I was called in to work extra. So I be bop in early to get report from a float nurse. He walks over to me and tells me that he left updates on the audex system and that all 4 of my patients are stable, except one who is getting blood. He said he had just hung the blood. And that was that. The problem which I will arrive to here shortly, is with day shifts reports, everyone was STABLE. No mention that one of them was bleeding out. He only left updates and didn't do a full asssessment....meanwhile...a pt is circling the drain....which I find when I get there and do my full assessments.
Okay well, my priority was to check on the lady with the blood going. I did a full assessment. She was lethargic, but easily aroused. I've taken care of her in the past and know her baseline...she didn't look so good. Pale. Her BP was slightly low but not anything out of this world. I left and did my other assessments. I went back to her room about 15 minutes later. I took a look at her, abd, she had 3 JP drains all had large amounts of blood in the bulbs. I thought the PCT didn't empty them, so I started on the first one that was the fullest....JP Drain #3. I emptied it and returned to the bedside to empty the others and #3 completely filled again with blood. I emptied it again...I did this over and over...at about 550ml in about 5 minutes, I was like...NOPE. This can't be good! I went to the PCT and asked her about it and she said that the pt drained 910ml from 7pm to 10pm. This is something the float nurse didn't tell me. So I went back into the room and saw that my pt had a change in her LOC. She had only the one unit of blood going. I called the PA immediately and she was so nonchallant saying that she knew. I said into the phone, "No, you don't understand....she's bleeding out." Then told her that she dumped out over a liter of blood in less than 10 minutes of me emptying the drain. Each time I went into the room, I or the PCT emptied that same drain over and over. I couldn't get the blood in fast enough!
We took her blood pressure, it was 71/39. Her HR 92-100 and all over the place. I went to my team leader and told her what was happening. Needless to say, the PA flew to the hospital.
It was a scary situation. I was flustered and had never seen anything like it. Within about 10 minutes of the phone call, there were 3 or 4 MD's in the room, 2 PA's, 3 nurses, a PCT...everyone was giving me orders. I felt horrible by the end of it. I got so flustered. 2L NS going in wide open, units of blood going in wide open....the MD put a subclavian central line in to get the blood to go in faster, because the PICC was too slow....it was amazing.
The pt was rushed to emergency surgery and then to the unit. She's still there and doing much better....
Does it get better the next time? I mean, when you are confronted with someone dying right there in front of you?? I was a nervous wreck!
