ready for a code STAT!!

I totally agree with this. It isn't the panic attack anxious that makes the hair stand up on the back of the neck, it's something about that anxious look, 'anxious eyes,' that pierces through you and makes you next look for the code cart.

FlyingScot, RN · Aug 2, 2009

I've seen it in babies. Their eyes look "old" for lack of a better term. Anybody who's taken care of a neonate with NEC knows what I'm talking about. Makes my stomach clench when I see it.

lovethechaos · Aug 6, 2009

Someone already mentioned the patient with a sudden urge to have a bm, but I especially worry if that patient was moaning right before. I have had a few moaners code on me without warning. Not the dramatic "I'm in so much pain I need my dilaudid" moan, but the patient that is rhythmically moaning and has a significant health history. Watch out!