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Twenty-two year old woman ingested vomit during labor resulting in an acute infection and pneumonia. Respirator was connected for four days and upon its removal today the woman has had reacurrent seizures. The attending physician stated the CAT-scan shows that the patient had a stroke possibly days ago. What is now to be expected? What are the patients options from here?

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Female

Customer (name blocked for privacy)

Status: Closed Value: $10

Was the cat scan specific for what kind of stroke? A bleed in the brain vs an area of poor blood supply causing an "infarct" in the brain tissue? A loss of oxygen at some point? How did the vomiting occur, was the lady awake then, or sedated, etc.? At what point was the endotracheal tube put in? Before or after the vomiting? Was she sedated while on the ventilator or awake?

Judy, RN ICU experience

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Relist: No answer yet.
She was under an epideral form of sedation during the time of ingestion. She had a tube put in to help her breath two days after she gave birth. She was primarily sedated while on the ventilator.

Edited by Customer (name blocked for privacy) on April 11 2006 at 11:17 PM

Was there any additional information about the type of "stroke" she suffered? Do you know if she had an oxygen monitor on her finger or ear during the time before she was intubated (placed on vent)?

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Reply to Judy's Post: They think it caused damage to her sensory nerves and won't know much more for 24 to 48 hours. She had an oxygen monitor attached to her finger.

I am sorry I forgot to check info request and I see you had to relist, I will stick with you and answer all your questions. I need more info to determine what is the status of her mentation now--is she awake? moving? responsive to commands and questions? Judy

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Reply to Judy's Post: She is awake and finally allowed to move. Still in ICU. Not very coherant and sedated with seizure medication due to the two seizures she's had since.

I think there is an option for you to chat with me online, but I don't know how the pricing works. If you'd like, I will be available for a bit longer. I have to work 12 hours tomorrow at the hospital, so I won't be getting back to you until tomorrow eve. other than until about 12mn tonite! pm me if you'd like when you have more info. The problem with this type of question is that there are so many variables. I was trying to determine if she was hypoxic for any length of time. (low oxygen level on the finger probe), but chances are that the most crucial time would have been during the immediate problem, not when you were around to observe it. The other info I would like is what was the oxygen level during the time before the intubation and what was she like at that time (short of breath/confused/coughing/wheezing/ etc.) Aspiration of stomach contents is like aspirating acid. It damages the lungs and makes them less able to absorb the oxygen in the air she's breathing. This damage would likely get worse over the first couple days, and then begin to heal. The ventilator is used as support-it doesn't fix the lungs, it just gives support to the body while the lungs are going through the healing process. The fact that she was only on the vent for 4 days tells me the lungs are healing well. The concern is what happened in the meantime.

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Reply to Judy's Post: Thats alright Judy. I realize I am asking a very comprehensive question. I am asking out of concern for my employee whose daughter I am greatly concerned about. She feels powerless at the moment and doesn't know where to turn. I am a rather pragmatic person and thought that if I could understand the situation better I might be able to guide her with questions to pose to her daughters physician. Thank you for your time.

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