Choking !

CAMMIERN · Apr 7, 2004

YOUR QUESTION IS NOT A STUPID ONE, ANYTIME A PATIENTS ABC'S(AIRWAY,BREATHING,CIRCULATION) IS COMPROMISED, IT NEEDS TO BE REPORTED AND DOCUMENTED, JUST IN CASE THAT THERE MAY BE SOME COMPLICATIONS LATER DOWN THE ROAD(ASPIRATION OF ANY PART OF OBJECTS):uhoh21: . ALSO IT IS IMPORTANT TO LET THEM KNOW SO IF THE PATIENT WAS CHOKING ON A LIQUID, IT MAY NEED TO BE THICKENED, OR IF IT WAS FOOD MAY NNED A SOFT DIET. ALWAYS REMEMBER PATIENT SAFETY FIRST.:)

game over · Apr 7, 2004

YOUR QUESTION IS NOT A STUPID ONE, ANYTIME A PATIENTS ABC'S(AIRWAY,BREATHING,CIRCULATION) IS COMPROMISED, IT NEEDS TO BE REPORTED AND DOCUMENTED, JUST IN CASE THAT THERE MAY BE SOME COMPLICATIONS LATER DOWN THE ROAD(ASPIRATION OF ANY PART OF OBJECTS):uhoh21: . ALSO IT IS IMPORTANT TO LET THEM KNOW SO IF THE PATIENT WAS CHOKING ON A LIQUID, IT MAY NEED TO BE THICKENED, OR IF IT WAS FOOD MAY NNED A SOFT DIET. ALWAYS REMEMBER PATIENT SAFETY FIRST.:)

Thanks Cammie for your reply. I did document the incident in the resident's chart, informed the MD and the next of kin, received orders for temporarily downgrading the diet until swallowing eval is done.

But according to one nurse, I didnt have to write/do an "Incident Report". Was i being overzealous in making this "Incident Report"? According to her the "Incident Report" is only for : Falls, Skin Tears, Bruises.

CAMMIERN · Apr 7, 2004

Good Job.. You Did The Right Thing...that Nurse Was Partially Correct An Incident Is For Fall, Bruises..ect,but Remember It Is Your License Not Hers That You Are Working With. Use Your Best Judgement.. And Keep In Mind, The Abc's(airway Breathing Circulation) Of Patients Anytime Any Of Those Are Comprimeised You Will Have A Potental Problem On Your Hand..(broken Record):)

CoffeeRTC, BSN, RN · Apr 8, 2004

When in doubt do an incident report..I wish we had a form for equiptment failure.

mandykal, ADN, RN · Apr 10, 2004

I guess I could say, "It's a good thing they have supervisors for information on policy and procedures."

For all supervisor's, I feel for you.

jkaee · Apr 10, 2004

We fill out an incident report for ANY unusual event......falls, elopement, choking, new bruises, etc. The purpose of an IR is to try to investigate why the incident happened, and what interventions we can use to prevent it from happening again, or at least document why this resident has frequent incidents. All for the state to make sure we are doing what we're supposed to.

You did the right thing.....the IR should state that the residents diet was downgraded until a speech eval could be done. This should also be documented in the care plan and updated as needed. Also be sure to document that the MD and family is aware of what happened, and make sure to update them as needed.

And people say that LTC nursing is easy, boring and uncomplicated.......yeah, right!

:chuckle

mcmike55 · Apr 10, 2004

To game over. GOOD JOB! It sounds like you made the right moves, filing a report, notification and all. It sound to me like that the other nurse has a little phobia about making reports, if she saves them only for falls.

Incident reports in my hospital are called variance reports. This puts an emphasis on a "variation" from the normal course of patient care. This has decreased "finger pointing" between depts. and staff members significantly.

I had a pt on gen. med. floor choke on a piece of chicken that had been readied by one of my most trusted aids. It turns out there was a small bone, and she sustained a esophageal tear. Thanks in part (I think) to my documentation, the legal issues were slight, despite a poor outcome.

To michelle126, at our hospital, we have, at least in OR, a form called a safe medical device variance. This is somthing we make out when a piece of equipment fails during a case that changes the course of pt care. We also make out the other variance sheet as well. We are lucky we also have a great biomedical dept that works with our equipment.

I agree with you all, document, document, document. This protects us initially, and if your administration is really reading those variances, they will start or change things that will protect your pt's as well in the future.

CAMMIERN · Apr 11, 2004

I guess I could say, "It's a good thing they have supervisors for information on policy and procedures."
For all supervisor's, I feel for you.

I AGREE WITH YOU SOME NURSES, DO NEED SUPERVISED!! ESPECIALLY THE YOUNG ONES!!!

zenman · Apr 11, 2004

Posted by mandykal: Another nurse will tell you one thing, your supervisor might tell you another.
I guess I could say, "It's a good thing they have supervisors for information on policy and procedures."
For all supervisor's, I feel for you.

Lot's of times we do what you do...look it up in the P&P manuals. And for all those times when something original pops up...make something up!

teeituptom, BSN, RN · Apr 11, 2004

Always do what the p and p tells ya

miss_nurse2004 · Apr 17, 2004

At our facility, an incident is "anything out of the ordinary" so I would do an I&A. This has happened before, and I sent the res. to the ER per family request because I was unable to get in touch with the MD (out of town) The res. had aspirated and ended up in the hospital for 2 weeks. I just made sure to document everything as it happened, and luckily everything turned out fine. And I had the I&A to back me up, if anything had happened.