"Scott, Charles" <[log in to unmask]>typed
> 24 year old local woman brought to Emergency Unit by husband who had come
> home from work in the afternoon to find her lying on the floor confused and
> very restless. Been doubly incontinent . Last seen by husband that
> morning as she left the house to take children to school. Has 5 week old
> baby, normal delivery.
> No known other medical Hx, no known drug or alcohol abuse.
> O/E
> Restless++
> Not talking, moaning. Fights off any touch. Bruises (?24+ hrs old) on
> both upper arms and sides of head and ear lobes. Not petechial. No neck
> stiffness.
> Pulse 125, BP 119/70, resps 24, Temp 37.0; Cap refill <2 secs. BM 6.4
> Pupils 5mm react to light equally.
> Bloods, ECG, Xray or CT scan unobtainable without violent struggle/sedation
> so decide to wait and see.
> What should I have done?
My instincts scream water intoxication, low [Na], for no really logical
reason.
Of course, I'd worry about an intracerebral bleed etc as well.
Sedate, intubate get bloods and CT in ideal world, which this is not...
--
Helen D. Vecht: [log in to unmask]
Edgware.
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