[FNP grrl]

i was unlucky enough to be one of the people to (peripherally) care for a patient recently w/ fingertip amputations--they were very distal & not reattachable--nonetheless, the tips had been prepared/packaged properly & at the bedside awaiting MD specialist eval. the pt. was admitted & sent to the floor prior to being seen by the attending MD- and, somehow, the tips never made it to the floor w/ the pt & were apparently discarded before the doc saw them. big, big no-no. the parts were not labled. bad scene.

so----do you have a policy about LABELING (as opposed to STORING/PREPARING) amputated parts? i know it seems like common sense- but when i stopped to think about it, in my 12 years of ED experience, this was the first case i could recall where parts were accidentally discarded before official MD ok- and i don't think any of the facilities i have worked at had policies about labeling parts. certainly neither i nor my coworkers in any of these facilities routinely labeled parts. now this is seeming very reckless to me!!!!

[athomas91]

if it was obvious by the fingers that the parts couldn't be reattatched - what is the big deal?? distal finger amputations are rarely reattatched - and when they are - the success rate sucks...esp. if the pt is a smoker...
i would think if it were a reattatchable part that the labeling etc would have been paid more attention....good mental note though!!

[FNP grrl]

the problem was that the family came in fully believing that the fingers could be attached & were very aggressive in making this point clear to everyone. they were told that there was really no chance that they could be reattached- but they were holding out hope that the hand surgeon could pull a miracle & were refusing to believe that prognosis until they spoke w/ the specialist. the fact that the tips were thrown away before the specialist even arrived made the family very, very angry- understandably so, imo.

i know & you know that there was no medical harm done- the fingers were unattachable. but that really isn't the problem- the true problem is that body parts were lost before a final diagnosis & disposition was made. you are certainly right that the body parts would have been watched more closely if there had been a chance of viability- but the family thought they WERE viable- so, to them, this was very negligent. at any rate, i am certainly going to be sure that any amputated parts- viable or not- that i deal with will be labled out the @$$ from now on!

[BarbPick]

It does matter even though they can't be used. Strong Religious reasons. A few religions require that all severed body parts be buried in sacred ground.
Chain of Custody thing. They are the nurse's responsibility. Like losing a specimen in the OR needed for pathology. You use Sterile containers. Ice or saline depends on the facilities protocol. You Label the container, not the top. Never let the body part out of your sight.

[FNP grrl]

GOOD point, BarbPick.