barb feltskog keene, RN, CCRN, CSC

Barb Feltskog-Keene recognized cognitive changes and motor changes in my patient who had emergency CABG for acute MI complicated by pulmonary edema, emergency endotracheal intubation and mechanical ventilation in our ER two days before. The patient had multiple reasons, and times to have a neurological event.
Barb had a high index of suspicion upon evaluating the patient the morning and early afternoon on postop day 1. Other caregivers including RNs, NPs, the ICU pulmonologist & critical care physician taking care of the patient, and myself did not pick up on what were relatively subtle changes in the morning. Barb's recognition of the changes and her persistence in pointing them out to me led to my evaluation which was supportive of her findings. Emergency CT of the head, CTA of the head and neck showed a large cerebral ischemic infarct with edema. Emergency evaluation by neurologist and neurosurgeon led to emergency measures to reduce edema, maintain brain perfusion and prevent herniation, further brain damage & prevented death. The patient is making an amazing recovery in acute rehab with normal speech, joking, walking with a walker and lifting left arm are above his head. Barb should be very proud and I am extremely thankful for her efforts.