You Know the patient is going bad when...

Nurses General Nursing

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You know the patient is going bad when their PA pressure is higher than their blood pressure (Pt quickly coded and died)

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Specializes in Neuro/Trauma SICU.

You check the labs of your trauma patient that is on the way up from OR: pH 6.92 and has a Hgb of 1.6 after 22 units of PRBC's, and then you see a med student running around the corner with a level I infuser yelling "where can I plug this in?".

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Specializes in MICU, SICU, CICU.
Along with being maxed out on all available pressors!!

Yeah there was a couple of pressors, an inotrope and amio hanging as well

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Specializes in ED, ICU, PACU.

They have that distant, anxious look in their eyes and say meekly "I don't think I feel too good...Am I going to be OK?"

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When a patient starts reaching to the heavens and talks to the "angels"----NOT a good sign

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Specializes in Neuro/Trauma SICU.
When a patient starts reaching to the heavens and talks to the "angels"----NOT a good sign

Or says something like "I am going to get the car", "I need to get out of here", " I want to go home". All of those can be mistaken for confusion, but if they are talking about going anywhere... watch out.

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Or says something like "I am going to get the car", "I need to get out of here", " I want to go home". All of those can be mistaken for confusion, but if they are talking about going anywhere... watch out.

EXACTLY!

I forgot about that.......

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Specializes in ICU.
You check the labs of your trauma patient that is on the way up from OR: pH 6.92 and has a Hgb of 1.6 after 22 units of PRBC's, and then you see a med student running around the corner with a level I infuser yelling "where can I plug this in?".

Omg:eek:

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Specializes in MICU, SICU, CICU.
Omg:eek:

My reaction exactly

One more, when the patient that has been screaming all day, suddenly goes quiet.

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Your pt in liver and kidney failure, suffering from hepatic encephalopathy pulls out his art line and femoral vascath while your getting report on your other pt.

Then you walk into the room after getting report to assess, only to notice a huge puddle of blood on the other side of the floor and bed, and a beeping alarm w/ a NBP of 60/30.

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You check the labs of your trauma patient that is on the way up from OR: pH 6.92 and has a Hgb of 1.6 after 22 units of PRBC's, and then you see a med student running around the corner with a level I infuser yelling "where can I plug this in?".

How about getting report from OR and the first sentence out of the nurse's mouth is "we don't know how this guy is still alive"

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Specializes in FNP, Peds, Epilepsy, Mgt., Occ. Ed.

When the experienced nurse says "this patient is fixin' to go bad" (yes, she's Southern) and the inexperienced doc blows her off...

not only is the patient going bad, it's not going to go well.

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Specializes in FNP, Peds, Epilepsy, Mgt., Occ. Ed.

The patient is sitting bolt upright in bed, taking deep gasping breaths, her eyes are about to pop out of her head, she's getting a little blue, you can see her jugular veins, and you pump the mercury all the way to the top of the sphygmomanometer and can still hear her blood pressure.

(That was when I was a student over 25 years ago and I still haven't forgotten her!)

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