Had a patient with a C7 fracture, dementia, but a+ox3 more or less. He was uncomfortable but doing okay with his head somewhat propped up on a few sheets. When the doctor came in and ordered the pt to lie completely flat, this completely sent my patient over the edge. I asked if he would be okay with the couple of sheets since being totally flat was extending his head (in cspine collar) and causing his pain to rise significantly. I may not be a doctor, but it seems to me if putting someone in a certain position causes them to be increasingly agitated/in pain, its probably not a good position for them, even if it goes against cspine precautions. Especially since this caused him to try and sit up, turn, get out of bed. Couldn't convince the doctor of that tho, but eventually me and the nurse I was working with decided that a few sheets to keep him in better alignment was the best move and we did so, patient was much better after that.
Same day, we had a medical alert patient come in, 30 year old on a ventilator, satting 50s-60s in ambulance. My job should have been to chart, but I immediately got flustered and did nothing! Its definitely not a good sign, I've been there long enough now to do SOMETHING, I would hope. Oh well.
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