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Consultation Letter - ATLANTIC HOSPITAL page 1 of 3 AUGUSTA...

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ATLANTIC HOSPITAL page 1 of 3 AUGUSTA, GA NAME: Brown, Edward ROOM: SNICU1 UNIT: 124543 LOCATIONS: SNICU ACCT: 684573 ADM DATE: 09242000 ATT PHYS: John A. Combes MD ------------------------------------------------------------------------------------------------------------ CONSULTING PHYSICIAN : JEFF JONES MD DATE OF CONSULTATION: 09/27/2000 REASON FOR CONSULTATION : Evaluation of patient’s mental status. The patient is a 76-year-old white male who presented to Atlantic Hospital on 09/24/2000 for a right thoracotomy and right lower lobe lobectomy due to the diagnosis of squamous cell carcinoma. Over a 24-hour period of 09/25-09/26 the patient was noted to have developed increasing and progressive respiratory difficulty with increasing disorientation at 5 o’clock in the morning on 09/26/2000. He had an asystolic event, which required CPR for approximately ten minutes. He did respond to Atropine and Epinephrine and was intubated. Apparently he had asystole for less than 5-10 minutes and then went into supraventricular tachycardia, which responded to no treatment and subsequently was placed on a ventilator. Pulmonary has been following with him. Reviewing the blood gases, his pH at 0600, 09/26/2000, was 6.979 with a pCO2 of 101, O2 saturation 80%. At 0615 his pH was 7.26 and 7.323 at 0748. At 0748 hours his pC)2 was 45 with pO2 of 273 and 02 saturation 99.9. He is still on the respirator. Review of the chart states that there was questionable grimace. He has had problems with his blood pressure being up when the Ditropan is off, and I did stop the Ditropan during the exam and restarted it afterwards. There were no problems with his blood pressure during this short span that
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