::vent::

[LJ85]

I have to vent somewhere about this...maybe I'll get some good advice.

Ok, so I'm new to the ER and a new RN (6 months). I had a 4 y/o come in in respiratory distress and wasn't getting better with treatments. Doc possibly wanted to intubate. We do not have a pedi unit in our hospital so we were sending the pt out to another hospital. Transport was currently on route. While I was out of the room the doc apparently asked another nurse to draw up 1:1000 epi. The nurse looked at the code cart booklet to compare the child's weight to the dose. She drew up 1.7ml. I entered the room at this point and she handed me the syringe and said to admin sc. There was also an anesthesiologist in the room at this time. I said "that seems like a lot" and repeated the dose out loud to the doctor and showed it to her and she confirmed "yes". Something inside me said it wasn't right. That was a lot of liquid and epi is a strong drug. I had given it to an adult having asthmatic symptoms before and it was way less than that. The anesthesiologist said hold up no thats not right. I looked and the sheet the other nurse had been referring to and saw that it said "ET" next to the dose. The anesthesiologist said it should have been 0.17 ml of the 1:1000 epi. I am upset because this was a near miss. I had asked the charge nurse in the room about it when it was happening and I do not feel like I got the support I needed to make the right decision. If that anesthesiologist was not in the room I'm afraid I could have made a fatal error. I would like to think I would have stuck with my instinct but I'm not sure I would have refused to give a drug the doctor ordered. There has to be a better way, a way to prevent this in the future. I'm besides myself. Luckily no harm was done but I need to find a way to make sure I maintain safe nursing practice at all times and not to ignore my instinct.

[Nurse 1 Smiley]

Congratulations; good save! We learned the visceral alert as "procedural pause", Good Luck in your nursing career.

[Dragonnurse1, ASN, RN]

Nice save. Never give any med drawn by another person unless you have verified their calculations and seen the vial yourself. I have refused to push meds drawn by another nurse and once I refused to push meds drawn up by a Doc. The Doc raised hell with my nurse manager that told her I was right. We treated that as policy in our ER.

Now you keep on trucking knowing that you made a huge save that night and keep on doing what you are doing. You are already a great ER nurse.