man holding wife still during epidural dies!

[smk1]

Just read the ap report about a woman in labor at a kaiser hospital. Apparently the anethesia professional (don't know which kind crna, mda or aa) asked the husband to help hold the wife still while the needle was inserted into the epidural space of her back and, he saw the needle going in and fainted, fell over and hit his head, suffered a fatal brain bleed and died 2 days later. Of course the wife is sueing, stating that he was asked to assist the procedure and so "reasonable" care should have been taken to prevent reasonable forseable complications/accidents. My thoughts as a simply a student, is that this is a firviolous lawsuit, and the lawyer that is encouraging her to go forth with this case should be ashamed. Also I am so saddened for this family to have such a joyous event marred and a life gone without warning. I guess to all of you L/D nurses and CRNA's etc... don't ask a family member to help hold the mom still. :uhoh21: What are your takes on this?

[canoehead, BSN, RN]

Just looking at what the person who claims to know the family said...I wonder if once he went down if the family expected that the staff would automatically take him on as a patient...and then staff expected that they would take him to the ER if they wanted him evaluated. If they were very busy perhaps they let him doze on the stretcher (especially if he had been up all night) while the family interpreted that as "doing nothing" for someone who needed medical attention.

Just a thought, but I am sure there are two sides to this story. It sounded like it wasn't the fall, but the (perceived) lack of attention afterwards that made things so much worse.

[SarasotaRN2b]

Since you asked what our take was on this....

I agree with prmenrs.

Me too! It is never recomended that a family member hold a patient while a procedure is being done. It doesn't mean the family member can't maybe hold the patient's hand or other comfort measure.

Kris

[tnacRN]

all three times i gave birth, my husband was asked to help hold me during my epidural by the anesthesiologist. i think they ask the father to include him in the event of childbirth. my husband is not the squimish type and enjoyed the inclusion to the event. honestly, i would not have been comfortable if he were asked to leave the room.

i agree with other posters who asked who would be responsible if he fainted while holding her hand? or while standing and watching the crowning? will it come to the point of posting signs in all ld rooms asking those who are queezy to refrain from standing? or better yet, have husbands sign liability waivers upon entering ld stating that they understand that if they choose to stand while knowing they faint they relinquish all rights to the hospital and death is a possible outcome. come on? is this what we want our world to come to?

this was a very unfortunate event. i dont believe that it is the hospitals fault or responsibility. i sure hope a judge and jury feel the same way because this law suit sends the wrong message about the health care profession. maybe once some time has passed this woman will come to her senses and drop this suit.

[BETSRN]

I worked L&D, and we always had family step out of the room for epidurals. We concentrated on taking care of the pt and vitals, and didn't need to be distracted by fainting family. For the fifteen minutes or less that it took, it didn't interfere with bonding. If someone truly didn't want to leave, then we could pull a drape and they could sit behind that and watch tv, prn. With the high rate of epidurals, sometimes it is a procedure that is taken for granted. However, the risks are there, and as I stated earlier, staff needs to be attuned to watching vitals and assessing the patient and monitor for early intervention. The toughest man may be able to take anything, however, when an epidural needle is being inserted into the mother of your child, nervous systems react and they go vagal.

If you just put the significant other in front of the mom (so he can hold her hand,etc) this person cannot see what is going on in her back. What is the big deal with having a fmaily member present? We have NEVER asked a support person to leave the room.

[BETSRN]

I wonder if this hospital used a "support person consent." We require all support people (husband, mother, etc.) to sign a consent that states we are not responsible for them, only the patient. Still sad, but as has been posted many times - bad things happen in life.

It astounds me how many of you have all these forms for protection against everything imaginable.

It is always said that people sue not because of the outcome but because of how they were treated. If some of you who make everything a secret (like leaving the room for an epidural or other procedure), it is no wonder people are not happy with the care. If you quit worrying about what everybody thinks (and include family members in decisions and procedures), you'd probably have a lot less likely to have these ridiculous things happen.

Support persons SHOULD be there during epidural placement. They are there for emotional support. End of story!! In all my years of doing L&D, I have NEVER even had anyone even mention worrying about the support person; including the anesthesiologist. If the support peson is allowed to stay, if he has questions and they are answered,etc.,, then there is LESS to wonder about after the fact. In the long run, the patient and family will be far happier with the outcome and less likely to find something to sue over.

Sure, I make darn sure that my support person(s) has eaten and feels good, but that's it.

I am always convinced that if nurses thought a little more "outside the box" instead of exhibiting the "we have always done it that way" mentality, there would be far less dissatisfaction with a person's care in general. This does not just apply to OB, but is for any branch of nursing.

If you read the post from someone who "knows the family", you will see that it mentions that the man who fainted was not given any evaluation for over 5 hours . That, in my opinion has absolutely nothing at all to do with her epidural or OB. He was not evaluated by the ER in a timely manner.

