Just when I thought I had a safe, sane nursing job.........
I was eating my lunch this afternoon when one of my staff members yelled, "Marla, you'd better come have a look at (name withheld)---something's wrong with him!" Within 15 seconds here came the both of them, the one caregiver literally dragging the other, whose eyes had swollen shut and who was grabbing at his throat and gasping for breath. All he could do was whisper "throat.....tickles.......can't breathe". We got him to a chair and he continued to wheeze and cough weakly; he shook his head when I told the med aide to call 911, but no sooner had I turned my back to direct traffic away from him than he collapsed on the floor!
By this time, he was unresponsive; his pulse was thready, tachy, and slightly irregular, and his skin was cool and clammy. Sternal rub brought him around only for a brief second; I couldn't get a BP, and in the meantime the dispatcher was telling my med aide to prepare to do CPR. Bless her heart, she was scared half out of her wits, but she's had training, and she did everything correctly........fortunately, we never lost his airway or his pulse, and the EMTs got there and slammed in some epi and some Benadryl, which brought him around enough to reduce the swelling and enable him to talk. THEN he didn't want to go to the hospital!! Dang kid---I know he doesn't have health insurance, but he'd been minutes from death right there on the floor, so I told him "No way, buddy, you're GOING."
At that, he smiled, just a little, and said to the EMTs, "You heard her.....and I always listen to my nurse". That's when we all knew he'd be OK..........but what a FRIGHT!! The poor residents were almost beside themselves; they all know and even expect that someday they'll be the ones taken out that door on a stretcher, but even some of our former nurses and our ex-MD were more than a little shaken by seeing this strapping young man laid low........and by what, we still don't know. He's had asthma since he was a child, but no history of anaphylactic shock before today. WHEW!!!!!!!!!
The last I heard, they gave him a little more Benadryl and some prednisone and sent him home; he'll be fine in a day or two. I hope he got an RX for an Epi-Pen---the staff and I privately agreed among ourselves to chip in for it since he doesn't have much money---or, failing that, we can figure out what caused the anaphylaxis. Of all the situations you never expect in assisted living, I'd have to say coding a co-worker would have to rank close to the top. Thank God he'll be all right........in fact, I half-expect that kid to show up for work in the morning, even though I've given him the rest of the week off. Thank God for Benadryl and epi and EMTs. And thank God for giving this young man a second chance!:yelclap: :w00t:
:yelclap: Great job Marla! It's a whole different ballgame when it's a staff member (or a friend or family member) who's having the problem- no matter how long you've been in the medical field.
Specializes in LTC, assisted living, med-surg, psych.
About a year ago one of our nurses had an anaphylactic reaction to shellfish in our staff break room. The offending substance seemed innocent enough: the flavoring packet from a package of ramen noodles. Apparently the shrimp protein in it disbursed through the air and this gal reacted.
You know, the residents had shrimp for lunch yesterday, and even though my caregiver hadn't eaten anything since breakfast and has no known history of shellfish allergies, I have to suspect that. Evidently he's also 'somewhat' allergic to nuts, so it's also possible that he inhaled some sort of essence in a resident apartment.
Phew.........a nurse has to play detective sometimes, especially when the doctors and hospitals don't want to chase down an allergen for an uninsured patient. But don't even get me STARTED on that subject.
We had a patient who was deathly allergic to beestings and was going outside with family. What a dance we had to do to get an epipen at bedside. It raised questions of who should and who could give it, staff, family or patient. (IE- which scenario were we more likely to get sued for; giving it or NOT giving it?). The issue was never fully resolved before he went home but luckily the need didn't arise during his stay with us.
Specializes in PICU, Nurse Educator, Clinical Research.
Do you have an occupational health nurse/department? He had the reaction at work, and worker's compensation should cover the ER visit, labs to determine what caused the reaction, AND an epi-pen. This is a macabre way to put it, but the people/company who run the facility should cover any costs that the employee can't....or they run the risk of him actually dying the next time he is exposed to whatever caused the reaction.
I had an anaphylactic reaction to PCN when I was a kid, then to sulfites as a teenager...went into respiratory distress from sulfa in college. While in nursing school, I used a pair of powdered sterile latex gloves in lab one day, and my hands swelled up to twice their normal size. I filled out a latex allergy screening questionaire when i started working at a hospital later that year, and they drew a titer- turns out I also have a type I latex allergy. Occupational Health gave me an epi-pen and told me to keep it on me at all times whenever I work. I also have a medic-alert bracelet (kinda crowded inscription with all of those listed!).
The MD who prescribed my epi-pen said something about anaphylactic allergies that I'll never forget: if you have a reaction one time, the next time may be fatal. How horrible it would be for this poor guy to die because he can't afford an epi-pen!!
