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right med, right dose, wrong route... ouchhhh

Nurses   (2,086 Views 43 Comments)
by winkiebob winkiebob, BSN, MSN, RN (New Member) New Member Nurse

winkiebob is a BSN, MSN, RN and specializes in Family, primary care.

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What would you do if you an RN, go to an emergency room with anaphylaxis. ED doc orders epic 0.3 mg IM, and the ED RN gives you the same amount of epic 0.3 mg IV......

of course your BP goes from 170/110 to 70/30... now you need fluids (5-7 bags), Troponin goes to 4.6, chest pain is severe, EKG shows lots and lots of PVCs, HR is 120-137 sustained for the next 7-8 hours. Cardiologist is called, now you have an echo, a stress test, a CT of chest, D-dimer is a bit elevated 518... Of course you are now admitted into this hospital for 3 days until luckily your heart is cleared.... When you finally feel more alert 4 hours later after the incident you ask, the nurse at this observation unit, Who gave the order for IV epi?

the attending NP comes in an says: you deserve to know there was a medication error...

You knew it all long but wondered why no one said a thing.... now you feel quite traumatized after feeling that Gigant Mule of EPI that kicked your chest. Your heart felt as if was going to explode together with your brain and head. You were stucked in a treadmill exercising for hours while you were lying in ahopsital bed sweating profusely and asking for ice packs and fans trough your stay....

Any ideas?

By the way, they say because you aren't death there is no case, and because you are young and sustain "no physical damage" there is no case...; but what about the emotional distress and having to be off work for 10 days after while your heart rate went back to normal... and the nightmares, feelings you were going to code....

anybody?

 

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I'm sorry you had to go through this I really am but I think, as a nurse, you know that we really can't address it other than suggesting you contact the hospital and lodge a complaint. 

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Who is “they”? A lawyer?  You should speak with one if you haven’t yet. And don’t expect any $$ for emotional distress. 

 

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Sour Lemon has 9 years experience.

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I would be gracious and let it go, considering that I've done stupid things in the past and will do stupid things in the future ...and that there was no permanent damage.

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winkiebob is a BSN, MSN, RN and specializes in Family, primary care.

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Absolutely! just wanted to see some opinions in general.

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winkiebob is a BSN, MSN, RN and specializes in Family, primary care.

1 Article; 34 Posts; 1,260 Profile Views

5 minutes ago, beekee said:

Who is “they”? A lawyer?  You should speak with one if you haven’t yet. And don’t expect any $$ for emotional distress. 

 

Yes! I have... no damage = no case

Just wondering why it happened. What was that nurse understanding of the situation. Did the nurse not know not to give it IV? What failed? Just curious... 

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winkiebob is a BSN, MSN, RN and specializes in Family, primary care.

1 Article; 34 Posts; 1,260 Profile Views

18 minutes ago, beekee said:

Who is “they”? A lawyer?  You should speak with one if you haven’t yet. And don’t expect any $$ for emotional distress. 

 

 

2 minutes ago, brownbook said:

I always get hung up in the details.....where the devil lives 😄. How would IV epi cause hypotension?

Ummmm? Could it be part of the patient going into cardiogenic shock? Maybe trying to compensate for the rush of adrenaline????

you tell me....

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Snatchedwig has 11 years experience as a ADN, CNA, LPN, RN and specializes in Medsurg.

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Leave a Google review.

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Asystole RN is a BSN, RN and specializes in Vascular Access, Infusion Therapy.

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18 minutes ago, rnfly29 said:

Yes! I have... no damage = no case

Just wondering why it happened. What was that nurse understanding of the situation. Did the nurse not know not to give it IV? What failed? Just curious... 

Not true. 

Some attorneys may not want to take the case because without lifelong, career damaging injuries the payout will be smaller but for a case like this it would be settled anyways. 

The fact that there were additional treatments and more importantly, a longer stay in the hospital is in itself the harm. It is a financial harm among others. 

You don't have to go to trial but a smartly worded letter from a competent lawyer will likely get you some recompense. 

Hell, I had my 1990 Hyundai Elantra bumped into a 2 mph (multi-vehicle accident) and they still gave me $500 to settle since it took time from work etc. 

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Pixie.RN has 18 years experience as a MSN, RN, EMT-P and specializes in EMS, ED, Trauma, CNE, CEN, CPEN, TCRN.

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1 hour ago, rnfly29 said:

Absolutely! just wanted to see some opinions in general.

Glad you are OK. I saw that happen — we realized the other RN in the room gave the epi IV instead of IM when the patient got really pale and went into a run of vtach. The doc and I looked at each other and we just instantly knew, I ran for some amio, but by the time I got back (very short time as the med room was close), the patient broke out of it. He had youth on his side! I tell you what — that nurse was never the same after. It weighed on her and she second-guessed herself for a long time after. I know that it probably doesn't help, but I am sure he/she learned a valuable lesson. This patient had no lasting issues that we ever knew about, thank goodness. 

Just as a reminder to the peanut gallery:  no legal advice, please. I love you peanuts, but unless one of you is a lawyer and wants this case, please refrain. 😄

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