So, I had this patient that just got back from angioplasty and she was doing excellent! She was talking and just her normal self. I left the room after all those checks on her every 15 minutes in confidence that she was going to be going home that next day.
Oh yeah, isn't that when things go wrong? LOL!
There is a few threads I could do on this one incident alone, but lets go with the old SaO2 monitor part!
My patient started gasping for breath...her accessory muscles going full force and her chest could barely rise and fall. She started getting the dusky tint to her lips and nails...and she was struggling hard. I quickly jumped on it, bumped up her O2 on her Nasal cannula, and called for a rapid response (this is a pre-code call...this alerts folks that if things don't happen fast we will have the full out code!).
Well...long story short, I did wind up switching to a non-rebreather even though her SaO2 said 92% on 5 L/Min and bumped it up. WHY? Because even though the SaO2 monitor said that...my patient was turning BLUE! An RT rushed in and bumped it up to 15 L/min...and we proceeded throughout this incident to have to give her lots of antiarrhythmics for SVT, and cardioversion X 3...almost had to intubate, and it bought her 5 days in the PCU!
However, I was totally reemed for increasing the oxygen when someone has a SaO2 of 92%! Okay...what ever happened to watching your patient!!!! No, they cared more about the numbers than my patient!!!! My patients tidal volume was nill...we needed every scrap of oxygen atoms I could give...and I knew this from common sense and looking at my patient!!!!
Needless to say, management still says I overreacted...MD's and RT's and others that actually remember a day without SaO2 monitors know better and are in full agreement with my intervention!
How about you guys....have you ever had to battle a machine that is to be used as a dx tool vs actually going by the reaction of your patient regardless of what that tool says??? Have you gotten into hot water over it, and had to justify yourself over a machine???
This is a huge pet peeve of mine, and if I had my dithers, I would have all manual back again till some people realize a tool isn't the end all to patient care~!
