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Discussion

My patient scared the hell out of me!!

I work private duty for a family with a 7 yr old child with Mitochondrial Disease. Well, my main job is to safeguard him from seizures and gagging as he has a G-tube for nutrition due to the fact that his swallowing is impaired. Well, for the last 2 months he hasn't gagged because I can usually help vent him(expel gas from his stomach manually) and the gas bubbles are gone. However, the other night, he was especially gassy and the bubbles were hard to break up, and he started gagging, turning red inthe face, and gasping. Well, I quickly unhooked the feeding tube from the G-button, and vented him out (the family vents him out with a syringe) All the while keeping his airway patent and open. Well, the gas finally expelled the distention in his belly went down, and I could start breathing again!! I swear, it's a wonder my hair didn't go all grey right then!!! Or fall out!! He settled down for the night, and I told the family what happened. They said it happens for them too, and not to worry. Whew!! What a night!!::eek:

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Sorry you had such a scare! I'm glad you were able to help this pt. Hope you have a better night next time around. :kiss

It just shows the baby has the right Nurse caring for him.

  • Author

Awwwww Thanks guys!!! You always make me feel so worthwhile!!:kiss

You get the award for handleing stress under pressure!

BTW: GREAT SKILLS! If I mentioned that a patient needed to be "vented" in the way that you're speaking of... Well, someone would be expecting me to get him intubated :)

Dave

  • Author

Thanks Dave!! Well, I knew that he was holding on to a LOT of gas bubbles. Because he has an esophageal wrap, because of reflux problems, he can't burp OR pass gas like we can. When he started gagging and gasping I was pretty sure it was gas buildup that had to be released. When I saw his belly magically go down as I finally released all the gas bubbles, I knew I was right. I just remembered from my EMT classes, AIRWAY AIRWAY AIRWAY!!!

You are awesome!

Probably because I don't know what Mitochondrial Disease entails, so I'm probably going to sound ignorant, but there's no such thing as a dump question. My question is: how does gas cause respiratory distress?? :confused:

Pressure on the diaphram. Lungs can not expand. Great job warrier. Aint home health grand. Most nurses don't realize how frighting it can be.

  • Author

Not a dumb question Tweety!!! It causes him distress, because when he gags, he either gasps or stops breathing altogether however briefly. He doesn't move air. Just gags.

Thanks. I appreciate the answer. I figured with distention that would cause atelectasis, but couldn't understand why it would cause him to stop breathing altogether.

Again, good job!

  • Author

Thanks Tweety!! After it was over I had to remind myself to breathe!!! LOL!!

  • Author

I just remember my mind screaming Okay BREATHE!! thru all this. My heart damn near stopped!

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WW . . can you give us a word picture of what this disease looks like? How does it manifest itself in this child's life? What is he capable of doing?

You are a brave woman and so is his family. Not being able to breath is scary.

Thanks.

steph

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