I am writing one entry for 2 days. The days have been busy. We have been getting admissions from the Emergency Department -- people with anything from congestive heart failure to generalized weakness to confusion … the typical admissions of a general Medical ward. The only twist: COVID-pending or COVID-positive.
The good news: no-one in my ward has needed intensive care treatment or died from COVID-19. The bad news: wow! We admitted a 31 year old young lady that was quite confused. We did a blood gas on her that showed a pH of 7.64 and a pCO2 of 15! Hitherto, I would not have thought this compatible with life. At the least I would have thought she would need to be in the ICU. I had a hard time convincing my resident that was respiratory alkalosis due to her mental illness and strange breathing. We had to recheck her blood gas. I am proud to say that after all these years of not having done an arterial stick, I got it in the first try after the resident could not get it with ultrasound.
After much struggle, she got an IV. After a night of sleep (thanks to Haldol 2mg), her blood gas was pH 7.4 and pCO2 of 36.
We have had a couple of sad old ladies admitted for generalized weakness and failure to thrive. They live alone. One told me, "the only person I have to talk to is the television. I used to go the Senior Center and play bingo but they closed with COVID."
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