This is NOT a hw question. It is an actual thing that happened:
I might should have put it in school nurses, but this could happen anywhere I guess. A person (not a child) is having a severe allergic reaction to something they did not know they were allergic to-having trouble breathing, etc. Person does not have an epipen but a parent who has a child with a severe allergy has one one their person. 911 has been called. Nurse has to decide whether to give someone else's epi to person.
Would the nurse lose his/her license for giving the epi? Do you let the non-nurse bystander give it? Wait for 911 and hope the person lives?
I think this episode has prompted the schools to have epi on hand in case of a new onset anaphalaxis, but I thought this was interesting case.
I have to carry glucagon for my T1 son. I don't know what would happen if I gave it to someone unresponsive d/t hypoglycemia.
Yes you should absolutely hesitate to give a lifesaving drug in a critical situation so that a lesser-educated individual can arrive in 15 minutes to give it
This is off the subject but in times past, I've seen first aid kits for groups of non-healthcare people and they did not have an epi-pen but instead a sublingual epinephrine pill.
I've been mystified as far as why so many people carry the epi-pen instead of the pill. Isn't the pill easier to give than a shot? Also, I guess the pills in this first aid kit were "a standing order," so someone could give them without any doctor being there.
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
I fail to see any ethical delima in the OP. I am disapointed that any RN would see one. It is a clear cut case.
On reading this discussion something has become apperent to me. I think too many of you are WAY to worried about losing your license.
In my career I have seen lots of nurses lose their license. Every one of them was for one of a handful of things:
Stealing and taking drugs from the faciliety / patient.
Arriving to work drunk or high AND causing harm to a patient as a result.
Sexualy abusing a patient.
Physicialy abusing a patient.
Abandoning a patient.
I would say that 98% of every lost license I am aware of was due to one of those 5 things.
I have never seen any nurse lose their license for making a med error. I have never seen a nurse lose their license for an honest mistake made in a critical and life threatening situation. I have never heard of a nurse losing their license for helping a person who was seriously hurt or dying outside the care faciliety.
I HAVE seen many nurses get theor picture in the paper and labeled as heros when they stopped at an accident seen and helped.
Sublingual way of meds delivery works by bypassing liver portal circulation (also known as "first bypass"). It works well enough if there is no collapse in systemic circulation. Anaphylaxis is a classical example of the latter, with arterial pressure failing because of massive influx of vasodilating mediators like bradykinin. Sublingually given med won't work as well in this case.
It does appear that some are saying that. However I want to give them the benifit of the doubt and let them answer your question themselves.
I don't know what other state boards of nursing would have to say about it, but in my state failure to rescue in the situation as described is far MORE likely to lead to action aginst an RN's license.
Just human nature and the fact that I value life would be enough for me to give it if I thought it would save the childs life.
I know these are all hypothetical answers, but It really, really scares me that there could nurses who when off duty would actually let a kid die to ensure they don't run in to legal problems later.
Sometimes I just think humanity is totally screwed...
TU RN, DNP, CRNA
461 Posts
Yes you should absolutely hesitate to give a lifesaving drug in a critical situation so that a lesser-educated individual can arrive in 15 minutes to give it