cpr n perforated bowels (?)

Nurses General Nursing

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hi... i am the stressedoutlady... i am new to this site... please be nice. i just have a quick question. we admitted a pt to our unit for t5 compression and pain management. the pt was on our floor for probably close to a week. and because the pt has some psych issues, the pt was transferred to the psych unit and the pt was stable anyway. but after a few days, this particular pt coded in the psych unit due to "self-induced apnea" (?). the staff started cpr and the pt was intubated and was transferred to icu. (okay, this is getting too long!) so, now the pt was found out to have perforated bowels, as well. and the pt had to undergo surgery. i remember the pt having distended abd, she received 2x enema. i believe the 2nd was tap water enema because the pt was complaining of being constipated. now, my question is : is there any relation between cpr and perforated bowels. can your bowels perforate from cpr and intubation. i am fairly new nurse and i have never heard this before. anyway, i am happy to hear any answer.

thanks.

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Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.

I can't get past the "self induced" apnea. What does that mean? She purposefully stopped breathing?

And no, CPR (DIRECT COMPRESSIONS) doesn't cause perfed bowel--all the other stuff may have though.

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Sounds like somebody may have dropped the ball. This patient was sick and a bowel obstruction/perf was thought to be psychological. I would bet the patients bowel perf caused the "self induced apnea" and "code."

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Specializes in Public Health.

I agree with Gila above, but I can't get past "self-induced apnea". Why not just call it respiratory arrest?

Should heart attacks now be called "self-induced arrythmias" d/t McDonalds/Wendy's/etc.? :roll

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Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.
I agree with Gila above, but I can't get past "self-induced apnea". Why not just call it respiratory arrest?

Should heart attacks now be called "self-induced arrythmias" d/t McDonalds/Wendy's/etc.? :roll

I was thinking the same thing.

Oy vey.

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I agree with Gila above, but I can't get past "self-induced apnea". Why not just call it respiratory arrest?

i took "self-induced apnea" to mean she was holding her breath, which obviously wouldn't be resp arrest.

when someone holds their breath, they end up fainting/losing consciousness, then resume reg breathing patterns.

i'm with gila, that the bowel perf caused all other symptoms.

if true, it really, really sucks.

at some point and time, psyche pts deserve serious assessments...

versus some sort of mental disorder.

dropped the ball, indeed.:stone

leslie

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Specializes in CRNA.

What part of the bowel was perforated? I saw a lady who came up to the OR with gastric perforation from an unrecognized esophageal intubation done in the field. Big time cerebral hypoxic injury. They literally bagged the shizit out of her and she later died on the floor.

Pubmed has a few case reports on this subject.

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Specializes in Oncology/Haemetology/HIV.

I am wondering what is missing from the story.

Kind of curious if the pt was using/ODing on narcotics/sedatives, which could lead to apnea and constipation, and result in a perforated bowel. Or if pt tried to suffocate herself, and when she was resuscitated w/aggressive CPR, perhaps preforating a bowel, due to obstruction/swelling/distention (which would also impair breathing).

Either way, to blame the pt's current condition on aggressive CPR is a bit off. Because what was the alternative......dead with an intact bowel? Like when a pt survives with broken ribs, or a liver laceration.

There is a lot to this story that has not been presented, that we would need to form opinion.

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