[BETSRN]

I had to have a epidural and am still having problems three years later, it was up to the nurses/consultant to make sure the husband stood back.

What does having trouble with your back years after an epidural have to do with the husband standing back?

[BETSRN]

It's not just "a hug". You are making sure the pts. spine is in proper alignment for needle placement and that a large woman in active labor does not move while the epidural is being placed.Be it elective or not, it is akin to having a lumbar puncture. Do we have husbands, wives, visitors, hold out pts for those? No where I've ever been.

Personally, everyone had to leave the room when I got my epidurals.My husband had a chair placed strategically behind him during delivery for his hx of being a fainter.

NO.....it is up to the anesthesiologist to make sure the spine is in proper alignment. It is NOT up to the support person or the nurse for that matter.

An epidural is a blind procedure, no matter who holds the patient. The dad fainted. The hospital is not liable for that. If he was taken to the ER and then NOT evaluated properly, that has nothing to do with OB.

Thisis a ridiculous thread as well as a stupid lawsuit. Maybe the patient will not be able to substantiate it.

[BETSRN]

So,I guess if the nurse was the one in there holding the patient they wouldn't not have been participating in the procedure either??

As an L&D nurse, I would say that no, we do NOT participate in the placement of the epidural in any way. We have absolutely nothing to do with the placement, meds, or anything. We touch nothing in the kit, and in no way do we help that anesthetist at all, other than to help keep the patient in the proper position. The anesthetist is the one who telle me if the patient is in an optimal position, etc.

My responsibility is to reassure the patinet and chart what is going on. I am responsible directly after the procedure when I ahve to monitor frequent B/P's etc.

We do not participate in any way.

[sbic56, BSN, RN]

BETSRN...you are clearly passionate about this topic and I think you give excellent argument for your viewpoints! The anesthesiologist does ask the family to leave during epidural placement where I work and I wondered if it was because of sterility concerns as that is the only thing that made sense to me; also, with C/S, the s.o. does not come into the OR until the spinal is done. After reading your statements, I am thinking you are right on. I'm interested to see those who feel otherwise back up their point.

[Spidey's mom, ADN, BSN, RN]

BETSRN...you are clearly passionate about this topic and I think you give excellent argument for your viewpoints! The anesthesiologist does ask the family to leave during epidural placement where I work and I wondered if it was because of sterility concerns as that is the only thing that made sense to me; also, with C/S, the s.o. does not come into the OR until the spinal is done. After reading your statements, I am thinking you are right on. I'm interested to see those who feel otherwise back up their point.

I too appreciate reading your posts BETSRN - and I too think you are right on.

Our CRNA does not ask anyone to leave and even the guy who takes his place when he is on vacation doesn't ask anyone to leave.

I think you points about labor and delivery being OVER regulated with paperwork pointing out every possible negative outcome and having patients and their families sign this is right on target too.

The support person is there for the patient, NOT the anesthetist, who positions the patients how he wants.

I agree that this is a sad case but it sounds to me, if what is posted is true, that the real culprit is lack of a timely assessment for the husband.

steph

[BETSRN]

BETSRN...you are clearly passionate about this topic and I think you give excellent argument for your viewpoints! The anesthesiologist does ask the family to leave during epidural placement where I work and I wondered if it was because of sterility concerns as that is the only thing that made sense to me; also, with C/S, the s.o. does not come into the OR until the spinal is done. After reading your statements, I am thinking you are right on. I'm interested to see those who feel otherwise back up their point.

There is no more sterility with the significant other out of the room. Sterility has only to do with the anesthesiologist's technique. dad is on the opposite side of the bed form the anesthesiologist anyway. In my opinion, the anesthesiologists don't ahev a leg to stand on when it comes to asking people to leave.

I think it has more to do with the anesthesiologist's comfort level with people around. he/she is not in the OR area where they are most comfortable. L

I guess it is easy for me to say because all of our anesthesiologists are wonderful about this where I work. I say let yours get a grip. LOL!

Like you, our support person is not asked into the OR until the spinal is complete and the first incision has been made. Everyone is in place and working before we walk that person in to sit by Mom's head.

[SmilingBluEyes]

There is no more sterility with the significant other out of the room. Sterility has only to do with the anesthesiologist's technique. dad is on the opposite side of the bed form the anesthesiologist anyway. In my opinion, the anesthesiologists don't ahev a leg to stand on when it comes to asking people to leave.

I think it has more to do with the anesthesiologist's comfort level with people around. he/she is not in the OR area where they are most comfortable. L

I guess it is easy for me to say because all of our anesthesiologists are wonderful about this where I work. I say let yours get a grip. LOL!

Like you, our support person is not asked into the OR until the spinal is complete and the first incision has been made. Everyone is in place and working before we walk that person in to sit by Mom's head.

sounds a lot like how things are done at our place, too.