Recently took care of a 90 yr. old lady who came in with syncopal episode. No medical history to speak of. When she got to ER she had 3 stools. Arrived on the floor and had loose maroon colored stool for me. Asked the pt. She said she had cramps all day at home. No BM's. When I asked her about the ones in ER she said she didn't pay attention to the color. Failed to get the BM news in report---came at shift change and I got report about 3rd hand I think. ANYWAY, vitals all fine. BP actually 150's over 70's I think. One more stool of the same. Then one more that was actually very small, minimal red blood this time. All this from 7-12.
Then at 5:45. Took her to the bathroom. Another nurse went in to get her out. Heard her calling for me. Pt. slumped over. Starring. Drooling. Sounds like agonal breathing. No response to name or sternal rub. She does have a pulse. SR with PVC's on the monitor. Took about 5 minutes to lift her off the toilet and man(woman)handle her to the bed. No response throughout. Called code.
OK- BP 168/64. Still in SR. Agonal breathing. Put on 02, started fluids and she came to in about 5-10 minutes. Slowly, yawning. Resource nurse said she vagaled even though her HR was in the 70's. Baseline in the 90's...is that possible?? I just don't get that.
As far as the PVC's go, I went back thru and they were frequent but not a run. What do you think?? Did she simply vagal out by a drop in HR 90's - 70's?? Would appreciate any enlightenment here.
ALSO, feel like an idiot calling a code if it was a vagal response. UGH!! Where did I put my nursing manual?!?!?!?!?! LOL