Test Your Knowledge

What is the appropriate patient status?

71-year-old female with a past medical history significant for HTN, pulmonary sarcoidosis, multiple back surgeries and loss of bladder function requiring self-catheterization presented to ED complaining of palpitations and associated urinary frequency.

Day of presentation:

2350: ED Physician Evaluation. Initial BP 205/98.

Day 1:

0524: Observation order placed

0533: H&P assessment: Frequent urination. Poorly controlled BP. Elevated troponin. Plan Foley catheter, empiric ceftriaxone, usual BP meds with prn hydralazine, trend troponin, ECHO, cardiology consult.

1039: Hospitalist note: History prior troponin elevations, attributed to sarcoidosis. Trend, no evidence STEMI. Elevated BP treated IV labetalol.

1724: ECHO-Normal systolic function

2212: Troponin 0.135 (H)

Day 2:

0049: IV hydralazine 10 mg for BP 164/74

1201: Hospitalist note: Cardiology consult for elevated troponin. Continue ceftriaxone. BP stable.

1502: Cardiology consult-No EKG changes, symptoms of ischemia. Stress test negative 6 months previously. Medical management.

Day 3:

0138: IV hydralazine 10 mg for BP 165/76

0747: Discharge order placed

1224: Inpatient order placed (no authentication needed)

1357: Discharge to home

Would you Status:

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