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Gurpal

One drink a day is good for you

6 posts in this topic

I'm sure we've all met this man...

doctorsaid.jpg

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want to put in a PMP

you are a ward based sho. On monday morning as you walk in to your ward one of your patient tells you about another patient being abused by a staff member over the weekend. what do you do?

[20-01-2002: reposted to PMPs forum (click here). Please reply there.]

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re: one drink

'Thoughts' on the matter.

1. Eth. can be health hazzard etc. etc.

2. Life is a miseable business anyway.

3. Prohibition has been tried.

4. The best things in life are the same as the worst things in life, except much less often.

to asr re: pmp

sometimes one drink is not enough.

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Here's another PMP

You are in a bar when you notice that the barman appears to be unusually elevated in his mood. He blows raspberry's in his first customer's face before serving them. Then he promptly skips over to the next customer and asks them to marry him. He then pops over to you, comments on how he feels refreshed despite having no sleep for the past 4 days. He then comments that you seem to be a nice person and that he will treat you and all your friends to free drinks for the rest of the night. Discuss how you would manage the situation

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Dear Justin re your PMP,

There are lots of ways in which organic conditions can lead to a euphoric, grandiose delerium, which it could be. But higher on the list of possibles...

1. Mania, likelty to be the younger guy, could be a BPAD.

2. Illicit psychoactive substances, such as MDMA etc.

3. Disinhibition due to organic lesion and affective lability, possibly multi-infarct/alcoholic dementia, for the older barman.

There are lots of other possibilities, it's worth mentioning psychotic ICD-10 F20-29 type stuff. (It could be factitious ie the man's taking the piss or you've walked into some sort of game).

Time to start asking questions. Asuming you don't decide to mass text all your palls about the free piss up.

This man needs to be protected from his own generosity, with drinks and rasberries.

'Thank you for the offer mate, but I'd like to pay for my own'.

Choose something non-alcohilic since you've decided to work.

'So how's it going, you seem real happy.'

Listen to the man's history.

Question other bar staff, is this new etc.?

Once you have a handle on what is going on, make sure (before continuing the binge) that the man (if necesarry) been detained by the medical profession. Use mental health act if necessary, though not YOU necessarilly.

Once in hospital.

1. Take systemic history, perform examination,FBC, U&E, LFT, blood sats, ECG and anything else needfull.

If no acute organic findings...

2. Psyche observation and assessment. Aim to restore normal sleep patterns. Further management would depend on information gainned from above actions.

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