18/37
8/24/93
      23 year old with benzodiazepine withdrawal.  Delirious
tachycardia, (?illegible) normotensive.  Continue
titrating dose.  Plans reviewed, agree.
                                        (Signature of Dr. ?Bertz/Burch   ICU Senior
                                          Admitting Resident)
Click here for image
Click here for previous page

8/25/93      Intern Dr. Laurel Mayer note
7AM
          Patient resting comfortably.  easily arousable this morning.  Remains
delirious.  "I'm in the CBS studio in Burbank"
VITALS   160/60   (overnight ?-130/60)   P(ulse) 110     R20
                 T (?max) 99  T(oral) 98     Input/Output   1600/1020
LUNGS    Clear
HEART     S1S2 normal    I/VI  Sinus Murmur @ Apex---->axilla
ABD          Benign positive Bowel Sounds
EXT           Positive diaphoresis, but greatly improved
Mental Status               Oriented to person
                  continues waxing and waning
                  appears less physically agitated
LABS      CSF       :   culture   (?P)
                  #1             1 WBC,  2 RBC
                  #4             0  WBC,  1 RBC
                  protein         27
                  glucose        91
Impression      23 year old in acute benzodiazepine withdrawal
Click here for image
Click here for previous page
1.  Withdrawal overnight   vitals were stable and improved from daytime
Patient received 2 mg Ativan at 7 (pm), 4 mg at 8, 2 mg at 9pm, 6 mg at 10:30
which held him until 6am today.  Patient then received 4 mg and is currently as 
described above.  BP slightly increased this am.  Will consider increasing Ativan
to 6mg q 4 (hours) if BP/P remains elevated   or/and patient becomes increasingly
agitated.
           LP results negative for blood (subarachnoid bleed) or infection
           Continue seizure precautions
Tolerating Ativan.  No need to switch to Xanax yet.
Will follow Creatine PhosphoKinase and hydrate to prevent
Rhabdomyolosis.
                                                   Signature of Intern Dr. Laurel Mayer, M.D.)
Click here for image
Click here for previous page
Click here for next page
Click here for beginning of chart.