On call review

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24 y.o/ male/ single

c/o: drowsiness for the last one week. Drowsiness usually started at 6.00 am in the morning and continuously drowsy until 7pm. After 7 pm, claim the drowsiness disaapear for few hours before narcoleptic episode around 10 pm.

Currently, patient has not been sleeping since the last 24 hours because he was doing his on call.

otherwise, there is no other active complain. No loss of weight, and no loss of appetite.

Past medical History - Nil
Past Surgical History - Nil
Allergic hx - allergic to penicillin and sometimes allergic to certain type of people.
Family history - not significant
Social history - Work as a house officer in Hospital Likas, work from 6.30 am until 8.00 pm everyday. Work 36 hours during on call. No smoking, no alcohol. Live somewhere around kota kinabalu.

O/E:

Patient comfortable, appear drowsy, pink, good hydration, exhausted.

BP 140/90
PR 92
T Hot and angry because have to attend an emergency case last night in A&E while the person that supposed to in charge for gynae was doing nothing but sleep.

Lungs clear
CVS DRNM

Abdomen - Soft, no mass palpable, distended.

No calf tenderness

No muscle weakness, no lymph nodel palpable.


Imp: Post call Drowsiness

Ix - Diagnosed clinically.

Management:
1. Continous rest in bed
2. Encourage Orally calm food, nice and warm
3. Encourage fluid in take.
4. Encourage to watch movie "action movie".
5. Allow discharge if possible from hospital
6. To come again tomorrow to work as usual.

Comments

  1. Anonymous10:08 pm

    Your stories are always so thrilling))) Please, write something about phentermine

    ReplyDelete
  2. Unknown10:34 pm

    The patient should be on intravenous fluids too while rest in bed

    Given his hectic workload he is obviously dehydrated and hypoglycemic..

    IV Dextrose saline 6 hourly should be good. :)

    ReplyDelete

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