Last week, I took care of a patient who came in with dehydration due to diarrhea. No history of gi bleed or ulcers. Her abdomen became more distended during her stay and the doc decided to do a ct scan of her abd with oral/iv/and even rectal contrast. the next morning i came in, she was lethargic, b/p-80/40, 02 sat-77%. she had taken her 02 off before my shift started. put her on o2 and called the doc on call. he ordered to hold her bp meds and insert a foley after i reviewed vitals, meds,ct scan,02 sats,lethargy,increased abd distention from the previous day. ct scan showed bladder distension,poss ileus. i was told in report she never had a bm after all that contrast,which is usually normal. foley put out 1200cc coffee-looking urine. called the doc again, who told me her regular doc would be in early that am. by the way, she is a full code. after awhile, resp decreased, more lethargic and i had a hard time finding a pulse..60's/30's. i called a code since it was apparent she was going into resp/cardiac arrest. when we turned her over, she vomited coffee ground emesis. she still had a pulse but eventually also went into cardiac arrest. after inserting an ng tube, it suctioned out almost 3 liters of coffee ground stomach contents. after giving her meds,fluid,cpr she continued flatlined, the doc called the code and she was pronounced dead. after 15 minutes!, we noticed that her carotid and heart had started pounding! she was sinus tach. she was even breathing but shallow and few between.we literally freaked out. we called the er doc and bagged her again. we realized she would be brain dead if we saved her and the doc soon told us to stop. she bled out and she was without 02 for too long. not even the doc could believe that the meds(epi) kickstarted her heart after so long. it was another 25 minutes afterwards before she stopped breathing and her heart stopped. has anyone else experienced this before?!? Sorry so long!
