Kickin ass

Below: the Main ICU, ahead is the special unit for open heart surgery patients, and in front a ventilator and next to that the defibrillator.

Last Friday in the ICU I had to kick some Zambian ass. And not just any backside, but the very backside of a physician. Why?
Because he screwed up a diagnosis.

Okay there was no actual ass kicking, but it happened indirectly, and the ass was kicked in my imagination when I found out that I was right.

So enough with the pedantry and on with what happened.

So we had this female patient who had an incomplete abortion and her uterus was manually aspirated by vacuum. In the ICU her condition deteriorated, and she was confused, and had lesions around her mouth, and on her thighs, which suspiciously looked like herpes. What made me notice the patient was that she was pulling her face, which is a danger sign of a pathological process in the brain (see tardive dyskinesia or dystonia).

I told the nurses that they should check the patient’s neurological status, and contact the neurologist, which of course never happened. I then decided to check her neuro status myself. Both her babinski’s (plantar reflexes) were positive, her right side deep tendon reflexes were hyper reactive, whilst the tone of her right limbs was decreased (paraparesis) and there was stiffness in her neck. This pointed straight at meningitis, most probably caused by herpes.

When the physician came to review her, I tried explaining to him my findings, and I recommended that he check the patients reflexes and consider meningitis or any neurological condition, but he just shrugged and would not listen.

Anyway, to my gratification came the attending gynecologist to whom I revealed my woes about that patient. He immediately examined the patient, redid everything I did, and confirmed my findings, and made an immediate consult for the neurologist and passitus (request) for a lumbar puncture.

I found the patient this monday morning feeling much better after having received some acyclovir loading  (treatment for herpes infections).

Things like these make me proud of becoming a nurse.

Health Tip: When kickin that ass, kick it in Style!