possible stroke patient under an Internist Doctor... Please help!
We admitted a 56 years old male patient with a chief complain of dizziness, while he is eating snack with his officemates he suddenly feel dizziness and they immediately brought the patient in the nearest hospital. He has a history of DM I and Hypertension... He is now handled by a Internest Physician with a diagnosis of Brain Stroke, IHD, DM and HTN (according to the AP). Brain CT Scan shows normal findings.. while the Lab Investigations shows BUN=66mg/dl, S.Crea=4.6mg/dl, CPK=474 U/L, CKMB=16.13mg/dl,Trop=0.30ug/L... the patient is given the following medications One Alpha, Inegy, ASA, Amlodipine, Folic Acid and Clexane...
The patient is sedated and we can not give oral medications since he has no NGT. We also have doubt on how they treat the patient... A stroke without even giving stroke medications such as mannitol... do you think this is a right way to treat a patient?
The patient have left sided weakness and frequently twicth his arms and legs at the right side... GCS 7 since patient is sedated and after sedation its GCS 14...
How is the patient? What other diagnostic tests were done after? The goal for the acute management of patients with stroke is to stabilize the patient and to complete initial evaluation and diagnostics within a certain time frame after the patient arrives in the hospital. Depending on the results and evaluation of the attending physician, critical decisions may focus on the individualized management of each patient, whether blood pressure control or determination of risk/benefit for thrombolytic intervention are initiated. It is best that you check with the attending also to ease any doubts. Take care and best regards.
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