Thursday, November 26, 2009

Please Stop....




The other night I was helping in the ED and we got this patient that was showing signs of an acute stroke.  She arrived talking though she had some expressive aphasia.  Then all of the sudden she went unresponsive.  As the doctor started getting the intubation supplies ready I shook her shoulder and yelled her name.  Not responding to that I did the next step....a sternal rub. 


 


At this she started posturing.  Never a good sign.  But, then she suddenly awoke again!  I rushed her to CT for a head scan and we all expected her to have a head bleed.  Nope!  In CT she had another unresponsive episode though.  Again, shake the shoulder....nothing.  Sternal rub....posturing.  Then a minute or so later she awoke again.  Very strange!


 


Back to the ED and she had 2 more of these episodes.  Always the same.  Then no more.  After that she was more awake but just kept complaining of being "so so tired" and just wanting to go to sleep.  Explaining to her that she really needed to stay awake until we could get more information on what was going on with her she looked at me and said:


 


"Can you please stop doing that thing to my chest because it really hurts" 


 


I was shocked that she even felt it since she postured each time I did it.  She went on to say that she was quite tired and that she heard me and that she was trying her hardest to open her eyes for me but that it was just so hard.  So then I would push on her chest and that hurt so much.  Could I please just stop doing that!!!  I felt so bad!!  The poor thing.  I promised her that I would stop as long as she stayed awake.  It was a deal!!


 


Everytime I went into her room after that and she saw me the first thing she would do was point to her eyes and say "see they are open"!!!!!!!  She was quite the cutie!


 


 


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