A Case Study On Copd Associated With Seizures in A Tertiary Care Hospital

ISSN: 2320-5407 Int. J. Adv. Res.
12(03), 629-631
Journal Homepage: -www.journalijar.com
Article DOI:10.21474/IJAR01/18432
DOI URL: http://dx.doi.org/10.21474/IJAR01/18432
RESEARCH ARTICLE
A CASE STUDY ON COPD ASSOCIATED WITH SEIZURES IN A TERTIARY CARE HOSPITAL
Dr. Stany Thomas

Zynova Shalby Hospital.
……………………………………………………………………………………………………....
Manuscript Info Abstract
……………………. ………………………………………………………………
Manuscript History Chronic obstructive pulmonary disease (COPD) is a significant cause
Received: 18 January 2024 of morbidity and mortality. It provides a concise overview of the
Final Accepted: 21 February 2024 literature regarding the impact of COPD exacerbations on both the
Published: March 2024 patient and the healthcare system, the recommendations for
pharmacologic management of COPD, and the strategies employed to
improve patient care and reduce hospitalizations and readmissions, and
most importantly to improve the complications based on wrong
treatment pattern.
Copy Right, IJAR, 2024, All rights reserved.
……………………………………………………………………………………………………....
Introduction:-
Case study:
A 73-year-old man came with a number of health issues to the hospital stating about breathlessness and nausea. The
care team helped in resolving the issue, but forgot a standard treatment that causes unnecessary harm to the patient.
A posterior drug error makes the situation worse, leading to a stay that's much longer than anticipated.
Mr. XYZ is a 73-year-old man with a long-standing history of a seizure disorder. He also has high blood pressure
since few years and due to habitual smoking, also has a comorbidity of chronic obstructive pulmonary disease
(COPD). He is more often admitted in our hospital because of his health-related conditions (a regular patient). At
home, he takes a number of medications, specifically in case of COPD and Convulsions (Lamotrigine,
Levetiracetam and Valproate)
Mr. XYZ came to the emergency departmentlast week, because he was wheezing and having trouble breathing. The
medical officer in the emergency (ER) department conducted a physical examination which revealed certain signs of
an acute worsening of COPD, which can also be stated as COPD exacerbation. The physician in the emergency
departmentadvices a chest x-ray, which did not show any signs of pneumonia. He admitted Mr. XYZ to the hospital
for treatment of acute COPD exacerbation, resulting from a relatively mild respiratory tract infection. Before leaving
the emergency department, Mr. XYZ also underwent routine test namely, Complete blood count, Kidney function
test, liver function test etc., which showed an elevation in his creatinine, a sign that his kidneys were pressurized to
work more harder due to his existinginfection.
Patient was shifted to the neurology ward, the care team treated Mr. XYZ with oral steroids and inhaled
bronchodilators (standard medical therapy for his condition), which resulted in a gradual improvement in his
respiratory symptoms. Nurses also gave him IV fluids for the issue with his kidneys.
Mr. XYZ was steadily improving, so it seemed this visit to the hospital would be one of his shorter 34ones. But on
the third day morning, Mr. XYZ complained to the junior doctor about acute pain in his left leg. This symptom,
potentially indicated deep venous thrombosis (a blood clot in his leg commonly known as DVT), thereby the
629
Corresponding Author:- Dr. Stany Thomas
Address:- Zynova Shalby Hospital.
ISSN: 2320-5407 Int. J. Adv. Res. 12(03), 629-631
concerned doctors were forced to address the existing condition by ordering an ultrasound of Mr. XYZ’s lower
extremities. (A primary concern with DVT is that blood clots in the legs may dislodge and travel to the lungs,
causing a pulmonaryembolism)
The junior doctor based on the complaint then checked Mr. XYZ’s medication orders and was surprised to see that
the admitting doctor had not ordered prophylaxis for DVT (i.e., blood thinners, such as heparin or enoxaparin). The
junior doctor was surprised because patient was admitted to the hospital typically in order to receive this treatment
to prevent blood clots from forming while they lie in their hospital beds. Further, nothing about Mr. XYZ’s medical
record suggested he shouldn’t have received this treatment as an important precautionary measure.
