Anchors Aweigh!

An otherwise healthy 38 year old patient was brought in by her family with vomiting and mental status changes from her pain medications. She had repair of a tibial plateau fracture performed four days earlier and was having a lot of pain. She didn’t like taking the Percocets that she was prescribed because they made her nauseous. She took one of them the day after her surgery and she was nauseous the rest of the day, so she vowed not to take any additional Percocets. However, her knee pain was worse that morning to the point that she couldn’t stand it any longer, so she took two Percocets … on an empty stomach, no less. A couple of hours later, she was acting strange and had vomited several times. When she arrived, she was lethargic and retching. She was afebrile, but her blood pressure was 87/50, her pulse was 120, and her respirations were 28. With a fluid bolus and some Zofran, her vital signs improved and she felt better. The option to give her Narcan was discussed with the patient and family but with the improvement in her symptoms, they didn’t want to reverse the pain relief that the medications had given her. The remainder of her exam went along with her history. She had been sleeping a lot after her surgery and hadn’t eaten much, so her mouth was a little dry. She was awake and drinking fluids in the ED. She was tachycardic, but her tachycardia was improving with fluids. Her abdominal exam was fairly normal – perhaps a little epigastric...
Source: WhiteCoat's Call Room - Category: Emergency Medicine Doctors Authors: Tags: Medical Topics Patient Encounters Source Type: blogs