I was in clinicals this week and had an elderly patient with BPOC who came back from a hip surgery.
The thing is that the patient came back from his surgery terribly dysphagic. The evening I was there, his family gave him some yogourt and he choked on it. (like more than ever).
I was in the room, so I told him to spit everything he could and took his SpO2.
It was still in the normal ranges for him since he had BPOC (it was at 90 and we were targetting 88-92%) and his respiration was at 24/min but in the context I thought it was normal, I checked again 30min later and it was at 16/min, SpO2 still at 90.
When he was coughing, trying to spit the yogourt out he made a sound like he was gargling with the yogourt/secretions, trying to get it out.
When that was over I listened to his lungs and it sounded like a bad car engine, but I assumed it was normal since he had BPOC + he was recovering from a surgery + his SpO2 was in the normal ranges.
There was no other incident during the evening, but at midnight when I left I heard him doing the gargling noise again and it makes me wonder, should I have suctioned him?? (because they did at midnight)
I knew he had secretions from what I heard with my stethoscope, but his vitals were completely normal 30 min after he choked and he did not had any trouble breathing after that, but I am seriously wondering if what I did was appropriate or not enough?
I was in clinicals this week and had an elderly patient with BPOC who came back from a hip surgery.
The thing is that the patient came back from his surgery terribly dysphagic. The evening I was there, his family gave him some yogourt and he choked on it. (like more than ever).
I was in the room, so I told him to spit everything he could and took his SpO2.
It was still in the normal ranges for him since he had BPOC (it was at 90 and we were targetting 88-92%) and his respiration was at 24/min but in the context I thought it was normal, I checked again 30min later and it was at 16/min, SpO2 still at 90.
When he was coughing, trying to spit the yogourt out he made a sound like he was gargling with the yogourt/secretions, trying to get it out.
When that was over I listened to his lungs and it sounded like a bad car engine, but I assumed it was normal since he had BPOC + he was recovering from a surgery + his SpO2 was in the normal ranges.
There was no other incident during the evening, but at midnight when I left I heard him doing the gargling noise again and it makes me wonder, should I have suctioned him?? (because they did at midnight)
I knew he had secretions from what I heard with my stethoscope, but his vitals were completely normal 30 min after he choked and he did not had any trouble breathing after that, but I am seriously wondering if what I did was appropriate or not enough?
As you are a student,your intervention would be call for the nurse and your instructor.
As you are a student,your intervention would be call for the nurse and your instructor.
I guess thats what I was having a hard time understanding, why was a student completely responsible for the assessment on this patient? Was this not reported to a clinical instructor or nurse?
I'm guessing it's situations like this as to why students are allowed to do nothing in clinical these days.
I guess thats what I was having a hard time understanding, why was a student completely responsible for the assessment on this patient? Was this not reported to a clinical instructor or nurse?
I'm guessing it's situations like this as to why students are allowed to do nothing in clinical these days.
I did not mention it but of course I mentioned it to my clinical instructor and the charge nurse (I considered it obvious) I was just wondering as a student, were my interventions appropriate, but thank you all for your answers!
I did not mention it but of course I mentioned it to my clinical instructor and the charge nurse (I considered it obvious) I was just wondering as a student, were my interventions appropriate, but thank you all for your answers!
Did the nurse and your instructor think they were? They know the patient and could assess the situation first hand, and they know what resources are available at that hospital, so their opinion is far more valuable than ours.
Been there,done that, ASN, RN
7,241 Posts
As you are a student,your intervention would be call for the nurse and your instructor.