Please, please, please remember the 5 rights! - page 4

We recently had a HUGE med error in our facility which I think can serve as a good reminder to all of us to NEVER get complacent, NEVER trust anyone else to handle our medications and ALWAYS check... Read More

  1. Visit  wooh profile page
    Quote from minnymi
    true, but i blame the nurse more than the pharmacist. she was the one administering the drug directly into the patient. i don't know how many times it was drilled into me during school, "you are the last line of defense for the patient!" i would imagine working with children that one would be even more cautious.
    But either one of those two people could have prevented this. Nurses may be the last line of defense, but aren't the only line. And the fact that there's someone after you is no excuse to not do your job too.
    sapphire18 likes this.
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  3. Visit  Scarlette Wings profile page
    Question, if the drug paralyzes all muscles and the heart is a big muscle why did the child still have a heart rate or a pulse???? At best I would think he/she would be bradycardic or some-thing. Just curious.
  4. Visit  Ashley, PICU RN profile page
    Quote from CheyFire
    Question, if the drug paralyzes all muscles and the heart is a big muscle why did the child still have a heart rate or a pulse???? At best I would think he/she would be bradycardic or some-thing. Just curious.
    Good question. Vecuronium is a neuro-muscular blockade. It works by blocking the uptake of acetylcholine by the nerves and cells and stopping the conduction of impulses from the brain to the muscles. Because the heart has its own intrinsic electrical conduction system, it's not effected by Vecuronium. This is fortunate, or we wouldn't be able to paralyze our intubation patients without killing them.
  5. Visit  GrnTea profile page
    the question about vecuronium brings up the point of knowing 1) anatomy, 2) physiology and 3) the mechanism of action for medications or 3a) how to look this up when the occasion arises.

    i am not being mean about this or picking on a particular poster (whose background is unknown to me); i am noting that a nurse must be able to do these prn. for all those who bewail the difficulty of anatomy and physiology and pathophysiology, this, this is why you must not only pass the coursework but acquire and maintain a good working knowledge of them to use until you retire.

    perhaps a medication may be unfamiliar, as this one was. not knowing the difference between skeletal and cardiac muscle is a significant item. putting the two together in a pressure environment could
    lead to a very bad outcome.
  6. Visit  Scarlette Wings profile page
    Thank you Ashley. I never worked with babies or peds and I have been out of ICU and floor work for about 5 years now. I appreciate your answer and also appreciate that you didn't think I was stupid.
  7. Visit  Scarlette Wings profile page
    GrnTea, I realize that I could have looked up the medication and when I worked the floors and ICU I kept a drug handbook and the Merck manual on my cart. always. They were my Bible and the 10 commandments so to speak.

    Later when PCs and the PalmOs came along I downloaded entire text books into my hand held. (....with frequent updates as it seems that daily there were drugs released or recalled LOL) I retired my Palm pilot and progressed to the smart phone and love the apps available to nurses.

    Younger nurses have no idea how blessed they are in this day and age. ((Or how much easier it is to touch an App for information than it was to lug around huge drug books and try to keep them clean ..... and not stolen or borrowed. Now I wonder how many germs were on those books going room to room on our carts and shudder!!)

    I can easily access the texts I need, the APIC site, and the CDC. These are the resources I need now in my job since I no longer work in direct patient care. As medicine advances we all need information at our fingertips to research whatever we need.(and that I may not have in my much older brain cells these days.)

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