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This issue might be subtitled "What will they think of next?" Getting high does not always require the purchase of illegal drugs, and all substances that alter sensorium, such as nutmeg, cannot be regulated. However, the emergency physician must remain aware of the latest fads of drug abuse, and should be able to recognize the symptoms they cause.
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If your ED patient is sedated, he or she may have an adverse reaction to medications used in the procedure, an allergic reaction, or become hypoxic from inadequate respiratory effort, warns Brad Guffin, BSN, RN-BC, CPEN, director of emergency services at Martin Memorial Medical Center in Stuart, FL.
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While observing an elderly woman rubbing her arm as though it was a muscle ache, which she said was from gardening work, the possibility of a heart attack didn't cross the mind of the ED nurse caring for the patient.
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If your ED patient is taking multiple medications, he or she may have no idea what they are for. "They may tell us they are taking them because they were prescribed, without knowing what the purpose is or if the dosage changed recently," says Jocelyn Cajanap, RN, ED educator at Glendale (CA) Adventist Medical Center.
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When an ED physician at Scripps Mercy San Diego (CA) decided to order lorazepam to help an elderly man sleep, the ED nurse caring for the patient got a very unexpected reaction.
