asystole then DC

  1. 2 Had a funny thing happen the other day. A young woman came in for some vague complaints of weakness. It was busy and some nurse not from our department was starting an IV and really digging around. I went in to talk with the patient and the monitor was right in front of my face. I noticed her rhythm slow, then she had 13 seconds of asystole! Her eyes rolled back as I put the back of the bed down and I shook her pretty hard and yelled at her. She gave a big jerk then woke up and said "what happened"? Her boyfriend then tells us, "oh yeah she always passes out when they start IVs". The funniest part was that the MD was chapped he couldn't find precanned discharge instructions for asystole. God I love this job...
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  3. Visit  nurse2033 profile page

    About nurse2033

    From 'Boulder, CO'; Joined Jun '07; Posts: 1,805; Likes: 2,646.

    14 Comments so far...

  4. Visit  sissiesmama profile page
    0
    "Release body to funeral home?" Seriously, I am glad I haven't had a patient do that when starting an IV -

    Anne, RNC
  5. Visit  LegzRN profile page
    5
    Yeah in my hospital she'd be admitted to the ICU, or should I say admitted to the emergency department as a hold
  6. Visit  bill4745 profile page
    3
    I can't believe she was discharged.
  7. Visit  Esme12 profile page
    5
    Quote from nurse2033
    Had a funny thing happen the other day. A young woman came in for some vague complaints of weakness. It was busy and some nurse not from our department was starting an IV and really digging around. I went in to talk with the patient and the monitor was right in front of my face. I noticed her rhythm slow, then she had 13 seconds of asystole! Her eyes rolled back as I put the back of the bed down and I shook her pretty hard and yelled at her. She gave a big jerk then woke up and said "what happened"? Her boyfriend then tells us, "oh yeah she always passes out when they start IVs". The funniest part was that the MD was chapped he couldn't find precanned discharge instructions for asystole. God I love this job...

    A vagal reaction to be sure......but an extreme one. I would have thought she deserved an overnight tele and a tilt table in the am.

    Do the Doc really discharge ger?????
  8. Visit  Pixie.RN profile page
    5
    I would have told the doc he could do the discharge, because I wasn't signing it! LOL. I guess you could argue that a 13-second pause with complexes on either side is just severe bradycardia, but geez.
    Crux1024, netglow, MassED, and 2 others like this.
  9. Visit  emtb2rn profile page
    11
    I would've started a second line in her to see if the episode was reproducible. In the interest of science of course.
    Roy Fokker, JSlice., casi, and 8 others like this.
  10. Visit  Pixie.RN profile page
    0
    Quote from emtb2rn
    In the interest of science of course.
    But of course!
  11. Visit  LegzRN profile page
    5
    Wonder what other fun activities cause her to pause like that.
    JSlice., merlee, emtb2rn, and 2 others like this.
  12. Visit  ktsummar profile page
    0
    I have vagal responses when I have IV's started on myself. Comes on quick and goes away quick with no effects. I feel an aura coming on and then out. I have even told nurses that I was about to go out. I used to do it upon any injection/stick. Now it only happens with IV's that they have to dig on.
  13. Visit  texkid profile page
    0
    Wow, thats worse than the pt I had last week. 30-something pt. kicking and screaming in my left ear while I was inserting a 20# in her forearm. My other patients in the hallway swore I was cutting her open.
  14. Visit  Flo. profile page
    1
    Scary, even scarier that she went home. In my hospital that would have been ICU with extensive testing. What did the doc say was causing her fatigue?
    Otessa likes this.
  15. Visit  murphyle profile page
    1
    I cannot for the life of me imagine sending the girl in this case home. In my department, that kind of incident would buy her an automatic night in CCU and a full cardio workup. Who only knows what kind of electrophysiological gremlins might be lurking in there...

    I do admit to laughing at the MD's frustration at not finding a canned discharge for cardiac arrest. "If your heart stops again, return to the Emergency Center immediately."
    Otessa likes this.


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