Four to Score

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Stephanie's apparently harmless chases after low level FTAs that look like they're going to be easy-picking low hanging fruit always seem to coincidentally cross paths and mesh with Morelli's much more complex cases. This case involves a woman named Maxine Nowicki who failed to appear in court after being arrested for stealing her boyfriend's car. All of the in-hospital deaths (other than brain death) resulted from withdrawal of care by family members faced with a catastrophic neurologic outcome.

I do like the way the cast of supporting characters is growing with each book and each of them brings something new to the party. I have a few more in the series that I want to read now that my intrigue of this series has been renewed. Stephanie then goes to visit Maxine's mother and finds an unpleasant alcoholic who is belligerent and unwilling to help. Joyce Barnhardt was sleeping with Stephanie’s ex-husband, well before she put the prefix ‘ex’ in front of ‘husband’.If anyone reading this is prone to depression or just needs to relax with a delightful, quick and entertaining book then this is definitely for you.

All of this pales in comparison, though, with an even greater danger Stephanie faces, when, homeless and broke, she and her hamster Rex move in with a vice cop Joe Morelli. Calculations must be re-checked and should not be used alone to guide patient care, nor should they substitute for clinical judgment. For patients who had undergone intubation, the lowest GCS verbal score was used both for scoring and for data analyses. Maybe when I found Nowicki I’d have my air-conditioning fixed, or maybe I’d spend a few days at the beach….The results of this prospective study show that the FOUR score coma scale maintains a high degree of internal consistency and interrater reliability among medical intensivists, including nursing staff at all levels of experience, fellows, and consultants. I find it kind of cool that their "relationship" has progressed at a slow burn throughout the series thus far. Comparison of the inter-observer reliability of the FOUR Score and the GCS suggests that the FOUR Score may have a modest but significant advantage in this particular measure of test function. For patients who have undergone intubation, the FOUR score records the presence or absence of a respiratory drive.

CONCLUSION: The interrater agreement of FOUR score results was excellent among medical intensivists. The 4 components of the FOUR score (eye response, motor response, brainstem reflexes, and respiration pattern) are equally weighted. These characters are larger than life, funny as hell and all of the books make me snort with laughter. A note tells Stephanie that she has gotten too close to someone's boyfriend and this person wants her to back off.

The coded messages were a game to torment Eddie, who was desperate to get the plates back, but Maxine did not anticipate that Leo would go hunting for her himself, including mutilating her mother and Margie.