Saturday, November 25, 2006
on blog leave....
...due to some inevitable circumstances...i'll be on blog leave.....ill miss blogging...be back soon/..
Friday, November 10, 2006
DNR
what would you do if you were asked by the Dr to sign the DNR (do not resuscitate) form?
i had a patient, a lola of 73 who suffered from hemorrhagic stroke and was stupurous, she had O2 via facial mask and was unresponsive. Stupurous, its like a deep sleep, not coma but the 4th stage of consciousness if im not mistaken. Coma is the 5th. Pain sensation is still present and little corneal reflex are also present. I asked the clerk what the results of her corneal checking was, brushing the tip of a cotton to the cornea to see if it reacts to pain, and she said that the LEFT eye is the only one responding. For my case study and assessment i tried to press her nails to see if shes gonna withdraw, another type of test for cosciousness) but i failed because i just cant press much harder so i asked my classmate to do it, and YES she withdrew her hands slightly. The next day, i saw that they have signed the DNR form, the husband actually, and saw that her BP that night was just 50/pap and she was given dopamine to increase it. when you auscultate her apical pulse, it cant be heard, and her radial pulse is also weak. she was intubated and was basically living through ambubagging. by the time i left, her BP was 70/pap and was still deteriorating.
how would you deal with this situation?? would you sign the DNR form???
i had a patient, a lola of 73 who suffered from hemorrhagic stroke and was stupurous, she had O2 via facial mask and was unresponsive. Stupurous, its like a deep sleep, not coma but the 4th stage of consciousness if im not mistaken. Coma is the 5th. Pain sensation is still present and little corneal reflex are also present. I asked the clerk what the results of her corneal checking was, brushing the tip of a cotton to the cornea to see if it reacts to pain, and she said that the LEFT eye is the only one responding. For my case study and assessment i tried to press her nails to see if shes gonna withdraw, another type of test for cosciousness) but i failed because i just cant press much harder so i asked my classmate to do it, and YES she withdrew her hands slightly. The next day, i saw that they have signed the DNR form, the husband actually, and saw that her BP that night was just 50/pap and she was given dopamine to increase it. when you auscultate her apical pulse, it cant be heard, and her radial pulse is also weak. she was intubated and was basically living through ambubagging. by the time i left, her BP was 70/pap and was still deteriorating.
how would you deal with this situation?? would you sign the DNR form???
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