8 month old baby dies because iv line could not be accessed

[ibnkoomson]

An 8month old baby was rushed into my ward with the complaints of diarrhoea and vomiting for 2days.on asssessment , the child was severely dehydrated and clinically pale.the rbs was 5.2mmol/l. temp 37.5,pulse 136bpm and spo2 98%.efforts were made to get an iv line on any part of the but it failed. an NG tube was passed n some fluid given through that route.but the iv line was still difficult to get .child finally passed away because of severe dehydration.assuming you were in my shoes what will u have done?

[HikingEDRN, BSN, RN]

How does a child die, in a hospital, because no one could get an IV started? Really? I/O, central line,....how could you not get access??

I know, it's so sad. Sometimes they just come too late, like Esme noted earlier. And by the time a kid looks that sick, you are already way behind

[PMFB-RN, RN]

We generally call an inpatient unit "the floor" (i.e. the med/surg floor, the tele floor, the neuro floor), and the primary nurse "the primary nurse".

That leads to notes like "I will examine this patient on the floor":)

[Esme12, ASN, BSN, RN]

How does a child die, in a hospital, because no one could get an IV started? Really? I/O, central line,....how could you not get access??

We need to remember that allnurses serves nurses internationally and not all places across the globe have the resources available to many of us.

[KelRN215, BSN, RN]

We need to remember that allnurses serves nurses internationally and not all places across the globe have the resources available to many of us.

Very true. Diarrhea is still a leading cause of pediatric deaths worldwide.

[blondy2061h, MSN, RN]

I wish the OP would come back and give us some more info on some of our inquiries.

[Aznurse711]

Intraosseous! Exactly!!! Was there a reason this wasnt able to happen?

[Esme12, ASN, BSN, RN]

Intraosseous! Exactly!!! Was there a reason this wasnt able to happen?

I don't think they are in an area of the world that has immediate access to these things. We need to remember AN has nurses here from all over the world.

[ZooMommyRN, ADN, RN]

Your facility doesn't do IO access for critical patients? I'm so sorry you had to deal with that

[K+MgSO4, BSN]

Your facility doesn't do IO access for critical patients? I'm so sorry you had to deal with that

If it is all you have ever dealt with how would you know any different?

When I wirked remote area nursing in the Australian outback I had no peads training - no doctor somedays - and still had an ED. I had a cardiac arrest roll in the door with the ambo's. I had a doctor 8 hrs away walking me through ALS which I have never studied. I had the exhausted ambo who couldn't do any more CPR on another line calling the flying doctors to update them on the situation and to get some people out to me. Plus I still had my med round to do for 10 HLC NH pt and a day 3 post C section who had arrived back from the local base hospital to be closer to her family.

People you have to remember that not everyone is working in a trauma center, or a teaching hospital or even in a first world region. Children die in these situations as do adults. there is a lot of research about rural / urban gap in cancer outcomes in Australia.

[Anna Flaxis, BSN, RN]

Amen.

[ZooMommyRN, ADN, RN]

If it is all you have ever dealt with how would you know any different?

When I wirked remote area nursing in the Australian outback I had no peads training - no doctor somedays - and still had an ED. I had a cardiac arrest roll in the door with the ambo's. I had a doctor 8 hrs away walking me through ALS which I have never studied. I had the exhausted ambo who couldn't do any more CPR on another line calling the flying doctors to update them on the situation and to get some people out to me. Plus I still had my med round to do for 10 HLC NH pt and a day 3 post C section who had arrived back from the local base hospital to be closer to her family.

People you have to remember that not everyone is working in a trauma center, or a teaching hospital or even in a first world region. Children die in these situations as do adults. there is a lot of research about rural / urban gap in cancer outcomes in Australia.

Something about this case caused her to post and reach, how does saying I'm sorry you had to deal with that warrant a lecture? I've worked critical access where coast guard is our life flight and level one with all the tools I simply wondered why IO was not available., I may have been wrong in immediately aiming they didn't have access to the EZ-IO then as well? I apparently also wrongly assumed that manual IO should have been available somewhere

[brownbook]

OP has listed herself as a pre-nursing student, gives precise number measurements but vague details and does not mention alternate routes of access at all... Homework question?

If not, sorry this happened. A physician should have been available to establish advanced access, and sometimes there is just really nothing you can do.

Fun fact for mmol/L. We say "4-8, feeling great, 4-7, you're in heaven" to outline the normal range for BGL. Nest time you read a Canadian or British post you can remember! If anyone has a similar trick for American values, I'm all ears... I always have to look it up.

I would say you took the words out of my mouth but I can't, you are so much more eloquent and concise than I.

The post is so clinical and unemotional it does not "read" like a real life situation. Still we got an interesting discussion about it so it wasn't a complete waste of time!