Tuesday, October 28, 2008

Scream

We could hear her screaming from the other side of the department.  

For the first four hours of my shift it was a near-constant whine coming from the distance, but when my assignment changed to the team that was taking care of her, I experienced the Banshee at full volume.  A 28 year old female brought in for acute anticholinergic poisoning, she screamed almost constantly for 8 hours.  

Red as a beet from vasodilation, dry as a bone from affected sweat glands, hot as a hare from hyperthermia, blind as a bat from dilated pupils, full as a flask from urinary retention, and mad as a hatter from blocked CNS receptors [thanks UpToDate!], she ended up receiving over 30 of Ativan with no effect.  Every time she was medicated, she would nod off for a few moments before jerking up in the bed again, tugging at the restraints and screaming at the top of her lungs.

Once an ICU bed finally opened up, five of us accompanied her up to the unit, where she was immediately classified as a Trick, not a Treat.

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