I started off as a new grad in the ICU and had gotten my first PCI patient. They didn’t give the full thrombotic dose because they saw on her CT a small bleed. So I was doing Neuro checks and the doc told me if anything changes, then to order a stat ct. So she ( the patient) started to become more confused but I was able to reorient her. She would talk about how she wanted to go home to pay her bills and was coherent. However, within the next minutes she started to become more confused.
My neighbor told me, hey she doesn’t sound good. I just blew it off because she was still coherent. Pupils were still the same and everything. But then she stopped talking and I freaked out. I looked at her and tried to make her react so I called my neighbor to come in. I checked for a pulse but then she stopped breathing and I yelled out for help! The strange part was, that half of her face was turning blue like only her left side of the face. Sadly, she didn’t make it and it was my first code blue and experience with all of this.
I called the doc to let her know and, lo and behold, I get a mouth full from her. It was bad enough that this had happened to me but the doc decided to say this in front of everyone, “I told you to get a CT if anything changes but you just stood there and watch her die. You let her die.” I tried my best to not cry right there and then but damn. That hurts and still hurts. My colleague tried to make me feel better by saying, “there’s nothing you could’ve done. She would’ve coded on the CT scanner.”
To this day, I have not seen this happen and I learned that with any Neuro change. Just call the doc and if they play it off then chart it and that’s it. This is why I hate Neuro patients because by the time you get the CT results, it may be too late. Stick me with cardiac patients because at least then I can act fast and do an intervention.