So I'm doing the charge thing the other night. It is kind of slow so about 1100 pm I start cruising the ED census looking for potential playmates also known as patients. I see 4 chest pains in the census, 2 been there since 630 not likely canidates and 2 that just rolled in at 1030 pm. Aha, these have potential.
The phone rings while I am looking at the stats on these two guys. Its bed control; Whatcha got for me? I ask. My friend tells me the name and I explain that this is not one of the potentials that I had been looking at. He says no its a Neuro ICU overflow. Okay I say, we can due a neuro case. Change in LOC he says. Okay I'm on it. And off I go to investigate this new case.
WHOA?! WTF, this change in LOC has been sitting in an ED bay since 1:30 in the afternoon. Upon further research I find that she has a history of UTI's that present with change in LOC. I call my friend in bed control and explain that this patient has been in the ED for a while and could we get a fresher patient. He assures me this one will probably be plenty fresh.
Upon further investigation the hospitalist has not ordered any neuro checks for this patient, her VS have remained stable since arrival at 1:30 in the afternoon, there are no IV drips, meds or even fluids ordered for this patient. I am seeing no indications of possible sepsis. Maybe she looks worse in person than she does on paper I think.
Ok so the patient arrives from the ED, she is in late stages of alzhiemer's with bilateral foot drop and upper extremity contractures. Her full time sitter will be staying with her. Skin looks great shes clean warm and dry. Again I ask myself "Why is she in the Cardiac ICU".
That was our only admission for the night. I wonder what ever happened to the CPs,wonder if they ended up on some med-surge floor infarcting.
Oh well, I love this job the good, the bad and the stupid.
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