Patient Attended Pharmacy Feeling Faint and Dizzy

Tuesday, November 12, 2019

A patient attended the pharmacy feeling faint and dizzy and was concerned about her heart rate as she had AF and was not feeling good. The pharmacist assessed the patient (manual pulse, manual BP and used the Pulse Oximeter. All of the equipment was previously provided as part of the IP pharmacist clinic needs). Although her BP and pulse when measured manually were within the normal range the symptoms the patient was presenting along with the fluctuating pulse on the Oximeter (56-152 beats per minute) and felt it was necessary to call an ambulance for this patient. During the assessment, it had become clear after accessing the clinical portal that the patient had been reviewed by the GP this week and was awaiting a review with cardiology. 

The patient was discharged from the hospital on Sunday afternoon. She had various tests in hospital and they are writing to the GP.

The phone call with the patient was very humbling. She thanked me for my help on Saturday describing me as "steady as a brick". I explained to her that although she was originally reluctant to have an ambulance called that my primary concern was for her welfare. 

The team were great at coping with the customers whilst I managed this emergency.

As an added bonus for the story (working with GP's): 

Whilst waiting for the ambulance to arrive the patient's husband said he was going to nip along to the surgery as his hearing aid battery had run out. I explained to the husband that the surgery in BOE was now closed but that we had taken in hearing aid batteries so that patients would not need to travel to Perth, Newburgh or Kinross in order to collect them. The husband was delighted that the hearing aid batteries (that had been provided by Taymount surgery to ourselves) allowed him to hear now. "I can hear you again doctor thanks."   

The patient had mentioned on Saturday that she was about to run out of her Edoxaban 60mg tablets soon and that was the original reason she had come to see me. I have phoned the patient today to say we will deliver out some edoxaban and we will sort out the prescription (either contacting the surgery or via UCF). The patient knew the hospital were recommending a "new" medication but could not remember the name of it. The Pharmacist accessed clinical portal and informed the patient that the hospital had sent an electronic discharge to her GP and were recommending Amiodarone as per BNF. I said I would keep an eye out for this prescription and deliver it out to her when it arrived. The hospital are going to arrange an echo, R-test and PFT's as an outpatient

As previously stated this was an excellent example of why the access to clinical portal was invaluable. With the patient's permission each time I have managed to assess, refer (via ambulance), communicate via SBAR to GP and follow up with the patient whilst referring to clinical portal to help me make my decisions. 

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