No Prior Existing Conditions but Dead Anyway - page 16

Who would think that a normally healthy woman would die so swiftly from influenza in June? Could you ever have imagined such a thing? No wonder her family and friends are in shock. So why did... Read More

  1. by   lamazeteacher
    Quote from janfrn
    umm... lamazeteacher there's no way a medically induced coma can replace ecmo. how much do you understand about how ecmo works?

    oops, you caught me. i've never seen ecmo, but thanks to all nurses, i did know much of what you explained, though with less hauteur.

    for influenza such as this, the ecmo circuit pulls blood from the patient, circulates it through an oxygenator that acts as an artificial lung (puts oxygen in, takes carbon dioxide out) and returns the blood to the body. putting someone in a coma can't do that. severe h1n1 causes the person's lungs to basically shut down so there is virtually no gas exchange happening there at all. the last patient we put on ecmo for h1n1 had po2s in the 40's and pco2s in the 140s while on high freqency oscillation ventilation on 100% oxygen. after 118 hours of complete lung rest there was enough recovery that we could take the patient off ecmo. how could a medically-induced coma done that?
    what i meant, was that if the induced coma was done earlier than resp failure with lack of perfusion occurred, it might lower the pulse rate accordingly, providing time for the body to recoup somewhat; and gather its resources to fight off the virus and it bacterial sequelae, providing antibodies, etc. also the debilitating stress that occurs when someone is conscious of their decompensation, would be circumvented, giving the cardiopulmonary and neurological symptoms less hassle. :spin:
  2. by   indigo girl
    Ottawa, Ontario, Canada

    http://www.cbc.ca/canada/ottawa/stor...swine-flu.html

    http://www.thestarphoenix.com/techno...428/story.html

    Quote from www.cbc.ca
    According to a press release sent out by the university, Dr. Keith Fagnou, a professor of chemistry in the faculty of science, passed away suddenly on Wednesday. CBC News has confirmed that he died of H1N1-related illness.

    According to university officials, Fagnou had no underlying health conditions.

    Fagnou held the University of Ottawa's research chair in the development of novel catalytic transformations. According to the university, he was an exceptional researcher who won several prestigious chemistry awards, including the Polanyi Prize, during his brief career.
    (hat tip pfi/miker)
    Last edit by indigo girl on Nov 17, '09
  3. by   indigo girl
    Topeka, Kansas

    http://www.ktka.com/news/2009/nov/12...man-h1n1-dies/

    Quote from www.ktka.com
    A 48-year-old woman from the Topeka area has died from infection with the H1N1 virus. That announcement came from the Kansas Department of Health and Environment today.

    The KDHE says the woman's infection was confirmed on November 10, and her death was reported on November 7. She did not have any underlying health conditions.
    (hat tip pfi/homebody)
  4. by   CrunchRN
    I am so glad I decided to get the H1N1 vaccination. Made my husband get it to.
  5. by   indigo girl
    Rensselaer County, New York

    http://www.wten.com/Global/story.asp?S=11516609

    Quote from www.wten.com
    Rensselaer County Officials have confirmed the death of a County resident from the H1N1 flu.

    Officials say the victim is an adult who died within the past few days, and had no apparent underlying health conditions.

    This is Rensselaer County’s second death from H1N1, also known as swine flu. The first happened this past spring.
  6. by   indigo girl
    Bauxite, Arkansas

    http://www.kfsm.com/news/sns-ap-ar--...,7443591.story

    Quote from www.kfsm.com
    Authorities say a Bauxite man has died after testing positive for swine flu.

    Pulaski County Coroner Garland Camper says 37-year-old Jeffery Rollinson died Wednesday night at Baptist Health Medical Center in Little Rock.

    Camper says he wasn't aware of Rollinson suffering from any pre-existing illnesses before he was diagnosed with swine flu on Nov. 7.
    (hat tip pfi/monotreme)
  7. by   indigo girl
    Niagara County, New York

    http://www.wivb.com/dpp/news/health/...rom-H1N1-virus

    Quote from www.wivb.com
    News 4 met with the boy's father, who told us that his son had been fighting the flu for nearly two weeks at Womens & Childrens Hospital.

    Tears flowed easily when Pavel Nichiporuk opened up the family albums to show News 4 some photographs of his son, Paul.

