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Lecture 11

INST 352 Lecture Notes - Lecture 11: Adderall, Oxycodone, HeadacheExam


Department
Information Studies
Course Code
INST 352
Professor
Gigigan
Lecture
11

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INST354 Lecture 11: Helping a Patient 2
Late in the afternoon the patient is conscious for a longer time, moaning and
complaining of a severe headache. Ming and Dan appear for their consult, and are able
to ask the patient questions about his current and past condition, and his medication
habits. He claims to have been in good health before the accident (which he does not
remember), but denies taking any drugs (prescribed or otherwise), including Adderall.
He asks for some Oxycodone, an opioid, for his headache. These responses cause
some skepticism among the three medical professionals about the patient’s
truthfulness.
Outside of the room, the three caregivers discuss what to do. Given that the patient
shows possible signs of drug abuse, they are unwilling to prescribe strong pain
medications. They decide that small doses of acetaminophen are warranted, as the
GCS is now at the high end (12) of the moderate injury portion of the scale. Another CT
scan would be advisable if the patient worsens, but not if he improves. They decide to
continue monitoring him and checking in again during the evening.
The next day the patient appears better in several respects. Apart from evident bruising,
other vital signs are good: lower blood pressure and normal body temperature. His GCS
is 13. The patient continues to complain about headaches, but not so loudly as the day
before; from training and experience Marta and Dan know that headaches are common
for concussion victims for several days after injury. The ICU has an interest in moving
patients along as quickly as possible, so that they always have beds free for emergency
patients. Two days into the patient’s stay the ICU has come close to capacity, and Dan
and Marta agree that the patient is stable enough to be discharged to his family. This is
done, but not before a police officer makes arrangements to take a statement before the
patient leaves the state. Through a court order, the police also obtain the results of the
blood test administered at the time of admission; however they are not given any other
medical records.
Among the features in this scenario are continuing measures of, and searches for,
information, careful recording of any relevant data, and frequent sharing of information
among team members. Given the life-and death nature of the work, missing or
inaccurate information is a constant worry, as there are many opportunities for potential
adverse events. There is also a concern for control of patient information, due to privacy
and legal issues. The collaboration of multiple skilled workers, equipped with both deep
knowledge and extensive physical resources, makes a positive outcome much more
likely.
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