A 24 year old with a stroke?
I was called to a critical care room for this 24 year old who's girlfriend brought him in stating he may have had a stroke. He was semi conscious and not speaking clearly. He would be unresponsive and then suddenly cry out like he had a nightmare. He smelled of alcohol. His girlfriend stated he had a stroke the year before because he has arterial disease and he has been complaining of a headache and right sided numbness. I had to lift him onto the bed because he could not stand on his own. In between going unresponsive he admitted to taking aspirin and drinking 2 large shots of alcohol today. Periodically he would have these episodes of crying out and being very alarmed and afraid and he would need to be calmed. He did exhibit right arm and leg weakness as almost partial paralysis. During the workup he became more alert and asked for a cigarette. He was informed he was not allowed to smoke on hospital grounds and needed to remain in his room. He suddenly became very agitated and began yelling and crying out. He sat up and tried to get out of bed. He was in no shape to do this as he could fall or worsen his condition. He then swung at the paramedic. When a patient poses a threat to a co-worker the patient will be restrained. This is not so easy. This guy was in such a rage, all his weakness vanished. It took more than 5 people including a 300 lb. paramedic to hold him down. This puts the patient and others at risk for injury so he was given 5mg Haldol and 5 mg Valium. Antipsychotic and a sedative/antianxiety medication. He still would stare off and cry out. He still resisted and fought. He did not succumb to pressure points and he yelled you can't hold me down with those. He looked at me and yelled to his girlfriend for his knife. He said "you and me are gonna go" "I'm gonna cut you up"... I yelled for him to be put down with another dose of Haldol and Valium. The police were called and he required being helled down and restrained just as much and would even lift some of us off the bed. When the police arrived, he recognized them and calmed. To conclude, he was really just sooo drunk with a BAL of 0.24 and was a recent war veteran with some type of special training. He may have had some type of seizure and had some signs of psychosis. It was sad in a way and very scary. This guy would have seriously harmed someone or himself had he not been restrained. He was sent to ICU with the police at his bedside.
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