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Girl Brain Dead after Tonsillectomy

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by EaglesWings21 EaglesWings21 (Member)

EaglesWings21 works as a RN.

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http://abcnews.go.com/Health/wireStory/california-mother-tells-tonsil-surgery-tragedy-21293017

This is such a tragic story and breaks my heart to hear of this, but shouldn't the people caring for this girl realized that she was hemorrhaging and that amount of blood was NOT normal? I mean I am not even a nurse yet but I realize that hemorrhaging after surgery is a HUGE risk and nurses need to assess and act quickly if it happens.

What are your opinions on this situation and what you would have done different had you been caring for this girl?

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Rose_Queen is a BSN, MSN, RN and works as a Staff nurse educator.

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My thoughts are that it's impossible to judge with only 1 side of the story. The saying is that there are 3 sides to every story: his, hers, and the truth.

Furthermore, the article on CNN a few days mentioned preop plans for the girl to go to ICU postoperatively. Now, most kids getting their tonsils out go home the same day. So what else was going on with this girl that there were plans to keep her in ICU even before the surgery occurred?

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wtbcrna works as a CRNA, MSN, DNAP.

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IMO she should have been brought back to the OR immediately when the bleeding was noted. There is a lot more to this story than what is being reported....

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meanmaryjean has 40 years experience and works as a Nursing Faculty.

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Our ENT docs routinely reserve a PICU bed for their tonsillectomies that are being done for severe sleep apnea WITH obesity.

This poor child had multiple co-morbidities (per the family's report) - but I hesitate to judge when all information is being filtered through the family's lens.

Reminds me, in a way, of the lung transplant girl in Philly (or was it Pittsburgh?) a few months back- family controlled the release of all information and put their own 'spin' on it. The press reported such as cold, hard medical facts.

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wtbcrna works as a CRNA, MSN, DNAP.

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OSA is common diagnosis for tonsillectomy. I didn't see any other mention of co-morbidities in the report, but I may have missed it. Post-tonsillectomy hemorrhage is probably around 2-3%, which is about what I have seen in my practice. Prevalence of Post-tonsillectomy Bleeding as Day-case Surgery with Combination Method; Cold Dissection Tonsillectomy and Bipolar Diathermy Hemostasis

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Esme12 is a ASN, BSN, RN and works as a Emergency / Trauma Nurse.

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moved to nursing news for best response.

I am sure there is more to this story....how sad for everyone involved. My prayers to the family and staff.

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KelRN215 has 10 years experience as a BSN, RN and works as a Complex Care Manager.

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California Girl to Be Kept on Life Support - ABC Newshis is such a tragic story and breaks my heart to hear of this, but shouldn't the people caring for this girl realized that she was hemorrhaging and that amount of blood was NOT normal? I mean I am not even a nurse yet but I realize that hemorrhaging after surgery is a HUGE risk and nurses need to assess and act quickly if it happens.

What are your opinions on this situation and what you would have done different had you been caring for this girl?

The article says the girl was being given blood transfusions. Why they didn't take her back to the OR, only the surgeons know. I doubt that there's anything different I could have/would have done as a nurse. I agree with the others, this case has to be more complicated than we know. A T&A is usually an outpatient procedure.

The child is brain dead and the family thinks she can recover. Brain death is determinant of death in all 50 states and, the hospital is right, consent is not needed to withdraw support from a dead person nor are they obligated to continue to provide medical care to her. The hospital cannot discuss specific details of the case because of HIPAA yet the family goes running to the media with their side of the story:

Family of Jahi McMath, Teen Declared Brain Dead After Tonsillectomy, Asks Hospital for More Time | NBC Bay Area

Honestly, where do you draw the line? The family is now asking for a feeding tube. The child is dead. And the family thinks it's "ridiculous" that the hospital won't allow an "independent doctor" to come in and examine her. I've never known a hospital to allow a doctor who didn't have privileges there to come in, examine a patient and then base their care of her off his recommendations.

Oakland family: Children's Hospital calls 13-year-old Jahi McMath 'dead' | abc7news.com

I feel bad for the family. Losing a child is terrible but subjecting a dead child to further interventions is unreasonable.

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NotReady4PrimeTime has 23 years experience as a RN and works as a RN, CNCCP(C).

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I have known of isolated cases where a completely neutral consultant physician has been permitted to assess a patient in similar condition. I know of NO cases where the neutral third party disagreed with the primary assessment. It is indeed sad that this girl has had this outcome, but as has been said before, brain death is death. Maintaining this girl on life support does no good for any one.

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Palliative Care, DNP works as a DNP, FNP.

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I can not even fathom losing a child or having to take my child off of life support. My heart breaks for that family. The child did have severe sleep apnea and was over weight. Maybe that played a part. Maybe when the mother repeatedly asked about the "strange" looking blood her child had coming up and the nurses shrugged her off part. I'm not placing blame I'm merely pointing out there is more than meets the eye here.

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The one thing that dissappointed me was the way the hospital responded. And i quote"Ms. McMath is dead and cannot be brought back to life," the hospital said in the memo, adding: "Children's is under no legal obligation to provide medical or other intervention for a deceased person. " I was like what? who handles PR at the hospital needs to be fired especially that the case is being broadcast across the nation. The wording and statement itself shows a Hospital more concerned about policy than doing what is right. I would never take a child to such a place.

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EaglesWings21 works as a RN.

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It is hard to judge without knowing what all was going on. I formulated an opinion from a previous article about this where a family member stated that the mother kept asking the nurses if that was normal and some said yes and others did not know. I was screaming in my head NO it's not normal to lose pints of blood!!!

Thanks for all the responses.

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