This patient was seen a few weeks ago back in the ward.
A lady, 43 years old, known case of previously diagnosed and treated abdominal sepsis presented to the ward with presentation of acute abdomen with fever.She was also a known case of end stage renal failure on maintenance dialysis via IJC and Diabetes Mellitus for 8 years. This time upon presentation, the first line of doctors who saw her just gave her Tablet Paracetamol for the fever which was spiking ( around 40 degree Celsius) on PRN basis.
This continued for duration of 1 day throughout her admission and when she was reviewed the next day, the medical officer then realized that she was not given any antibiotics. She was then started on IV Augmentin.
Note : When a patient comes in with high fever and abdominal pain, we have to always rule out abdominal sepsis before anything else because if not treated early the patients can go into shock and fatality is high. Hence early administration of antibiotics is needed. Adding on, the medical officer also told that if at any point as a house officer we are not sure about the management or hesitant to start with any medication, we should always consult the medical officer on call. This is important in ensuring all our patients get the best treatment from the health care staff.
Shelva Meena
When faced with this patient who had fever, I think the attending doctor was only concerned about symptom relief. Hence paracetamol was given for fever. That attitude is not correct. When faced with any kind of symptom, we must ask ourselves "Why" and try to find the disease, if any, that causes the symptom.
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