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Wednesday, December 23, 2009

Lucid Altered Patient

We got called out just before the end of the shift. On of the things that made this call interesting is that our patient had no idea that we were coming. Our patient's son had received a call from his father at about 0730 on a Monday. His father wanted to know why he couldn't find the football game on TV. Since his father seemed confused he thought it was best to call 911.

We arrived on scene and were greeted by our patient at the door. He was a male in his late 60's and looked it. AS he sat in the chair in the front room I started to question him. He was able to answer almost all of my questions without hesitation or problems. He thought it was Tuesday morning but then said that he could be wrong and it might be Monday. I can't tell you what day of the week it is without looking at my watch first. During the questioning we noticed a full wine glass on the table.

He explained that he had poured it last night and forgotten about it. Not likely. Then my captain found several empty wine bottles in the kitchen. We asked if he had had a party recently and he said no. I asked him about his medical history to which he replied, "You name it, I got it." Not a great answer so I started to ask more pointed questions.

Do you have heart problems? No. Breathing problems? No. High blood pressure? No. History of strokes? No. Diabetes? Diet controlled. Thyroid issues? No. Anything else? No. So much for having everything.

Next I asked about his current medications to which he responded, "I take lots of meds." We were instructed to go over to the kitchen counter to retrieve the bottles of medication. He took Tylenol and Ibuprofen.

We checked his sugar which was fine. The little voice in the back of my mind kept yelling at me that there was something wrong. Something just wasn't adding up. My patient eventually said that he didn't know what was wrong but he was confused so I started a line on him and sent him to the hospital. The son arrived at the house just as we were about to leave and explained that his father has a alcohol abuse issue and that when he drinks he doesn't eat. Quite often they have to take him into the hospital because of malnutrition. I wonder if it was the alcohol/malnutrition or if he had early onset of dementia. It seemed more like the latter to me.
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