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Is it safe to continue self catheterization for a person with septic shock?

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Posted on Sat, 30 May 2015
Question: If you had a patient with the diagnosis severe septic shock, obstructive small bowel in your treatment,
(1) which location in the hospital would you treat this patient, and why?
(2) If this patient presenedt to you - doing self catheter from home(as her usual) would you continue, if not why?
(3)What medication would you place this patient on/or not, and why?
doctor
Answered by Dr. Prof. Kunal Saha (25 minutes later)
Brief Answer:
Multiple variables are involved

Detailed Answer:
Thanks for asking on HealthcareMagic.

I have gone through the question. I am sorry for your loss. In order to determine the answers to your questions, it seems that there are further variables that might play a role in the decision.
* Sepsis is different from septic shock. While the former simply indicates an infection and can be treated by placing the patient in the ward, the latter involves haemodynamic compromise or unstable pulse and blood pressure, and would need treatment in a critical care/ICU setup. If obstructive small bowel disease is evaluated to be the course, surgery might be mandated after making the patient haemodynamically stable.
* I do not understand what you mean by self catheterisation. Do you mean venous cannulation or do you mean urinary catheterisation. In any case, it remains to be evaluated why these are required. In any case these are not supposed to be done by ownself unless she is medically qualified.
* The choice of medicines might depend on a number of variables. Some antibiotic needs to be given depending on what infective organism is being suspected. Vasopressor support might be required to make the patient haemodynamically stable. Other supportive medications might be required depending upon the specific condition. Unless there is some specific allergy, I do not see any cause to restrict the use of some medicine.

Hope that helps.

Regards
Dr. Kunal Saha
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Prof. Kunal Saha (8 hours later)
Thank you for your report. (A)Here is my clarification question, she was not able to pass her urine naturally, so she has to use a catheter to help to urinate each time she need to pass a urine. My spefic question: Should she be continuing this routine in a hospital setting considering the following diagnosis? (1)lab reported after sample: severe septic shock, and (2) lab reported after sample: ecoli(escherchia) and (3) Emerg Dept diagnosis her with: small bowel obstruction. (4) pointing to ileus, according to lab., and (5) low blood pressure

(B) Here is my second clarification: re medicine prescribed: She was allergic to Penicillin(amoxillin). So she had been prescribed oxycontin, morphine, dilaudin(hydromorphin), Tylenol, plus other medicines
doctor
Answered by Dr. Prof. Kunal Saha (13 hours later)
Brief Answer:
The condition was indeed critical

Detailed Answer:
Thanks for writing back.

* E coli is a normal inhabitant of our body. But somehow, due to infection related to self catheterization or due to the intestinal obstruction and ileus, could have entered the blood stream leading to septic shock. In such a case, treatment with suitable intravenous higher antibiotics other than penicillin group, in hospital setup is important, preferrably in the ICU. The mentioned medicines are ok to be given to her.

In case you have a specific query, let me know and I would be glad to help.

Regards

Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Prof. Kunal Saha

General & Family Physician

Practicing since :1954

Answered : 4471 Questions

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Is it safe to continue self catheterization for a person with septic shock?

Brief Answer: Multiple variables are involved Detailed Answer: Thanks for asking on HealthcareMagic. I have gone through the question. I am sorry for your loss. In order to determine the answers to your questions, it seems that there are further variables that might play a role in the decision. * Sepsis is different from septic shock. While the former simply indicates an infection and can be treated by placing the patient in the ward, the latter involves haemodynamic compromise or unstable pulse and blood pressure, and would need treatment in a critical care/ICU setup. If obstructive small bowel disease is evaluated to be the course, surgery might be mandated after making the patient haemodynamically stable. * I do not understand what you mean by self catheterisation. Do you mean venous cannulation or do you mean urinary catheterisation. In any case, it remains to be evaluated why these are required. In any case these are not supposed to be done by ownself unless she is medically qualified. * The choice of medicines might depend on a number of variables. Some antibiotic needs to be given depending on what infective organism is being suspected. Vasopressor support might be required to make the patient haemodynamically stable. Other supportive medications might be required depending upon the specific condition. Unless there is some specific allergy, I do not see any cause to restrict the use of some medicine. Hope that helps. Regards Dr. Kunal Saha