It all happened pretty quickly

My blog this week currently revolves around my current placement where i do a bit every day on the wards and in the outpatient department. I was on the wards in the morning and was seeing an elderly gent who i was mobilising and prescribing bed/chair exercises to following a humeral fracture managed conservatively. He has a very extensive PMHx as a lot of the elderly patients in hospital do which was somethihng i tried to keep in mind every time we did a PT session. I saw him in the morning and went through our treatment session and he seemed to cope really well and then left him out of bed for the rest of the morning and lunch.
I cam back in the afternoon to try and push on with some more treatment but his notes had disappeared when i went to look for them which was pretty odd. I kept searching to no avail then looked outside his room where there were multiple doctors, nurses and machines. It was then i realised something had happened.

I approached one of the doctors to try and ascertain what had happened. As the patient had previously issues with his hypertension and heart failure he was on captopril (ACE inhibitor). He became bradycardic late the afternoon before and was taken off the captopril. He consequently went into tachycardia early afternoon and heart failure.

I couldnt believe the transformation in just a few hours where my patient had gone from doing well to a life threatening position. It just makes me realise that when dealing with patients it is always wise to be thinking about their PMHx when treating them and what effect it might have. Especially in the elderly who are more prone to co-mobid conditions it is always worthwhile monitoring them during treatment and if they are improving or worsening. Even though this event occured when he wasnt under my supervision i am now a little more careful when confronted with these type of patients and will monitor them more closely.