Drinking, Drugs, and Medical Treatment

The 68 year old man liked to
have fun and drink. On the fourth
of July he had done both. He spent
the day with family at a picnic and
that night watched fireworks. On
the way home he stopped at his
favorite bar to celebrate the fourth
with some friends. He left the bar
around 1 am and headed home.
Unfortunately, he did not make it.
For what ever reason he ran off the
road and his automobile was found
headfirst in a tree the next morning
by some people going to work.
He was brought to the trauma
center and although he had a broken
leg, bruised ribs, and a dislocated
shoulder, he was doing pretty
good and communicated to the
staff. His blood alcohol level was
0.18. He refused any thing for the
pain, stating that he did not believe
in taking drugs.
His family arrived and was present
in the room when questions
were asked for the history and
physical. When asked about his
smoking and drinking habits, the
man stated that he smoked but did
not drink all that much. He stated
that he was only drinking last night
because it was the Fourth of July
and every one else was drinking.
No one in the room (not his wife or
sons) contradicted him. This denial
probably cost the man his life.
During the day and waiting for
surgery, the man became anxious,
developed a headache and was nauseated.
Seeing that all the lab and
paper work were ready for the surgery,
the nurse discussed with the
man his need for pain medications
and he agreed. She also gave him a
dose of Ativan for
his anxiety and
Zofran for his
nausea. The man
was calm at the
time of surgery.
The surgery
went well. When
it came time to
take him off the ventilator after the
surgery, he did not want to breathe
on his own. His blood pressure also
began to rise and his heart rate
began to slow. He was sent to the
intensive care unit.
Because the family and the
patient refused to acknowledge the
man drank (a lot), the medical team
did not prepare for treating alcohol
withdrawal. Because no one
informed the staff that the man
drank multiple beers every day and
on weekends added mixed drinks to
the picture, he developed major
symptoms of alcohol withdrawal
with in 24 hours. Just a note:
Alcohol withdrawal is a medical
emergency and people can die if
not treated.
He began to hallucinate. He
pulled at all the equipment in the
critical care room. His heart rate
rose and remained at 120 beats a
minute. His blood pressure rose to
180/100. He developed a fever.
Only when the daughter from
another state visited did the staff
obtain the whole picture.
She stated that her father’s alcoholism
was the reason she lived to
another state. Treatment was started,
but the damage to his brain and
heart was done and the man died.
Please, when your health care
provider asks about alcohol consumption-
tell us. If you use marijuana,
cocaine, crystal meth or the
newest combination to get buzzed
or high-tell us. We are not the drug
enforcement agency and we are not
trying to judge you or even turn
you in. If you find yourself in the
emergency room, or preparing for
elective surgery or any proceduretell
us.
What we are trying to do is
adjust your treatment. So if you
drink a glass of wine every night or
a can of beer or even smoke marijuana
to help you sleep-tell us. It
will help us help you. Most people
are aware that alcohol is a drug,
and just like any other drug, prescribed
or not, legal or not, we
need to know how much you take.
We need to know all the drugs you
take.
It just might save your life. Tell
us.

Kathy Latch
BA, RN, MN
vssrcorkpine@aol.com