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Burn Nursing /

Stevens Johnson case



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No. 10
Old Jun 09, 2004, 08:54 AM

If you are convinced this patient is not being treated adequately and do NOT go over the doctors head, you are unfortunately as liable as he will be should a family member elect to sue. I once had a pre ecclamptic patient who was getting edematous, confused, and changing before my eyes..The call doc came in and read me the riot act for bothering him, never mind that I could no longer hear breath sounds and the patient had epigastric pain as well. I finally bit the bullet and called the attending who started to yell at me until I mentioned the symptomology, that the patient was definitely in trouble, that I had contacted the call person not once but twice and he had already told me he was going to ignore any more of my calls...He came in, checked the patient and she was immediately shipped. Sometimes it is the hardest thing you have to do but if you have the knowledge, it is your duty to report abuses, especially at this level...A court of law would ask you why you didn't do such a thing.
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No. 11
from clgmezzo
Old Aug 19, 2004, 10:21 PM

This is aweful! Our unit has these patients frequently, and to me it sounds as if she was completely mistreated from the beginning. Xeroform is a good dressing, but certainly not the cetaphil lotion alone, and probably with no tubbing or baths either. Pts survive with thei % of SJ or more ALL THE TIME. Pig skin, dressings, and appropriate care at a regional burn center accredited by the college of surgeons might have saved your patient. there are guidelines for which pts need to be seen at an accredited burn center, she falls in the category hands down.
im so sorry for this family.
SJS is treatable, and is no olnger as uncommon as we might like to think, also the drugs that can trigger this disorder may surprise you- PRILOSEC has had more than 4 reported cases, given more time that number will simply increase. I had a healthy young Nursing student with this problem from prilosec only a month ago. 60%, on a vent, pig skin, all kinds of stuff going on. It can happen to about anyone.
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