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Re: What do you do? From: art fougner, md (evsono@pipeline.com) Thu Jan 18 07:41:14 2001 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Robert J Woolley: "Re: observation" Previous message: art fougner, md: "Re: observation" In reply to: Efrain Ramirez: "What do you do?" Next in thread: Efrain Ramirez: "Re: What do you do?" Reply: Efrain Ramirez: "Re: What do you do?" Reply: K Dew: "Re: What do you do?" might be a good idea for the nurse to put the patient herself on the phone prior to discharge. art At Wed, 17 Jan 2001, Efrain Ramirez wrote: > >What do you do? > >You receive a call from LDR nurse at 1AM - 24 y/o GI P0 38 3/7 weeks - >uneventful prenatal care - contractions every 8- 10 -15 minutes for the >last 30 -45 minutes- Cx long, FT -posterior - FHR tracing - reactive. >Vital signs WNL The patient is in no distress. There is no other >obstetrician in the LDR. > >Would you: >a) Tell the nurse to discharge the patient home with the instructions >that if contractions would get stronger to return to LDR -if not -- you >will see her in the morning at your office. >b) Tell the nurse to observe the patient for 2- 3 hours - reevaluate - >if no cervical changes in spite of contractions every 10 minutes - send >her home with previous instructions - if cervical changes did occur to >call you back. >c) You admit the patient - give her Morphine SO4 (or the sedation of >your choice) - with the intent of reevaluating her in the morning - you >instruct the nurse to call you if there is any change in the patient's >status. >d) You would immediately go to the hospital and evaluate the patient. >e) None of the above - if so - what? > >-- >"Life is neither the notes nor the silence between the notes, but the music that > arises out of sound and silence felt as a living whole. Stop choosing...between > chaos and order, and live at the boundary between them, where rest and action > move together..." > -- art fougner, md A series of 1000 cases begins with but a single anecdote. Next message: Robert J Woolley: "Re: observation" Previous message: art fougner, md: "Re: observation" In reply to: Efrain Ramirez: "What do you do?" Next in thread: Efrain Ramirez: "Re: What do you do?" Reply: Efrain Ramirez: "Re: What do you do?" Reply: K Dew: "Re: What do you do?"

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