Thus, USG reports came and, it was found that, there were blood clots present in Mr. XYZ’s left calf. Due to his
impaired kidney function, treatment for the blood clot required him to remain in thehospitalonmedication
On 8th day in the hospital, at around 10pm at night, a member of the environmental services (also known as
housekeeping) staff found Mr. XYZ on the floor of his room. She immediately informed it to the nurses on the
assigned ward. The nurses noted seizure activity and called the Rapid response team to Mr. XYZ’s bedside. The
medical team reached to the ward on urgent appeal and gave him intravenous (IV) medication ofantiepilepticthat
stopped his seizure.
Since, there were no one present on bedsidewhen he had a fall and seizure, thereby Mr. XYZ had to undergo an
emergent CT scan of his head to check for any sign of bleeding. After regaining his mental consciousness, he
complained of pain in his left shoulder and elbow, but x-rays of these joints showed no evidence of a
traumaticfracture from his fall.
After ensuring that Mr. XYZ was stable, the overnight care team reviewed the chart and the medication history to
try to determine the cause of Mr. XYZ’s sudden seizure. Later they found that one of his old therapies of seizure
medications (Levetiracetam) had not been given earlier in the day when it should have been. There was a notation in
the medication administration record (MAR) from the daytime nurse indicating that the ordered dose was not
available in the pharmacy earlier in the day, staff wrote in the treatmentchartas NA(Notavailable).
Furthermore on discussions, the following day with the daily care team of doctors and nurses, it revealed that the
nurses didn’t notify the doctors or residents or the pharmacy that the essential medication was not administered.
Neither did the staff explained the importance of the medicine and thereby it was not issued
throughmanualmethodofprocuringmedicinefromoutside.
Fortunately, the overnight physicians restarted Mr. XYZ on his medication, and he suffered no apparent permanent
harm. Mr. XYZ was discharged after 10 days in the hospital. Most hospitalizations for COPD are far shorter. In fact,
many stay in hospitals only a couple days.
Conclusion:-
Accurate therapy at the right time is a major part of patient care. Quality of treatment and care can only help the
patient to sustain their health, so when a patient shows any sort of symptoms, being a healthcare professional, it is
our responsibility to look into the matter and resolve it appropriately.
630
ISSN: 2320-5407 Int. J. Adv. Res. 12(03), 629-631
Reference:-
1. Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease. American Thoracic
Society. Am J Respir Crit Care Med. 1995; 152 (5 pt 2): S77–S121 [PubMed] [Google Scholar]
2. Pauwels RA, Buist AS, Calverley PM, et al. Global strategy for the diagnosis, management, and prevention of
chronic obstructive pulmonary disease: NHLBI/WHO Global Initiative for Chronic Obstructive Pulmonary
Disease (GOLD) Workshop summary. Am J Respir Crit Care Med. 2001; 163: 1256–1276 [PubMed] [Google
Scholar]
3. National Heart, Lung, and Blood Institute. COPD essentials for health professionals. NIH Publication No. 07-
5845. December 2006. Bethesda, MD. www.nhlbi.nih.gov/health/public/lung/copd/campaign-
materials/pub/provider-card.pdf Accessed April 30, 2008.
4. Stoller JK, Fromer L, Brantly M, et al. Primary care diagnosis of alpha-1 antitrypsin deficiency: issues and
opportunities. Cleve Clin J Med. 2007; 74: 869–874 [PubMed] [Google Scholar]
5. Sutherland ER, Cherniack RM. Management of chronic obstructive pulmonary disease. N Engl J Med.
2004; 350: 2689–2697 [PubMed] [Google Scholar]
6. Viegi G, Pistelli F, Sherrill DL, et al. Definition, epidemiology, and natural history of COPD. Eur Respir J.
2007; 30: 993–1013 [PubMed] [Google Scholar].
631

A Case Study On Copd Associated With Seizures in A Tertiary Care Hospital

Uploaded by

Copyright:

Available Formats

A Case Study On Copd Associated With Seizures in A Tertiary Care Hospital

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

A Case Study On Copd Associated With Seizures in A Tertiary Care Hospital

Uploaded by

Copyright:

Available Formats

ISSN: 2320-5407 Int. J. Adv. Res.

Journal Homepage: -www.journalijar.com

Dr. Stany Thomas

You might also like