My new signature

[heyang]

Re: The gift of music is priceless

Am I off the hook? I've been busy baking cookies for the bake sale at work tommorrow - part of my fundraising efforts.

 

[mathman444]

Re: The gift of music is priceless

Heyang -- Well, nobody's given the answer to the question in the 10th post on this page yet.

emiC -- Did you send the left hemisphere (logical, mathematical) or the right (intuitive, artistic)?

MM

 

[JOHIO2]

Re: !!! How did I miss that one ?!?

Emmy, love the note next to your name. Pure musical class!

Mathman, have you ever used a former math teacher's favorite line - close enough for government work - on an answer given by a student? In high school, I suppose that passed for humor. Personall, I think we laughed because he was cute.

 

[rgirl181]

Re: mmandel you asked for it

<blockquote><strong><em>Quote:</em></strong><hr>The ambo brought in Mr. John Doe who was in a motor vehicle accident. Mr Doe sustained multiple bone fractures, that required emergency surgery. Pre surgery labs including tox screen and blood ETOH levels were within normal limits.

Post op hospital day 1 - 3 : Mr. Doe was recovering nicely. There were no signs of infection or any surgical complication, vitals were stable. Post op hospital Day #4, Mr. Doe's vitals were elevated, he was disoriented, hallucinating, and had a clouded sensorium.

What is the most likely cause of his change of mental / brain status. (or if you prefer, give a list of possibilities, and name the most likely one).[/quote]

Here's my explanation:

Early on the morning of Day 4, the hospital's billing representative informed him that his HMO had declared bankruptcy and therefore would not be covering any of his bill, which was now over $100,000.
Rgirl

 

[mathman444]

Re: mmandel you asked for it

Rgirl, if only that were a joke.

MM

 

[mmandel]

Re: mmandel you asked for it

:lol:

 

[emiC]

MM. sorry I hijacked your thread

Apologies


<blockquote><strong><em>Quote:</em></strong><hr>Early on the morning of Day 4, the hospital's billing representative informed him that his HMO had declared bankruptcy and therefore would not be covering any of his bill, which was now over $100,000.
Rgirl[/quote]

From mmandel and rgirl:

1 Lack of Oxygen
2. Pulmonary Emboli - Fat vs. Blood
3. Septic Shock vs. Hypovolemic Shock
4<strong>. Sticker shock</strong>
5. ETOH Withdrawal vs. Drug Withdrawal
6. Medication Reaction

More information:
•_ _ _ _ ABG (arterial blood gas) ruled out hypoxia (lack of Oxygen)
•_ _ _ _ Ventilation-Perfusion Scan ruled out pulmonary emboli
•_ _ _ _ Hemorrhagic and septic were ruled out, perfect surgery with no post op infection
•_ _ _ _ Prelim hospital bill was >$100,000
•_ _ _ _ Mrs. Doe called mmandel the nursing supervisor/ charge nurse and gave the following story. Mr. John Doe has been drinking like a fish for the past 3 decades. 2 days PTA, he decided to quit drinking. 36 hours after his last drink, the craving was unbearable; Mr. Doe drove to the liquor store to buy some ETOH. On his way to the store, he was hit by a drunken driver.

Nursing supervisor mmandel reviewed the pre op labs again, ETOH (blood alcohol) level was 0.

What is your diagnosis?

 

[mmandel]

Re: MM. sorry I hijacked your thread

Stupidity. :lol:

 

[DORISPULASKI]

Re: mmandel you asked for it

rgirl, Yes I believe it about the bill. But there are other possibilities

Scenario 2:
Mr. Doe had asked for an aspirin. The hospital actually dispensed a very high dosage of an antidepressant. Mr. Doe had a stroke.

Possible Causes of the mistake:
1. Bad handwriting by Doe's doctor. Nurse thought
a@5n$5 was antidepressant, not aspirin.
2. Careless stocking of pills by nurse
3. Nurse confused John Doe with Jane Doe, who
needed the antidepressant. She got the aspirin.
4. Doctor being paid by drug industry to push
antidepressants
5. Dingbat doctor once had a patient that once had
a better result on antidepressant than on aspirin
(as defined by doctor)
6. Fraudulent activity by drug wholesaler (very
unregulated.)

Scenario 3: Same as above, but Doe is allergic/oversensitive to the antidepressant, and it conflicts with his morphine. Doe also stops breathing briefly after the morphine dose, but his
alert nurse catches the problem and puts him on oxygen.

When he revives, Does asks the nurse to cut down the woman hanging by her feet next to the TV set because woman seems to be in pain.

Scenario 4:
Doe has been drinking too much liquid and has way reduced sodium levels.

Scenario 5 (actually Scenario 3 with more detail):
Doctor thinks Doe has reduced sodium levels, and that this is the problem rather than his sensitivity to the antidepressant.
Doctor fails to check that Doe's last 2 years of sodium levels are just what they are now. Doctor restricts the amount of liquids that Doe can drink. Doe gets dehydrated. His tongue is dry in his mouth and feels like cotton. He is still hallucinating.

There are others

dpp

 

[emiC]

Dorris we were posting at the same time

Possibilities according to Doris, mmandel, and rgirl

1 <strong>Sticker shock</strong>
2. ETOH Withdrawal vs. Drug Withdrawal
3. Medication: Reaction/ side effect/ or error (mistaken ASA for antidepressant)

What is your diagnosis?

mmanel, you have the answer.

 

[mmandel]

Re: What is your diagnosis?

Or maybe....John Doe was sitting in his hospital bed, reading the Sunday NY Times. When a 19 year-old nursing tech/nursing assistant came into the room, stating "It's time for me to put this catheter in your bladder" as she proceeded to swing the catheter in her left hand. Stunned and dazed by the statement, John Doe asked the young girl if she had the right patient. She ignored his statement and she went on to state that "The nurse told me to put this catheter in your bladder. Besides, this is my first day on the job and I want to make a good impression performing my first procedure."

I wonder...could this have caused John Doe's stroke? :lol:

 

[mathman444]

Re: What is your diagnosis?

:rollin: Good answer, mm. The truth hurts. So, we all know the basic rule: never get sick in July. That's when the new medical students begin their first rotations.

Mathman