Do you have an occupational health nurse/department? He had the reaction at work, and worker's compensation should cover the ER visit, labs to determine what caused the reaction, AND an epi-pen. This is a macabre way to put it, but the people/company who run the facility should cover any costs that the employee can't....or they run the risk of him actually dying the next time he is exposed to whatever caused the reaction.
I had an anaphylactic reaction to PCN when I was a kid, then to sulfites as a teenager...went into respiratory distress from sulfa in college. While in nursing school, I used a pair of powdered sterile latex gloves in lab one day, and my hands swelled up to twice their normal size. I filled out a latex allergy screening questionaire when i started working at a hospital later that year, and they drew a titer- turns out I also have a type I latex allergy. Occupational Health gave me an epi-pen and told me to keep it on me at all times whenever I work. I also have a medic-alert bracelet (kinda crowded inscription with all of those listed!).
The MD who prescribed my epi-pen said something about anaphylactic allergies that I'll never forget: if you have a reaction one time, the next time may be fatal. How horrible it would be for this poor guy to die because he can't afford an epi-pen!!
Worker's compensation does not cover any illness that happens to occur at work. It must be caused by the job, or an accident at work. Sadly, worker's comp is not responsible for this.
Unless he has latex allergy. That would be an on the job illness. I've read that apprx. 2/3 of healthcare workers who have latex allergy win worker's comp claims for it. Even that issue is difficult to prove sometimes.
But any illness that happens to occur on the job - no.
Since the exposure happened at work, perhaps workman's comp would cover a test to find the allergen, a scratch-test or something. I mean, that makes sense since he had the reaction to something in his work environment. Couldn't they be held liable if it turns out he was alelrgic to something in the workplace and he had the reaction again and died?
The MD who prescribed my epi-pen said something about anaphylactic allergies that I'll never forget: if you have a reaction one time, the next time may be fatal. How horrible it would be for this poor guy to die because he can't afford an epi-pen!!
When I had my anaphylactic reaction to Sulfa, the doctor told me next time would kill me. That was ~ 1982. Then a couple of years ago, a doc prescribed Celebrex for me. Big red sticker on the chart saying I'm allergic to Sulfa, and I even looked it up in an older med book. No mention of Sulfa.
When I broke out in a horrendous total body rash and swelled up like the Pillsbury Dough Boy, off I went to my PCP. Turns out Celebrex is remotely related to Sulfa. :stone
I later wrote to the drug book and they apologized, saying it had been added in later editions.
Just seems like you can't be too careful. And always have that Epi-pen - and make sure to get a new one when it expires.
Specializes in PICU, Nurse Educator, Clinical Research.
When I had my anaphylactic reaction to Sulfa, the doctor told me next time would kill me. That was ~ 1982. Then a couple of years ago, a doc prescribed Celebrex for me. Big red sticker on the chart saying I'm allergic to Sulfa, and I even looked it up in an older med book. No mention of Sulfa.
When I broke out in a horrendous total body rash and swelled up like the Pillsbury Dough Boy, off I went to my PCP. Turns out Celebrex is remotely related to Sulfa. :stone
I later wrote to the drug book and they apologized, saying it had been added in later editions.
Just seems like you can't be too careful. And always have that Epi-pen - and make sure to get a new one when it expires.
Grr, celebrex!! Had a doc try the same thing with me....luckily, he went and double-checked online before he sent me home, saw the sulfa warning, and nixed that idea.
I had spinal surgery in april- same chart decorations as yours, big red stickers everywhere, and me being annoying all through the whole process about the latex, PCN and sulfa (better annoying than dead, I say). The rude little preop nurse that hung my antibiotic happened to casually say, 'ok, here's your ampicillin'.....I yelled, 'STOP!!!' and reached for the clamp on the IV. Reminded her about the allergy...she stood there and looked at me for a while (was she trying to decide if it was worth her time??), then sighed and said, 'ok, I'll go see if the pharmacy can send up something else in time.'
:madface:
I ended up with vanc....when the floor nurse removed my IV, we discovered the source of my right hand pain....extravasation. Ugh. That hand hurt for three weeks.
I get really angry about medical professionals who pooh-pooh allergies! I've seen docs and nurses see a drug allergy on an MAR and say, 'oh, it's probably not a REAL allergy....may have made his stomach hurt or something.' HUH?
I know!! I've been in ER's telling them I'm allergic to Sulfa and having the nurse (different nurses on different occasions) say things like "Oh, yeah, when I eat fish it upsets my stomach" or "I know what you mean, shrimp gives me a rash".
Pretty scary when a nurse doesn't know that Ampicillin/Penicillin are the same. :uhoh21:
:w00t:
vampiregirl, BSN, RN
824 Posts
:yelclap: Great job Marla! It's a whole different ballgame when it's a staff member (or a friend or family member) who's having the problem- no matter how long you've been in the medical field.