my patient went a little nutty. but a pleasant nutty, like hallucinating that she was baking us cookies (oh how i wish it was real) and kept asking us to go on vacation. now number one on the differential diagnosis would be causes secondary to the massive amount of blood that was already in her brain. makes sense, you know. but like good medicine, there is always more to work through. the differential list, if you will. high up there on the list was 'icu delirium'. happens to old people and medical students. you lose track of the days and your mind. so we wrote the order 'out of bed (OOB) to chair, facing window during the day and quiet, dark, no tv at night (plus a little somethin somethin to get her to sleep).' as we we entered the order, i was thinking that should probably be entered for me. except i would have the opposite-i need an 'out of chair and into bed order'. and a 'should see natural sunlight' order. and an order to sleep, by whichever means you can offer. a nice solid 8 hr would be great. order it for me!! dont i have friends with the all powerful M.D. stamp of approval? cant you make things happen?
also on the differential is alcohol withdrawal. im going to go work on that now : )
Friday, July 31, 2009
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