The surgical patient who is 'a bit agitated'

A 52-year-old man, day 2 after an emergency laparotomy, is sweating, shaking and pulling at his drain. The surgical resident is in theatre and you are covering.

52-year-old manSurgical ward, bed 14 (medical cross-cover)Fictitious educational patient

Perforated duodenal ulcer, repaired 2 days agoDrinks 'a few beers'Smoker

Day 2 · 02:10

The page

Nurse: 'He was fine at handover. Now he is drenched, shaking, keeps asking where his dog is, and his heart rate is 128. The surgeons said to call medicine. Can you give him something?'

Vitals

HR128BP168/98RR22SpO295%T37.9

What is the leading diagnosis, and what is the one question you ask before you go?

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