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Surgical ICU December 4, 2009 From: Dr Asif Qureshi To: Dr Abdul Rashid Bhat, consultant in neurosurgery at SKIMS. Emergency SKIMS Surgical ICU Can you bring me up to date? Fazl Haq Qureshi was rushed to a hospital in a critical condition:Is that correct? On admission to the hospital: Is the patient conscious, oriented in time, space, and person? Can the patient talk? Can the patient respond to verbal questions accurately? Does the patient respond to painful stimulus? Where exactly is the injury? What type of injury is it? When and how did this injury occur? What are the indications of a medical procedure or surgery? About surgery: What should go in surgical notes? What is the diagnosis? Who verified the diagnosis? What type of procedure was done? How was the procedure done? How long did the procedure last? Where was the procedure done? What were the findings? Who verified the findings? What are the post-operative instructions? What is the name of the medication? What was the indication of medication? What are the vital signs? Can the patient talk? Can the patient respond to verbal questions accurately? Does the patient respond to painful stimulus? What is the plan of action? December 7, 2009 From: Dr Asif Qureshi To: Dr Abdul Rashid Bhat, consultant in neurosurgery at SKIMS. What are the vital signs? What is the configuration of the ventilator? What is the treatment? What exact medication is the patient receiving now? When will the treatment plan be reviewed next? Who will do it? December 23, 2009 On December 23, 2009, this update was given through The Medical Superintendent SKIMS and associates. “He is communicative and he is also taking his medicines orally. But he can’t move his right arm and his right leg is also partially mobile. He didn’t need any special medical attention. In such cases, the patient recovers with time and if his family wishes they can take him home." From: Dr Asif Qureshi To The Medical Superintendent SKIMS and associates. He is communicative is a vague term. Precise answers are needed to these questions: Can the patient do spontaneous eye opening? Can the patient respond to verbal questions accurately? Can he take oral medicines on his own? Does he move any extremity on instructions? What extremities can the patient move on instructions? Where is the lesion or precise affected area of the brain? As per them, he didn’t need any special medical attention. I disagree. Does he need special medical attention? Yes. Why does he need special medical attention? He hasn't recovered completely. His neuro deficit at this stage can't be declared as permanent. Medical doctors attending him at SKIMS haven't answered all questions precisely. His treatment on hospital discharge has to be deliberated fully. How has the wound been closed? What is the current treatment? What are the treatment options? His safety and all other needs at home have to be ensured prior to discharge from hospital. How many police stations are there in Srinagar in 1600 square miles? How many workers are there? Which police station looks after his vicinity? Who will care for him at home? Do they have enough food, clothing, habitable housing needs, transportation for follow-up, and security for those who care for him? Who will give the final advice on hospital discharge? How often should there be hospital follow-up? What is the recovery time? Will the patient recover completely? What is the advice on hospital discharge? What should be the advice on hospital discharge? |