Question from a patient...

[badger54]

I'm not a nurse. I was certified as an EMT when I was a military policeman but it was a long time ago. I do have a curiosity about health in general and that's what brings me here.

I have a question about something that happened to me during a recent 2 week stay for surgery at a major hospital. I did receive a basic explanation from my nurses about what caused it to happen, but I want to know what went on in my body to cause the symptoms I experienced. I chose your site at random and I'm betting that I get a good answer.

• I had an IV in my neck for the full 2 weeks because they had a problem finding a good vein before surgery. I called it a pickline because I have had them in my arm before but the nurses corrected me and said that is not what it was. They did tell me the correct name but I didn't recognize it nor do I remember it. But it was not just a regular IV.
  
• On the day of my discharge I was sitting on my bed and a nurse came in to remove this IV.
  
• A few seconds after she pulled it out I felt like I was having a heart attack. I couldn't breath, it felt like I had a heavy weight on my chest and the chest pain was quite severe. I was also very lightheaded. One symptom I didn't have, that I remember from EMT training was a feeling of impending doom.
  

I heard Code Blue and my room number over the speaker. I have never had heart problems and was quite confused and honestly scared. Fortunately 2 of my regular nurses in addition to the nurse who pulled this line out were already in my room. My surgeon must have been close because he came in shortly after the code was called.

• The nurses took my vitals and said all was ok. Then I heard the code blue cancelled over the speaker. They started talking to me in very soothing tones, telling me to breath slowly etc. and said my heart was fine and I'd feel all right shortly.
  
• They were right. My regular nurses explained that the nurse who removed the line should have had me lie down before removing it. They also said she pulled it out too fast. They started explaining about how the line went into major heart veins or something (my training is failing me here).
  

My curiosity wants to know what physically happened to cause the symptoms. I will ask the doc next time I see him but I'm sure there is a nurse out there that knows what happened and I hope he or she will share it with me. The attitudes of the nurses and their demeanor worked well and with everything that had just happened I could tell the nurses knew exactly what had happened and even before the symptoms had stopped I could tell I was okay.

Just so you know this was a VA hospital and other than the incident above, my stay was made very comfortable by competent nurses and the outcome of the surgery far exceeded my expectations.

Thank you and happy holidays!

[TheCommuter, BSN, RN]

1. The vascular access in your neck was most likely a jugular central line. However, since we were not there, this is purely conjecture on my part.

2. To obtain the full reasoning on why a rapid response or 'code' was called to your room, you might want to request a copy of your medical records. As a patient you have the right to obtain a copy, and I'm certain this incident was recorded by one of your nurses as well as the doctor.

Good luck to you and happy holidays!

[badger54]

Thank you for your reply. As a VA patient I have access to all my medical records, even notations, thru a portal called myhealtevet.com.

I already checked there and all I could see was what I had already observed e.g. getting me calmed down, explaining it was removed too quickly etc.

I will look up your jugular central line and see what I can learn. I'm could be way off base but I'm guessing that the device took up space in the blood vessel and when it was removed too quickly there wasn't time for the blood volume to be replaced in a timely manner.

Thank You Very Much.

[KatieMI, BSN, MSN, RN]

I am pretty much sure that it was central jugular line which normally ends somewhere in the right atrium. Now, the right atrium is the place where heart pacemaker (the clump of specialized cells which send electrical signal causing the heart contraction) normally sits, pretty much close to the opening of the superior cava vein, through which central iv lines are passing. When the line is pulled out, pacemaker may react. A couple of abnormal contractions can be seen pretty often if patient is on cardiac monitor at this time, although there is no physical symptoms most of the time.

I would get a copy of medical record if such event took place, just in case.

[mmc51264, BSN, MSN, RN]

We us IJ and EJs. MD has to take out the IJ because a-it is sutured in, and b-it is a central line and there are protocols to avoid what sounds like what happened to you. We are allowed to take out an EJ b/c it is considered peripheral.

Sorry this happened to you and glad you are ok.

[SierraBravo]

I am pretty much sure that it was central jugular line which normally ends somewhere in the right atrium. Now, the right atrium is the place where heart pacemaker (the clump of specialized cells which send electrical signal causing the heart contraction) normally sits, pretty much close to the opening of the superior cava vein, through which central iv lines are passing. When the line is pulled out, pacemaker may react. A couple of abnormal contractions can be seen pretty often if patient is on cardiac monitor at this time, although there is no physical symptoms most of the time.

I would get a copy of medical record if such event took place, just in case.

The tip of a central line should terminate in the SVC, not the RA.

[TheCommuter, BSN, RN]

The tip of a central line should terminate in the SVC, not the RA.

The central line tip can terminate in either the SVC or the cavoatrial junction, but it should never ever end up in the right atrium.

[NRSKarenRN, BSN, RN]

We really can not answer personal questions per our Terms of Service.

Members have given you good advice to obtain your records and review event with your surgeon.

Closing thread.