A helping of dance fever

I casually walked into the emergency room to verify that they had proper equipment for ventilating a patient. As I walked in the door, I was surprised to see an unconscious teenager supine on the table. She was febrile and frothing at the mouth. Her eyes were twitching and her face grimacing. This was an obvious convulsion with a fever.

Her family stood at the foot of the bed and a nurse aide held her hand and wiped the drool as it pooled in the corner of her mouth.

I stood near the door for 1-2 minutes, just watching and writing notes. Nothing happened. Finally, I asked the nurse aide “where is the nurse?” and she replied “I don’t know”.

I then said, “you run and get the nurse and physician’s assistant. I will monitor the patient.”

Moments later she returned with the nurse but said the physician’s assistant would come after rounds. The nurse immediately grabbed some gauze and started wiping the patient’s saliva. Before he could finish his first cleaning, the patient began having forceful, generalized tonic-clonic seizures. Everyone in the room looked shocked and just stared at each other.

Do something, please!

I threw my notepad down, walked to the patient, forcefully turned her on her side, secured her head, abruptly told the nurse to put in an IV and commanded the aide to run, not walk, and get diazepam.

I then sprinted to the inpatient ward. I put my head in and told the PA there was a patient with seizures in the emergency room and he must come now. He followed me over.

The nurse got the IV perfectly on the first try and immediately gave the medication. Within seconds the seizure stopped. Two hours later, the patient was sitting up in bed eating rice and chicken.

This observer roll can be frustrating at times. I have enough information to say that the care here is horrendous, so I may jump into the teaching roll a bit more quickly and often.


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