Colonoscopy Post Vital Signs

Been there,done that, ASN, RN · Apr 27, 2022

The patient was stable after the procedure, the patient is fine 2 weeks later. A blood pressure reading now would be useless.

Think this out. You did make a mistake. You did not check that the auto BP was on. You won't make that mistake again. Learn from it and move on.

DavidFR, BSN, MSN, RN · Apr 27, 2022

Always be suspicious when you get a BP reading totally identical to the previous one. It does happen, but not often. Check your machinery.

If the patient was actively bleeding gallons you'd have noticed. You didn't notice because the patient was fine. Chill. Learn, but don't lose any sleep over this.

nursej22, MSN, RN · Apr 28, 2022

I guarantee if a patient was having bleeding after a colonoscopy you would know without a BP. The maroon lake running off the edge of the bed and the smell would be your signs. Also, your patient will take on a pale, waxy appearance. A decreasing BP is actually a late sign, because the body will compensate, to a degree.

Seriously, just remember to check your monitor settings and move on.

Firewood, RN · Apr 28, 2022

I'm new to endo, so I was more worried about an extra colonic bleed that you can't see.

**CommunityRNBSN, BSN, RN** · Apr 28, 2022

I was so dehydrated before my colonoscopy that my BP was super low at discharge. I don’t remember the exact numbers but definitely low enough to make me dizzy. They discharged me on schedule anyway— because like someone else said, a patient who was bleeding would have additional symptoms! An isolated low BP wouldn’t have told you a whole lot anyway.

Firewood, RN · Apr 28, 2022

Aren't the post endo vital signs mainly for the purpose of anesthesia recovery? Not so much for blood loss? Also, isn't a bleed outside the colon into the peritoneum (so blood loss wouldn't be noticable) from a colonoscopy super rare? Not talking about a perforation, just blunt trauma or maneuvering of the scope?

kp2016 · May 4, 2022

On 4/29/2022 at 1:07 AM, Firewood said:

Aren't the post endo vital signs mainly for the purpose of anesthesia recovery? Not so much for blood loss? Also, isn't a bleed outside the colon into the peritoneum (so blood loss wouldn't be noticable) from a colonoscopy super rare? Not talking about a perforation, just blunt trauma or maneuvering of the scope?

I've done PACU for well over a decade. I would say perforation / complications are extremely rare. I've personally seen 1 perforation. It happened during the case (I wasn't actually involved in the case, just attended the rapid response). In all the years of on-call for PACU I've never seen anyone come back with complications post discharge.

As someone noted above hypotension due to dehydration and the versed and propofol or fentanyl is fairly common. Depending on the opinion of the provider we often gave a fluid bolus of several hundred ml's prior to the procedure. Many providers refused to ordered post procedure IV fluids as they said the patient should just drink fluids.

I admire the fact that you are willing to be honest about a mistake but I think at this point this should just be a learning point for you going forward re how to set the monitor and rechecking unlikely readings, abnormally high/ low or multiple identical readings. Nothing good will come of continuing to announce this mistake that caused your patient no harm.