In your lungs.

6 Oct

Pneumo Vaccine: It always seemed to annoy me that in the acute  care setting I was worrying and spending lots of time making sure that all my patients were given a Pneumoccal vaccine. It seemed whether they liked it or not: if they fell into the category they got the shot. It is like a crazed mission to eradicate this type of pneumonia. Of course Pneumococcus has 80 different strains but the vaccine does cover 23 strains! 🙂

Well… as Karma, and Murphy’s law do work. I received a very sick young man with lobar pneumonia. The patient was very sick under the age of 25 and presented with chest pain, cough, pleuritic pain. Chest x ray revealed the pneumonia, and the patient was admitted to a general medical floor. The patient was assessed by the nurse to be tachypnic, tachycardic, and hypotensive, febrile. His BUN and creatine were elevated–the patient was becoming septic and going into mild renal failure. They transfered him to the ICU where he received close monitoring, fluids, antibiotics and aggressive treatments. One day after that the patient was transfered to my tele floor–stable, less tachy, still hypotensive and in alot of pain.  And the cough! IT was harsh. IT hurt me to listen to it.

The patient of course wanted to know when he was going home, back to his life, his job, not really knowing or understanding that it was not palm trees mountains or apples in his lungs. That he was seriously ill, and could not go anywhere anytime soon.

 The most common cause of bacterial pneumonia is Streptococcus pneumoniae or pneumococcus. Pneumococcus usually causes lobar pneumonia, attacking an entire lobe or portion of a lobe of the lung. The signs are usually: shaking chill pain in the chest while breathing, a cough, and blood-streaked sputum. This usually happens after a viral respiratory infection→ than bacteria get in.

I guess I do not mind so much injected those huge needles anymore into muscles–if it really helps knock out some pneumonias.


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