Published Apr 22, 2007
crissrn27, RN
904 Posts
What the heck would cause low O2 sats after a ORIF of hip? Spinal ana, low hgb, tx with 1 unit PRBC, no other problems? No hx of lung dx, infections. Any ideas?
veegeern, BSN, RN
179 Posts
Pain or sedation resulting in shallow breathing or slowed respiration rate? I've seen it with other procedures.
TexasPediRN
898 Posts
Anesthesia or meds? Thats my best guess...
reesern63, RN
267 Posts
Low hgb could be giving you the low sat reading. Decreased mobility causing decreased pulm. function. How old is the pt? How far into the post-op period? Lots and lots of reasons why this can happen.
I voted for the low hgb, but the nurse I was talking to said no way. Pt is 87y/o, 36 hours post-op. Taking DCN-100 for pain and had spinal ana. I do babies, we know what causes there low sats! lol, thanks for the responses guys!
meownsmile, BSN, RN
2,532 Posts
Usually even with spinal, they have iv sedation and it takes a while to metabolize. Decreased depth of respirations will cause it. The patient coughs and deep breaths, uses the spirometer a few times and it comes back up usually. It may take 12-24 hrs for it to stay up.
TazziRN, RN
6,487 Posts
Sedation, pain, pain meds. I had a spinal for my c/s with Duramorph and had trouble keeping my sats up because I kept falling asleep and my resps got shallow.
Roy Fokker, BSN, RN
1 Article; 2,011 Posts
87 yr old post hip fx and tx?
I vote shallow breathing r/to low mobility.
That and the ana (but 36 hours post op might be pushing it. I would check kidney function and see how they're urinating wastes...)
The patient coughs and deep breaths, uses the spirometer a few times and it comes back up usually. It may take 12-24 hrs for it to stay up.
RedCell
436 Posts
Unless the dude has a high spinal, I would not exclude a PE. Fat embolisms are fairly common in suckers who have had their hips replaced/fixed etc... Might want to see about getting a chest CT or V/Q scan.
Spidey's mom, ADN, BSN, RN
11,305 Posts
Yup - very important to do teaching prior to surgery in how to use the incentive spirometer. And to start that asap after surgery. Shallow breathing due to anesthesia is a risk for pneumonia . . . use that incentive spirometer!
steph
P_RN, ADN, RN
6,011 Posts
Pickwickian? Big Belly and having to lie flat?
Did you account for your patients age in the offset before determining the O2 sats?
RedERRN
30 Posts
Sounds like its time for a d-dimer and spiral CT of the chest to rule out PE (fat embolism). This is VERY common after ORIF of long bone Fxs.