    Paul's father told News 4 his son was a healthy teen with no known underlying medical condition when he fell ill with the flu.
    (hat tip pfi/pixie)
  8. by   lamazeteacher
    Channel 4 went on to quote the family further:

    "Elena Panasyuk, the sister of the teen said, "He was a very timid quiet typical teenager."
    It was difficult for her to talk about her little brother just two days after his death. 14-year-old Paul Nichiporuk was hospitalized for over two weeks before he passed away on Monday.
    Elena says it wasn't just the H1N1 virus that killed him.
    "What really killed him was MRSA, and the power of MRSA and the H1N1...the two powers combined is what hit him," she explained."

    To make matters worse....... a possibly nosocomial additional infection. 2 weeks in the hospital, especially in ICU, makes it a distinctly possible nosocomial infection, which makes me wonder if the antibiotics with which this boy must have been treated, were known to work on MRSA. This brings out the Infection Control Nurse in me.
  9. by   NotReady4PrimeTime
    Our sole documented H1N1 death to date was also a combination of MRSA toxic shock and H1N1. The media is reporting that this child had pre-existing health problems, but the only thing other than the flu that she had was MRSA, suggesting community-acquired infection. (Our nosocomial multi-drug resistant organism rates are extremely low. At the time of her admission we had no MRSA positive patients on the unit.) She was treated with appropriate antibiotics but the combination of pathogens created a situation that resulted in complication after complication until she was removed from ECMO and died.
  10. by   lamazeteacher
    Quote from janfrn
    our sole documented h1n1 death to date was also a combination of mrsa toxic shock and h1n1. the media is reporting that this child had pre-existing health problems, but the only thing other than the flu that she had was mrsa, suggesting community-acquired infection. (our nosocomial multi-drug resistant organism rates are extremely low. probably that is to to the faulty thinking that the unit has to have a patient there with mrsa, to make a nosocomial infection report, ignoring the fact that some nurses and visitors may carry that pathological, dangerous bug.....at the time of her admission we had no mrsa positive patients on the unit.) did a blood specimen get sent for culture when she was admitted, to rule out community acquired mrsa? she was treated with appropriate antibiotics was the dosage checked, to be sure adequate amounts were given? but the combination of pathogens created a situation that resulted in complication after complication until she was removed from ecmo and died.
    while i realize that some h1n1 patients can progress quickly to irreversable conditions without mrsa muddying the field, it would help the perception of nosocomial infection rates, if baseline tests for mrsa were taken upon admission to icus (when another stick isn't necessary, and there might be time to halt the synergistic process of that lethal combination).

    are antivirals being used in icu withb h1n1, or are patients getting there later than 48 hours after commencement of symptoms, obviating the use of them?
  11. by   NotReady4PrimeTime
    We swab everyone who has been transferred from another facility, including the child I mentioned. Blood cultures were sent on admission and were positive for MRSA within a day. We monitor drug levels for many antibiotics routinely even though our lab doesn't like it when we do it, and we especially monitor them for patients on ECMO because the circuit slurps up a lot of drugs. Her vanco dose would have been therapeutic as would her linezolid and rifampin. We also have constant surveillance by our infection control department with daily visits from the IC NP. Our ECMO patients have daily blood cultures drawn from both the patient and the circuit and antimicrobials are adjusted accordingly.

    Our hospital doesn't worry about the 48 hour thing. If we have a suspected influenza A they get oseltamivir within an hour of the admission orders being written.
  12. by   lamazeteacher
    Jan, I appreciate your full response and quality of care; and all the work you've submitted to keep us at allnurses.com, up to date! Even though I'm 70 and not gainfully employed right now, I hate to miss anything coming down, or up the pike.

    Sounds like you work in Canada, as I have (eons ago). I'm so proud, seeing what you do, taking responsibility for continuing the education of all nurses.
    Your health care system's anticipation of the need for ECMO is admirable, but somehow, someone dropped the ball...... does that happen frequently? I'm interested in knowing, due to the U.S. government's approaching involvement in our health care.
  13. by   indigo girl
    Powell, Wyoming

    http://powelltribune.com/index.php/content/view/2808/2/

    Quote from powelltribune.com
    Influenza has been confirmed in the death of Kerby Brandon of Powell, 47. Brandon was hospitalized at Powell Valley Hospital on Nov. 10 and life-flighted the following day to St. Vincent Healthcare in Billings. He died there on Friday.

    State Epidemiologist Dr. Tracy Murphy confirmed Brandon's death was the 10th fatality in Wyoming caused by influenza since the first case of H1N1 was diagnosed in the state in May. Nine of those were from influenza A, all of which are believed to be novel H1N1, Jamieson said.

    A news release from the Wyoming Health Department on Wednesday said Brandon had no identified underlying medical conditions that put him at greater risk complications from influenza.
    (hat tip pfi/aurora)

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