Ever experience a code after pronouncement of death of same patient? - page 2

Last week, I took care of a patient who came in with dehydration due to diarrhea. No history of gi bleed or ulcers. Her abdomen became more distended during her stay and the doc decided to do a ct... Read More

  1. by   DutchgirlRN
    The worst experience of my 30 year nursing career. About 15 years ago we delivered a 23 weeker at about 5 in the morning. I worked in a small hosp and no OB was available, no Ped was available. The child was born dead. We let the mother hold it for about 10 minutes. I took it to the nursery to clean it up and take photos and I noticed the baby was breathing. I listened for a HR and there was one. The resp were like 5/min and HR 20/min. I called the ER doc to come up stat and he came but would not order anything. He forbid me to tell the Mom and to let her continue to think her baby was dead. I cried with that baby in my arms for over an hour until the resp and HR stopped completely. I felt so guilty that the mother wasn't holding it but I was scared to go against the doc. He figured we would be sued. She had no prenatal care and had hitch-hiked to the hospital. If that would have happened to me today I would have given that baby back to the mother regardless of what the doc said. What would you do?
  2. by   pricklypear
    Dutchgirl, What a horrible experience. I've never been on either end of a situation like that, nor do I work in OB. But on thinking about it, do you think it would have been better or worse for the mom to be told, "Your baby is alive again, but she will die again soon"? I think having to go through that once is enough. Lawsuits aside, she may wonder someday if something could have been done to save her baby, and felt guilty. I think you saved that mom more pain, and took some of it on yourself.
  3. by   Audreyfay
    I had almost exactly the same thing happen while I was working in L&D. The baby was a twenty some weeker. Baby was a stillborn. After having the mother see and hold the baby, we took the baby into another room. When opening up the blanket, the baby gasped and started breathing with a very slow heart rate. The OB MD came in, examined the baby, and had us do exactly the same thing. Said the baby would never be able to make it. Identical situation. I always felt bad and thought that somehow maybe the baby would have made it if . . .
  4. by   shaggie
    Quote from bobnurse
    this reminds me of that baby last year????? that was pronounced dead. the policeman was doing his report and saw the baby breathing under the sheet.......

    Does anyone know what ever happened to that baby?
    Are you talking about the little girl who "drown" in Southern California?
    There was an article about her in the local paper here (Orange County) awhile back. Apparently she's at home and doing relatively well. She undergoes a lot of therapy and I'm not sure of the extent of her developmental issues.
  5. by   Gompers
    I didn't have it happen after fifteen minutes, but I've seen pretty close. I once went down to the ER for on a high risk delivery call. Baby was born at home, was already gone when we got down there. Coded the baby anyway, the most intense one I've ever been a part of, it was like an episode of ER for me. After twenty minutes, the doc just said, "Unless anyone else has any ideas, I'm going to call it..." and started to say the time. Of course at that moment the baby got a heartrate. Was bright pink and warm by the time we got it to the NICU. I was in shock.
  6. by   stidget99
    I had a pt in the hospital. She was a DNR. She was totally flaccid, totally unresponsive. One nite, I was on the other end of the hall starting an IV for a co-worker. My co-worker told me that she had died. They told me (including the RT) that she was pulseless and breathless for over 5 mins. Well, I went in to assess. I still heard a heart beat on auscultation and she was breathing although agonally. I listened for another couple of minutes and she was breathing regularly and had a strong pulse. I honestly thought that they were playing some kind of a joke on me. I monitored her closely for the next hour or so and she was "stable" as she was at the beginning of my shift - unresponsive and flaccid. Approximately an hour and a half later, the went in to check on her again and found her to be trying to get OOB...her legs were wedged between the side rails. I called for help. The aide came in and we unwedged this LOL legs from the side rails but not after the pt began swinging...she even blackened the aides eye. Once we got her into the bed, she immediately became breathless and pulseless. Needless to say, I waited several more minutes before I pronounced her. It would have been difficult to explain to hospice, the doc, not to mention the family that she really didn't die after all.
  7. by   NeuroNP
    When I was working in the ER, we had an 11yo kid, severe developmental disorder, came in. He was sent across from the clinic because of some irragularities (can't remember all the details, it was a long time ago). This kid had SEVERE hydrocephalis - his head was EASILY 50% of his body weight and size - and was only about the size overall of a 6 yo. Severe contractions in arms and legs, etc.

    In the course of treatment, he codes. We intubate him, shock etc. have to give epi per ETT because we can't get a line. Finally we get a line and start giving drugs IV. Eventually, he goes asystole and it becomes clear that this is futile. Attending pronounces death and goes to tell the family. As I'm getting the kid cleaned up for mom and dad to come back, he takes a big breath - scared the LIFE out of me! - then I notice that he has resumed sinus rythem on the monitor! Call the attending, he resumes the code as the parents had previously said they wanted everything done.

    Attending is like, "Are you kidding me?! I already told mom and dad that he was dead!" We code him for a few more minutes and then asystole again. We stop. Everyone stands there. Feeling for pulses. Boom. Sinus. Listen to his chest, heartbeat, faint femoral pulse. Resume CPR.

    Again, a few minutes later, asystole. We all watch and wait...... Nothing this time. Attending says, "unhook that monitor before he goes back into sinus again!" We all waited there staring at the body for a good 20 minutes. No one wanted to bring mom and dad back and have the kid start breathing again.

    Finally, it's all settled. Mom and dad come back, have there time. But, the story isn't over yet! It's very busy and so I have to get the kid's body to the morgue but there are no morgue carts. So, my charge nurse says, "he's small, just carry him." So, we wrap up the body good in sheets and it looks like I'm just carrying a load of laundry. Call security to unlock the morgue and off I go.

    Get up there, no security. Morgue locked. So, now I have 2 options, wander around the hospital looking for security to unlock this door (of course there are no phones nearby) while carrying the dead body of this kid, or leave the body laying in the hallway. Well, obviously, I can't really do either! Luckily, while I'm standing there trying to decide what to do, a security guard happens by. No one had ever told the guards to unlock the morgue! It was pure dumb luck that he walked by when he did.

    Bad night all around......