I had a patient come in the other night............drunk with a head injury. As typical of us jaded ED nurses we kinda rolled our eyes and figured he was one of our regulars who had slightly bumped his head while intoxicated. That was not to be......
This man was someone who had only had 1 previous ED visit with us. He came in the ambulance doors with snoring respirations and his face covered in blood. He was immediately intubated and rushed to CT. Unresponsive throughout it all.
His CT scan showed a LARGE intracerebral bleed with a shift. Not a subdural bleed but intracerebral. His pupils were uneven too. We headed back to the ED and by then neurosurg was there to see him. After an exam and look at his CT it was evident that his prognosis was terminal. He was, in fact, brain dead in less than 24 hours. The only good thing that came of this is that his organs were harvested.
So...........you may be asking why the post is titled "Doing the right thing" with such a sad story?? Well, it gets sadder. This man was drinking at a friend's house that night and decided he was too drunk to drive home (he was, as his etoh level was 2x the legal limit) so stayed at the friend's house. He then got up at some point that night and fell causing his fatal head injury.
Just sad, so sad. He was only doing the right thing. I only hope that he is resting in peace at this time.
On the Anniversary of the ABIM's MOC Mea Culpa
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