Last week I experienced my first MET call.
Whilst on lunch in a room adjacent to the gym, a patient started shouting for help. The physio responded immediately, with a few students in tow soon after. Another pt had arrived at the outpatient department, seated himself and whilst waiting for his session to begin he had had a seizure, fallen off the plinth and hit his head on the ground (which is the point at which the other patient started shouting for help). The pt was still in seizure for the next few minutes. During this time the physio put the pt in sidelying and I put a pillow under his bleeding head and applied pressure to the wound (even managed to remember to glove up first). Another physio entered the gym and made a MET call.
The patient was conscious throughout, was scared and was aware of his pain. He was concerned about his bleeding (he’s on blood thinning meds) and was also aware that his already hemiparetic side, which had previously made good recovery, was now weaker (he’d had a stroke 8 mths ago, which is why he was receiving rehab). The MET team took a little longer to arrive than I had expected and unfortunately the crash cart didn’t arrive with them.
The patient was much calmer now, still obviously shocked though and concerned that he had had another stroke. After the team had done their examination they decided he should be transferred to another hospital. The health team were chatting amongst themselves, when the patient asked if I thought perhaps he should see a doctor.. I quickly explained that the doctor had already assessed him and that it was thought he had had a seizure. At this point one of the physio’s explained to him that about 10% of stroke pts go on to have seizures post stroke and that the increased weakness he was currently experiencing was usually transient. The patient was visibly calmer and was even able to start making jokes.
Ultimately, the patient was ok - before leaving that afternoon we had news that he was being discharged that evening with anti-seizure meds. I was so pleased the physio was able to provide him with that info about seizures post stroke - I guess with experience we will have more to offer in such a situation. In the meantime though, this experience has re-iterated to me how important it is to keep the pt informed about who they’re seeing and what has been found, especially in an acutely ill pt.
1 comment:
Sometimes I have been in situations where I could have hit the alarm in the patients' room but I didn't as I had a nurse with me who assisted. These have all been situations where the patient is discovered with very low saturations, or drowsy with cyanotic fingers or suddenly shivering. In each of these situations, I just jump into hyperdrive to get things sorted, so that by the time I even register the alarm button things are remediated. However, I am clear that should there be any secondary respiratory distress or any cardiac or spontaneous trauma I would be hitting that button mighty quick. I guess that clinical experience will teach us more about the variety of emergency situations and when we do and don't need to go for the assistance or alarm. I know I am veering more on the caution side now as I have had a few of these situations, but at the same time I am more confident about what to do while the emergency team arrive. Nothing like practice!
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