We use LPNs on my floor. They cannot do IV pushes. So an LPN asked me give solumedrol and ativan to her patient. So I agree and head down to the room. When I get in the room the patient seems to be in quite a bit of respiratory distress. I don't know much about the patient so i question her if she has been SOB for long. She tells me she just returned from xray and she has been short of breath throughout her hospital stay but not this bad. I also hear a terrible sucking, burping type noise. I remember hearing something about a chest tube removal earlier in the shift. I ask her if she had a chest tube removed today and she said she did. I grab a set of vitals and an O2 sat. Her O2 sat was 82% on 2L and I bumped her up to 5L where she came up to 92%.
Remember I know nothing about this pt. I call for her primary nurse to come to the room. I see her outside the room and she says she just picked up the pt at 1500 and she hasn't seen her yet b/c she'd been in xray.....
Anyways she reinforces the dressing and we get a stat portable CXR. She calls the physician and i go back to my patients...
My questions is.. why was it making that terrible sucking noise?? I know that can't be good and it has something to do with the air passing through the old chest tube site, but i don't quite understand why it would do that. And I hate to sound like an idiot. But the other nurses just told me it shouldn't be doing that.. But I was wanting a better explanation. If y'all could help that'd be great.
She was tachycardic (around 115), but her BP was high 170ish/90ish. I don't remember seeing and JVD. My main goal was to get the primary nurse and get the physician notified. It wasn't my patient so once the patient's O2 sat was stable and she was no longer in acute distress I had to go back to my patients... So I'm not sure what the portable CXR showed or what became of the situation.
I think however, that the physician was on the way to possibly suture the site. After reinforcing the dressing the sucking stopped, however like I said I'm not sure what the CXR showed. I wish now that I knew. Everything was so crazy on our floor this afternoon that I didn't have a chance to stop and find out.
Last edit by TigerGalLE on Aug 3, '07