After lurking on this site for years I just joined last week, and I have to say, you guys tell the best stories!!!
So, I'm wondering: Has anybody had patients who probably would have died if they didn't happen to be in the hospital for a completely unrelated complaint?
Had an elderly patient years ago in the ED to rule out small bowel obstruction. Came from a nursing home, had a 'touch' of pneumonia (whatever that means) for which he was already taking antibiotics. X-rays showed that his 'bowel obstruction' was simply constipation and gas. About to get discharged, waiting for transportation back to the facility, hanging out eating a ham sandwich, and BAM, he codes.
After twenty minutes of resuscitation, he's up to the ICU. Apparently he had a systemic inflammatory response related to his pneumonia. The poor resident nearly wet himself, and kept saying over and over, "I don't know how I missed it!" Not sure if the patient ever made it home, but I'm certain that he wouldn't have survived if he hadn't coincidentally been in the ED with bad gas! Blows my mind to this day.
We had a 80-something year old lady who came in the ER with RUQ pain, sent up to our floor to await a chole. Pre op testing included an EKG at which time we found she was actively having an MI. Completely asymptomatic, VSS, talking to us, and a little confused as to why we were all of a sudden rushing around and pushing IV meds. She was whisked away to a partner hospital as we did not have a cath lab in our small community hospital.
I don't know what her outcome was but it surely would have been bad had she not had that pre opEKG for unrelated surgery.
Not a patient per se, but my bosses wife went to the hospital for signs of a possible PE, she had recently had surgery. They ended up finding out she had cancer (not related to the SOB she was having). It probably would have festered for a long time before they found it otherwise.
Mother's day this year, my Mom-in-law went to the ER for low back pain - chronic. Found to be in complete heart block. Home a couple of days later with pacemaker.
Had a pregnant patient at the hospital for childbirth classes. Had a full blown abruption. Rushed up to L&D, Stat section, mom and baby lived. Both could have died if it happened anywhere else.
We've discovered a few large ovarian masses during routine post void bladder scanning in post op spinal patients. Usually after re-insertions of catheters with minimal output despite large amounts of fluid showing up on the bladder scans, we've sent these women for ultrasounds/CTs to find that it was an ovarian mass showing up on the bladder scanners.
Had a patient once who came in for pneumonia, late 70s, was discharged and leaving in the morning but kept going brady overnight. I printed the strip from the monitor to put in the chart when he went down to 34, and the strip I printed was TEXTBOOK complete heart block, got a pacemaker the next day.
Specializes in Cardiac,critical care,wound care, med/su.
Yeah, had the same thing happen to one of my patients. After having 4 days off, as Charge RN, was reviewing the AM strips. Noticed the Hospitalist was DCing patient who had several sporadic episodes of bradycardia to 34 during 3 day admission. Asked Hospitalist if F/U with cardiologist was in the orders. Thought it had been brought to the attention of the Hospitalist. Nooooooooooo! Patient stayed and had her meds tweaked and HR became stable.
Years ago was teaching a nurses aide class in long term care facility. After discussing how to take vital signs, I allowed all the students to begin practicing on each other until I could get all the way around the room to check each student off. All the students were under 30.
Across the room, a student yelled out to me "i've got to be doing something really wrong. I think her heart rate is 130ish but I can't count that fast and her blood pressure is 200/130. Certain she had to be way off on this healthy looking, I asked her to trade partners until I could get over there to show her how to do it correctly. Not long after, the next student said, "Umm, nascarnurse, I can't seem to count that fast either. It's nothing like the last girl I did". Thinking these girls were nuts, I stopped and went over and sure enough - her heart rate is 120-130 with blood pressure at least 200-120. She was not SOB, asymptomatic, insisted she felt just fine.
Explained to the student that she needed to leave for the day and try to get into her Dr. ASAP. Long story short, she ended up on a transplant list! This girl had passed a pre-employment physical right before beginning the aide class!
4th year preceptorship. Rural hospital. Patient (older male) comes in for a routine dressing change - had an incident with a table saw about a week ago and lost a couple of fingers, I think. Mentions that he feels a bit dizzy. Heart rate 150, atrial flutter. We admitted him, put the crash cart in his room, put him on a Cardizem drip, and had a nurse 1:1 with him.
Little old lady came to ER via ambulance with low back pain. Monitor showed SVT. Low back pain was her only complaint.
Guy came in with a bloody nose (ER again), HR in the 150s. He was crotchety old guy who couldn't understand why we wanted to start an IV on him and place him on the monitor and give him meds.
Crash cart in the room and a 1:1 assignment due to a flutter? Isn't that a bit of an over reaction? Had to be unsettling for the patient, and that's not going to help the rhythm any.
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jubu97rn
8 Posts
We had a 80-something year old lady who came in the ER with RUQ pain, sent up to our floor to await a chole. Pre op testing included an EKG at which time we found she was actively having an MI. Completely asymptomatic, VSS, talking to us, and a little confused as to why we were all of a sudden rushing around and pushing IV meds. She was whisked away to a partner hospital as we did not have a cath lab in our small community hospital.
I don't know what her outcome was but it surely would have been bad had she not had that pre opEKG for unrelated surgery.