Monday, September 17, 2007

Never Expected This...

Had an unresponsive drunk 18 year old brought in frantically by his parents. We are cutting of his clothes, putting him on the monitor starting IVs, cathing him etc, all the stuff we do in this situation. Sats and vital signs are fine, but this guy is not responding. Not with the 14 gauge IV stick, not even with the Foley insertion. The ICU nurse in me kicks in and I start doing all of the mean things to elicit a response. Now you should know that I am the nurse that people come to get when they have an unresponsive patient because I can usually make ANYONE respond to pain. I am very vigorous at eliciting response to painful stimuli. Quotes one nurse I work with, "If I am ever brought in unresponsive, don't let bohica near my room". Now before you go thinking I am some kind of sadist that gets off on people's pain, this is so not true. I am trying my hardest to truly assess a patients neuro status. I don't just jump right in with the vigorous sternal rubs and nipple twists, but do get there if nothing else elicits a response and if those do not work, I will do nail bed rolls. Back to the story. So this guy does not even flinch on Foley insertion, which tells me 1. he is not faking 2. he is really close to comatose. Now I am not wanting to intubate this patient if at all possible so I give him a sternal rub and I get a little twitch of the mouth. I proceed to do a nipple twist, and what does this drunk guy do? He smiles, rolls his eyes,moans and has experienced a sudden rush of blood flow to a certain medial lower organ. The doc and I had to run out of the room and died in a fit of laughter.

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