Geraldine Auguste
September 2020
Geraldine
Auguste
,
RN
Emergency Department
St. Joseph's Hospitals and South Florida Baptist Hospital
Tampa
,
FL
United States

 

 

 

Two weeks ago, I admitted a young man with weakness. He had a history of a-fib, on chronic Eliquis therapy. He was found to have prostatitis and a UTI and was appropriately placed on IV antibiotics. His weakness was attributed to his infection. At the bedside, upon my examination, he also complained of a headache. I prescribed Tylenol. A few hours later, I received a text from this nurse stating the headache was worse, uncontrolled with Tylenol, and "the worst of his life." She also gathered from the wife that the patient had fallen earlier and struck his head. She requested a STAT CT scan. This showed an actively bleeding subdural hematoma! The patient was transferred to the ICU, given Kcentra and FFP, and then transported for emergent neuro-surgical evaluation. Without her attentiveness to this patient's ongoing symptoms (which we normally have attributed to his infection), there was a high likelihood that he would have continued to bleed, herniate, code, and expire. In my professional opinion, I believe she saved his life.