s/p lap appy...died in 24 hrs

Specialties Med-Surg

Published

i work in a med-surg floor, had a pt s/p lap appy, pt was stable, alert and oriented, ambulatory to the bathroom post op. main issue was pain. pt died after a day. whats the probable cause?

pt is young early 30's, hx of drug abuse, obese...

i just heard that they gave the pt bolus of 1liter and still no UO. VS on my shift 99 degrees something, sbp around 130's, 93-96 % rooma 2liters, checked again, wthin dat range also. but the next morning he's febrile, tachy and diaphoretic, dont knw the bp, able to sleep after pain shot. md came to visit and didnt detect anythin wrong. then he coded the next day.:o

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Specializes in Cardiac.

Diaphoretic, tachy, low (no) urine output even after a liter, post op...sounds like he was bleeding.

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Specializes in med-surg, cardiac, ICU.

I agree with CardiacRN. Dont worry I dont think you missed anything hunny pye. Surgery is not without risk.

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pt is young early 30's, hx of drug abuse, obese...

i just heard that they gave the pt bolus of 1liter and still no UO. VS on my shift 99 degrees something, sbp around 130's, 93-96 % rooma 2liters, checked again, wthin dat range also. but the next morning he's febrile, tachy and diaphoretic, dont knw the bp, able to sleep after pain shot. md came to visit and didnt detect anythin wrong. then he coded the next day.:o

It is always possible that the original diagnosis was incorrect. Also could have a nicked colon. Could have had a ruptured diverticuli instead of appendicitis and been septic from peritonitis.

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Specializes in med/surg, telemetry, IV therapy, mgmt.

It will probably be required, by law, that he be autopsied by the city or county. They'll find the cause of death. I have always heard that while endoscopies are less invasive, they carry greater risks of complications, particularly for strangulated hernias shortly after the surgery if not done by an experienced surgeon. I can guarantee you that this case is going to go before your surgical department's peer review process. They will determine whether or not the surgeon did anything that contributed to the patient's death. I don't know if you would ever be able to get the results of the surgical peer review of that case since it is a confidential process, but you could certainly ask around of the surgeons, particularly of the Chief of Surgery, if a cause of death was ever determined for this patient.

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Gossip and rumor will run rampant regarding the result of the peer investigation into this death. Had this happen on another unit, was a nicked bleeder, nasty lawsuit, physician left area because awards was so high.

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