9 year old female presents with chills, states "I have breathing problems" No medical history on file, no medications at school. When asked if she has asthma, both her AND MOM say "I don't know". Mom is on the way and the hospital is literally 3 minutes down the road from school.
Her pulse ox sat at 95-98% and every 2-3 minutes it would decrease to 90-93% for maybe 10 seconds, then jump back up to 95-98%. At one point the pulse ox read 78% but I'm pretty sure that was a machine error because it immediately jumped back to 94%. Not even two minutes before Mom shows up, she becomes lethargic, pale. Strong carotid pulse but thin radial pulses. Heart rate stable in 80's the entire time. Mottled with cap refill 3 seconds. Able to speak with no distress during transport to ER. The other nurse working with me started workup and I was paged to come help towards the end. Since parents arrived literally a minute after she "hit a wall" the nurse volunteered to ride with them to the ER down the street. Ride was uneventful, she was alert and talkative and pulse ox reads in 94-96%. The child is "completely fine" per Mom, parents told us we over reacted and that she clearly just didn't eat enough breakfast. Covid test pending, but they did not get her a thorough workup. She will have to get one before returning. It looked pretty rough at the end, and I couldn't stop thinking about her last night.
I just keep wondering............should we have called 911 at the very beginning of it all? My other nurse is questioning if she did the right thing, hesitant to call if it wasn't a true emergency, since she was fine in the end (per the parents). It obviously could have gotten so much worse so quickly. Just one of those "did I do everything right?" moments.
Just curious.........with respiratory issues, what are your guidelines for calling 911?
NutmeggeRN, BSN
2 Articles; 4,743 Posts
My favorite line....
"Based on the evidence and presentation in front of me, I made the best professional decision I could."
I always try to picture myself in front of a judge is a malpractice trial...explaining why I did NOT call...
You did great!