Don't just do something, stand there!
نویسندگان
چکیده
Physicians are under tremendous pressure to act, especially in emergencies. ‘Don’t just stand there, do something! After all, you’re a doctor!’, is a common admonition. Nevertheless, oftentimes the best action is inaction. ‘Watchful waiting’ is the term used for this strategy. Physicians should be familiar with clinical tools to decide which of both strategies is appropriate in a given situation. A 68-year-old disoriented woman was admitted to our emergency room at 18:00 in the evening. She was awake, but hardly aware and could not follow simple commands. There were no localizing neurological findings. She had undergone a complex tooth extraction that morning. She had a known platelet disorder and had been prepared with 4 μg/kg desmopressin infusion at the recommendation of a haematologist. Her blood pressure was normal. Her only medication was trimipramine, which she took since the death of her dachshund 1 month earlier. The serum sodium concentration was 118 mmol/L, potassium 3.6 mmol/L, glucose 8 mmol/L, urea nitrogen 4 mmol/L and serum creatinine 45 μmol/L. We concluded that her disordered mental status was related to acute hyponatraemia.
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عنوان ژورنال:
دوره 6 شماره
صفحات -
تاریخ انتشار 2013