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Suggest Treatment For Multiple Comorbidities
Question: If an elderly, non ambulant patient has COPD, CCF with a pacemaker, dypnea, hypoxia, dysarthria (but no brain bleeding), hypotension, T2 diabetes, recent pelvic fracture, myeloproliferative disorder (without acute transformation), delerium, recent development of hypernatremia, two TIAs a few years ago, malnourishment, is on 2 antibiotics for suspected sepsis and pneumonia, and is given 0.5 mg IM of haloperidol for delirium which has nil effect even after 1 hour then COULD this be a sign of a new medical problem or a worsening of a pre-existing problem or merely that the patient needs a higher dose of haloperidol?
Brief Answer:
he needs icu care
Detailed Answer:
Hi,
Your patient is critically ill elderly with multiple comorbidities. The patient must be managed in an equipped ICU setting. Hypotension, delirium, hypoxia, dysarthria, dyspnea with suspected pneumonia & sepsis all are indicating a grim situation. It is highly likely that the patients may be unable to protect the airway and unable to cough out sputum. If that's the case then patient needs intubation and ventilator support and should undergo early tracheotomy.
Seranace (haloperidol) can be given 1mg IV repeat every 10minutes; but it should be avoided if patient becomes more drowsy.
Such problem can be due to worsening sepsis but can be due to hypoxia, renal and liver derangement, ICU delirium or a CVA.
Patient should have central venous catheter and arterial line and Foley's catheter for urine output hourly measurements.
I hope the advise would be informative and useful for you.
Take Care!
he needs icu care
Detailed Answer:
Hi,
Your patient is critically ill elderly with multiple comorbidities. The patient must be managed in an equipped ICU setting. Hypotension, delirium, hypoxia, dysarthria, dyspnea with suspected pneumonia & sepsis all are indicating a grim situation. It is highly likely that the patients may be unable to protect the airway and unable to cough out sputum. If that's the case then patient needs intubation and ventilator support and should undergo early tracheotomy.
Seranace (haloperidol) can be given 1mg IV repeat every 10minutes; but it should be avoided if patient becomes more drowsy.
Such problem can be due to worsening sepsis but can be due to hypoxia, renal and liver derangement, ICU delirium or a CVA.
Patient should have central venous catheter and arterial line and Foley's catheter for urine output hourly measurements.
I hope the advise would be informative and useful for you.
Take Care!
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Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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