That is very interesting about the low Hgb not contributing to low O2 sats - I didn't know that! I feel like an idiot now. I knew it wasn't the sole reason, but I did think that her low Hgb was contributing to the low O2 sats. Thanks for the truck explanation - makes a lot of sense.
Do you guys think I should have called the RR when I first noticed her slightly cyanotic lips? I am always afraid of overreacting and then having the MDs/RR nurses lose respect for me and my judgement. They already have low respect for us floor nurses (sometimes rightly so. . .sigh. . .)
When the RR nurse arrived, he ordered ABGs (I don't remember the exact results because everything was chaotic, but I do remember hearing RT say that the person was slightly hypoxic but that's it), an EKG (v-paced), and we got a stat T&C and order for blood. Before taking her to the unit, they took her for stat CT chest and abdomen.
As far as the pnuemothorax, would a chest xray have shown that? because she had had one that morning and it showed stable pleural effusions that had not increased since the previous day's xray.
I wonder if her lung spasms/sharp pain upon inhalation had anything to do with this?
Thanks for your responses. It's hard on the floor (when I had 5 other patients) to truly stop and take a good look at the whole clinical picture. I feel like as floor nurses, we tend to focus on the task at hand/main problem and don't have the time to ever put all of the pieces together/get a feel for the whole person. Like - with this patient I was focused on getting her labs, getting her ABX hung and ensuring her sats stayed above 92%. Just like with my 5 other patients, I was focused on the tasks of getting orders done, calling MDs, etc. . .so hard to have the time to truly know a patient and think about situations. That is why I like to think back on cases like this, analyze, learn so the next time I am in a similar situation it comes together for me.
anyway, I'm rambling
Next time I see the RR nurse that came, I will ask him about this patient, what ended up happening and any advice. He was really great.