Whenever drugs are involved in a patient’s admission, the outcome is either craziness or comedy. Methamphetamines and cocaine seem to be the popular drugs of choice requiring admission. These people are usually angry and agitated. However, it seems like pot humor always adds a little touch of the unexpected to an otherwise boring admission.
Take for example the 27 year old truck driver who was brought in by his roommate for “acting weird’. What happens when you mix a little marijuana and a little alcohol? You get Happy’s pot humor post of the day.
Tommy: picking at things and acting goofy
Happy: Tommy. You’re acting a bit strange. What’s going on?
Tommy: I’m not acting strange.
Happy: Do you know you tested positive for weed?
Tommy: I don’t smoke dope.
Happy: Do you know why you’re in the hospital?
Tommy: My friend brought me. I’m going to kill him.
Happy: Why would your friend bring you to the hospital?
Tommy: So he could smoke my big bag of pot.
Happy: I see Tommy. We’ll see you later.
How would I document this interaction?
S) ROS unreliable secondary to altered mental status
O) BP, HR, O2 Sats normal
Alert but not oriented
Labs: ETOH 230. Postive THC screen. Telemetry tracings reviewed: Normal
A) 1) Delirium
2) Polysubstance abuse
3) Smoker (pot and tobacco)
4) ETOH abuse
Sleep. Reviewed with RN. Haldol, Ativan prn Intervention nurse for pot and ETOH. +/- review internet for outstanding warrants. Discuss tobacco smoking cessation in am CPT 99406
Charge: CPT 99233, $250 high level hospital follow up.
Expected payment: Zero.
*This blog post was originally published at The Happy Hospitalist Blog*