Emergent Situation Gone Wrong. Ideas? - page 3

Hello all! I have been a nurse for 11 years, 8 of which I've spent in Hospice care. This is my 3rd year as a school nurse. Recently my school had my first truly emergent situation in which a... Read More

  1. by   kidzcare
    Quote from Farawyn
    "LOL"

    Yea. Ummm...No.

    We don't do that in this Forum. We are one of the most welcoming and helpful and supportive Forums on AN.

    Put the spoon away, please. This pot doesn't need stirring.
    Yep! This forum is only support and constructive suggestions!
  2. by   WineRN
    Quote from Farawyn
    "LOL"

    Put the spoon away, please. This pot doesn't need stirring.
    Completely Agree.

    And
    I'm putting this on my door.
  3. by   OldDude
    Quote from kidzcare
    Yep! This forum is only support and constructive suggestions!
    And anyone who believes mermaids are real; like I do.
  4. by   MrNurse(x2)
    Quote from OldDude
    And anyone who believes mermaids are real; like I do.
  5. by   Farawyn
    Quote from OldDude
    And anyone who believes mermaids are real; like I do.
    Quote from MrNurse(x2)

  6. by   kidzcare
    Quote from OldDude
    And anyone who believes mermaids are real; like I do.
    Who wouldn't believe that mermaids are real?!? I've seen Splash AND The Little Mermaid. What could be more convincing?
  7. by   OldDude
    Quote from kidzcare
    Who wouldn't believe that mermaids are real?!? I've seen Splash AND The Little Mermaid. What could be more convincing?
    ​SEE!!
  8. by   marcos9999
    Sugar...sugar...sugar. All these kids eat is sugar. Our diet of refined carbohydrates laced with sugar is all these kids eat. Eventually a kid with propensity for hypoglycemic disturbances end up like that.
  9. by   Tencat12
    I have another question. If I put an EMT on my posse of folks who respond in an emergent situation, who is in charge of the scene? The EMT obviously has more experience with emergent situations than I do, but I am the nurse.....How could I utilize an EMT?
  10. by   QuackPack
    Wow!

    Again , my background is in Emergency Medicine not a school setting. Keeping that in mind...

    People who do not have medical training needs to be out of the situation and only help if the person handling it who has medical training asks for that help and directs them as to what they need to do.

    It is VERY common for a patient who is seizing to cease respirations during the seizure and o2 sats to drop. Once the seizure stops they often will spontaneously begin respirations again.

    Rolling to the side is to help prevent aspiration from mucus or vomit, also common after a seizure.

    You did not say how old the child was , but the fact they had more than one seizure seemingly back to back would be concerning and I hope he got a full Neuro work up wherever he was taken. That is not a normal reaction to low blood sugars in a non diabetic or even dehydration that is not extreme.

    Its important to note that even once a patient stops tonic and clonic movements seizure activity can still exist without obvious signs to the naked eye.

    Being prepared to do CPR was good, getting the AED was good, Calling 911 also good, keeping the airway clear.. good.

    As an ED nurse , I am trained to look for zebras , so I would be concerned about a toxin or drugs in a patient with no Hx of Seizures etc.. I'd be checking pupillary responses, BP etc.. also pain responses to help access GCS

    Since this was a child without history , then the fect he had one seizure should guarantee him a trip to the ER ALWAYS. While waiting for EMS, you'd want to keep them quiet and the area around them calm as possible and do not allow them to sit or stand .

    You would also want to ask others who were around when he had the first seizure if he fell, how he fell etc.. to look for additional injury and advise EMS.

    Again this is not a typical response , so I would be prepared to handle this situation again in the future with this child should it recur.

    It might be a good idea to meet with other staff and Admin and go over a plan in the event it goes on again and explain why its important to control the scene and outline duties each of them could do to help.

    That must have been a hec of a day huh?
  11. by   Gizmo44
    I think schools need to practice medical emergencies like they do fire drills and tornado drills. and now often active shooter drills. At least for the adults to know how operate. Sounds like you had utter chaos and your instincts kicked in meaning your focus was on the patient. This was more than skinning your knee on the playground and needing to go to the nurses office.
  12. by   Ellie G
    I would make sure to have a post event evaluation looking at what would have improved the response. It is a scary thing for health care professionals, but especially so for those who have other jobs in the school. It sounds like there wasn't any set role designation in an emergency and that needs to happen so that everyone is responding appropriately. We all know that even in the hospital, emergency situations can get chaotic and that is with trained people. Sounds like you did a great job with what you had available.
  13. by   Crgoergen
    Regardless of how teachers or administrators respond, the nurse is always in charge of the patient.
    You saved the day in this instance, but you had unnessesary interference. Carve out what is your domain, per your State School Nursing Certificate or Nurse Practice Act, whatever applies where you practice. Educate staff about your role and how it's implemented in your school. Consult other School Nurses to get ideas and create a comprehensive safety, best practice emergency response plan. But don't settle for the back seat of the bus. You really need to have control over the care of the precious children entrusted to you, and you seem to be competent.
    Best wishes.

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