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Got a call for a #Psychiatric #assessment of an 80 year old woman in #COVID ICU. Apparently, she was talking irrelevantly despite her blood parameters being WNL. Full #PPE Kit with two masks and a face shield, I worried how I would communicate with her. @DrHarish139 1/n
Inside the ICU, all staff looked alike (and sounded muffled) 
. The patient was on about 20 different medicines and on oxygen through a mask (!) and was sleeping (it was 3pm). Woke up easily, greeted her with folded hands, to which she responded immediately. @netshrink 2/n
. The patient was on about 20 different medicines and on oxygen through a mask (!) and was sleeping (it was 3pm). Woke up easily, greeted her with folded hands, to which she responded immediately. @netshrink 2/n
Attempted to start a @conversation with her, but all I got was either a complaint of pain and weakness or her question (WHAT) She told me where she lives and identified the @hospital correctly, but then lost track of my questions. Active but not resistant, her oxygen is 90%, 3/n
Checked her #medicines and advised stopping daytime #benzodiazepines. She had been prescribed #donepezil yesterday 
by my #neurologist colleague which I did not feel should continue either. #Dementia is the least of our problems and is unlikely to get better by an 4/n
by my #neurologist colleague which I did not feel should continue either. #Dementia is the least of our problems and is unlikely to get better by an 4/n
#AChE inhibitor during a #COVID-19 ICU stay. Called her son and after informing him about my (failed) assessment asked about her hearing. He confirmed she had hearing problems for the last 2 years and was only able to hear loud voice 
. They would use gestures mostly 
, 5/n
. They would use gestures mostly , 5/n
So I 
and impressed upon the nursing staff to use more #gestures and less verbal #communication, change her (lying down) position every 2 hours and wrote a provisional #diagnosis of no major #Psychiatry disorder. I did not prescribe any medicine. #Psychiatrist #psychtwitter end
and impressed upon the nursing staff to use more #gestures and less verbal #communication, change her (lying down) position every 2 hours and wrote a provisional #diagnosis of no major #Psychiatry disorder. I did not prescribe any medicine. #Psychiatrist #psychtwitter end
