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Apr. 27th, 2007 11:01 am![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
grim23So, yesterday, I'm en route on Southwest FLT 520 to PDX on the last leg of my flight, from Chicago. I go to the bathroom in the back to get rid of the first leg's coffee, and as I'm finishing up, an announcement comes over the PA system, "Is there a doctor or a trained medical professional on board this aircraft?" John, a Fire Chief from the Chicago FD, and I, respond. John does the initial interview of a gentleman seated near the back, who is nauseated and dizzy and may have blacked or greyed out briefly, as well as having substantial diarrhea. John looks at me and says, "I haven't taken vitals in a long time", and steps aside.
The next thing I know, I'm taking vitals, performing a mental status examination, a neurological screening, and a clinical interview. I note vitals, food, fluids, and medication intake, current symptoms and cognition, check pill bottles and consider medication side effects,as well as his history of mild emphysema and elevated blood pressure. I offer a tentative diagnosis of my patient based on his medication, which can cause dizziness and disorientation (especially in higher altitudes), his substantial international travel in the last 24 hours, and his possible dehydration and glycemic level. I suggest followup with his primary care physician, make the decision after consultation with John about not diverting the aircraft back to Chicago, and consider contingency plans with the flight attendants and the pilot if his vitals start to crump. I write report.
Throughout the several-hour flight, I continue to monitor my patient, taking hourly vitals and checks, while reading Hesse's Siddhartha. He stabilizes at first, but then his dizziness and nausea return and his vital start getting lower and more erratic. The flight attendants keep me informed of his status, bringing me a never ending cup of coffee. I again consult with John and the flight attendants, and we decide to continue to PDX, but have EMS meet us on the ramp, and the pilot increases speed and clears a faster final approach. The flight attendants, after we land, have the passengers stay seated until we get the paramedics on board, give a brief report, and get my patient of the plane. Once we're out of the way, the passengers disembark, and I give a full report to the paramedics, who, based on my report and their own assessment, decide to transport to Providence hospital.
"When the going gets weird, the weird turn pro." - Hunter S. Thompson
Yeah. My patient is safe, and I'm safely in Oregon.
I think I may be about ready to be a psychologist.
The next thing I know, I'm taking vitals, performing a mental status examination, a neurological screening, and a clinical interview. I note vitals, food, fluids, and medication intake, current symptoms and cognition, check pill bottles and consider medication side effects,as well as his history of mild emphysema and elevated blood pressure. I offer a tentative diagnosis of my patient based on his medication, which can cause dizziness and disorientation (especially in higher altitudes), his substantial international travel in the last 24 hours, and his possible dehydration and glycemic level. I suggest followup with his primary care physician, make the decision after consultation with John about not diverting the aircraft back to Chicago, and consider contingency plans with the flight attendants and the pilot if his vitals start to crump. I write report.
Throughout the several-hour flight, I continue to monitor my patient, taking hourly vitals and checks, while reading Hesse's Siddhartha. He stabilizes at first, but then his dizziness and nausea return and his vital start getting lower and more erratic. The flight attendants keep me informed of his status, bringing me a never ending cup of coffee. I again consult with John and the flight attendants, and we decide to continue to PDX, but have EMS meet us on the ramp, and the pilot increases speed and clears a faster final approach. The flight attendants, after we land, have the passengers stay seated until we get the paramedics on board, give a brief report, and get my patient of the plane. Once we're out of the way, the passengers disembark, and I give a full report to the paramedics, who, based on my report and their own assessment, decide to transport to Providence hospital.
"When the going gets weird, the weird turn pro." - Hunter S. Thompson
Yeah. My patient is safe, and I'm safely in Oregon.
I think I may be about ready to be a psychologist.
