I feel stupid!

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I'm a substitute nurse today, called to student having seizure > 5 mins. Pulled Diastat, checked order, went to student now 6mins into seizure, gave Diastat, and then realized it had expired. I feel like an idiot! Super said not to worry. I don't know why it was in there, but I should have checked. I feel so bad.

Just looking for support from someone that's "been there done that". Thanks,

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Hard to stop and think in the middle of an emergency to look at the expiration dates.

The person responsible for upkeep of the meds should have been on top of this.

Do not beat yourself up about this. Was the outcome ok?

Let us know how the child did.

Best wishes.

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Specializes in ER/ICU/STICU.

Agreed, it's hard to sit there and check over the expiration date while they are having an active seizure that long. The meds should be checked for expiration dates at regular intervals to avoid this type of situation.

I wouldn't beat yourself up over it, you did what needed to be done at that moment. Everyone has 20/20 hindsight.

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Please don't let this make you feel stupid. Like merlee said, "hard to stop and think in the middle of an emergency." This will present the opportunity to evaluate a better process for maintaining meds.

Your response time was great!!! You obviously kept your cool through the episode:yeah:

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

Been there done that..:hug:. The facility should have a policy that addresses the expiration dates on meds and equipment. It's extremely difficult if not impossible to check dates on meds in the midst of a crisis. I take it this child was already known to the school/residential program and giving the Valium was a standing order which is why it's available for them.

As a part of keeping meds there has to be a method of checking expiration dates clearly marked when the check sheets are signed. When I sub there again I would inquire about these policies and what was done to take care of this issue in the future.

Worse case senario the child kept seizing because the meds was old and had lost it's effectivness. It's happened to us all....:)

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Specializes in LTC, Memory loss, PDN.

You did the right thing. What would you have done had you observed the exp. date before admin - not give it? I have filled in on private duty cases only to find diastat expired and wasn't able to get a refill right away. I didn't have to use it, but surely would have if necessary. I found out that some families have to pay for diastat out of pocket and $40 can buy a cool video game (I had to go there).

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Specializes in Rural Health.

Yep, I woulda done the same thing! This makes me realize that during a code I've NEVER checked to see if the meds I'm giving are expired! I know they are checked monthly though and if it came to something expired or nothing at all, well I'd probably chance the expired med.

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Specializes in Emergency Nursing.

Well, feeling stupid is better than being stupid. I'd know. :crying2:

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If it were all you had on hand, and even if you'd known it was expired; would you have NOT used it? Who would bother to check at that point! First things first. Most medications are actually just fine for quite a bit of time after their expiration date anyway..(except for mix now, use now ones). What in the world else COULD you have done?! I am assuming you are a school nurse? And that the med was the familys' med provided by them?

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Thank You all so much. I still feel bad, but not so stupid. The child is OK, and is home for the rest of the week with mom. Seems that her Keppra dose had been changed the day before. I am a school nurse (sub), the Diastat is provided by the family, and the regular nurse had told family to bring a new one. I'm trying to figure out why that was still there, but maybe it was fate. I guess she seized last week, and nothing was given, but the seizure didn't last as long as the one I had witnessed yesterday, going on 6mins. by the time I got there, I was called at 4mins. Exp. date isn't one of the 5 or 6 rights, but I may be more mindful of it next time.

Again, Thank You all for the support, I feel much better!

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What do you guys think about giving Diastat in the school setting that is known to be expired. I am a new school nurse and a mom sent rescue Diastat in with the student on the first day of school. I checked it and it had expired the previous month. I sent it back home with a letter that explained it was expired and we needed a new one sent in. His mother emailed me to confirm receipt and asked if we could keep the Diastat until she could get a new one filled. She also commented that she understood that giving expired meds is a liability, but less than having damage from a seizure that is not stopped. What would you do in this situation? The student will be in school without unexpired rescue med until she gets a new one. Would you give it if needed, even though you knew and confirmed this with others?

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My name taken in vain:sarcastic:.

This about the patient.. not the order. Was your intervention successful?

Seriously..the student is having a seizure.. you treated it APPROPRIATELY!

Who gives a rat's patooty if the order had expired? Would you have then... not administered the correct medication?

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