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O2 checks

Safety   (807 Views | 2 Replies)
by Working4Lord Working4Lord (New) New

773 Profile Views; 7 Posts

Guys, I just made a dumb dumb mistake. Had a patient, COPD and other issues. On 10 L and refusing things at times. Checked vitals at beginning of shift and O2 was 91%. Had scheduled nebs and RT checked O2. Throughout the day, checking BP because of meds and baseline low BP. Yet, I failed to check on his O2 and was so focused on his temp and BP and later in the evening, he had to be placed on Bipap. Why, I ask myself, did I dismiss his lethargy and only attribute it to some known confusion and infection? I feel like the dumbest nurse for this most basic of vitals!! I’m going to write a report on myself when I go back to work. But I can’t get over my stupidity. Anybody else just want to kick yourself for these things?? 

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buckchaser10 has 3 years experience.

11 Posts; 25 Profile Views

I know it has been a month and a half now but just thought I'd write back to you.  We are constantly learning.  Every mistake you make makes you that much better.  Going forward, never forget to fully think about what you should look at for focused assessments.  

As far as the patient in question, if he was that bad off RT should (and may have been) more involved. It's very possible that they had been monitoring the patient all day without you realizing.  BiPAP is not that big of a deal (it is but it's not a ventilator for cripes sake.) It is very possible your patient would have ended up on BiPAP regardless. O2 sats alone won't show you the need for BiPAP because CO2 can cause high pulse ox levels but actually is an indication for BiPAP use. ABGs would be your friend here. 

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Okey Foley is a RN and specializes in Surgical Floor.

10 Posts; 216 Profile Views

Sometimes it's easy to get caught up in something happening and hard to back up, see a bigger picture and remember fundamentals. Things like this really reinforce the importance of fundamentals.

Like buck said, this patient maybe would have needed bipap no matter what. Good reminder for me too that retaining CO2 could cause the high pulse ox and ABG would be a better tool.

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