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re: Prayers Needed from the OT Community *Update Page 28*
Posted on 3/20/19 at 7:38 pm to redstick13
Posted on 3/20/19 at 7:38 pm to redstick13
quote:
Not sure of the size of the first IV bag but my wife told me when they brought in the second IV bag they told her that they didn't have any bags for small children and the nurse poured part of the contents into the sink before connecting the bag.
How can a pediatric urgent clinic NOT have small IV bags?
quote:
Start Time: 13:00 NS 0.9% IV 200 ml/hr Stop Time 13:30 Amount Infused 200/0.
This makes no sense. Fluids were started at 1300 but stopped 30 minutes later. If that is the case...why is 200 ml documented as infused when really...an iv going 200 ml/hr would only infuse 100 ml?
quote:
They were not using a programmed pump to deliver the fluids.
Again...how can a pediatric clinic NOT have a pump to deliver IV fluids?
I really hope you and your wife are able to get answers on what happened. I will continue to keep you guys in my thoughts.
ETA: Unless they were doing rapid fluid boluses. My peds experience was not in the ER or ICU setting so using pressure bags to deliver IV fluids was not something we ever used in our scope.
This post was edited on 3/20/19 at 7:44 pm
3
Posted on 3/20/19 at 8:25 pm to lsunurse
Agree. Best practice would be to use an IV pump on a pediatric patient. I don’t think there is any other place that would do this without a pump, except maybe EMS or in an absolute dire emergency and drops can always be counted. Just poor practice!!!
Posted on 3/20/19 at 8:31 pm to redstick13
A pressure sleeve. Hmmm. Can’t say I have every seen that used on a pediatric patient as young as your son. An IV will not flow if it is clotted off, if it is not in the vein and if the bag is too low. Hate to ask these painful questions, but about how long were you at the clinic? My heart still breaks for you and your family.
Posted on 3/20/19 at 8:34 pm to redstick13
When you went through the records, you didn’t notice anything medication that was given IVP (IV push)? In a later post you mentioned seeing a nurse push something in the line.
Posted on 3/20/19 at 8:35 pm to redstick13
i really hate to say this, but wondering how many other patients that visited that clinic died?
Posted on 3/20/19 at 8:38 pm to redstick13
Probably not an artery since this would cause blood to flow up into the IV line. Arterial lines do use pressure bags if not on a pump.
Posted on 3/20/19 at 8:43 pm to Isabelle81
I looked through all the reports and there's no mention of an IVP and we are absolutely certain we watched the nurse do this.
The times in their report do not make sense either. The end times in the IV records are all wrong and they comment that at "13:30 pt in room grimacing". That's not accurate at all. He was sitting up in the bed drinking fluids at that exact time. We know this because my wife had taken a photo of him and sent to my mother at that exact time.
We had taken him in at around 10:30 AM, we didn't have to wait very long for him to be seen. He had been under their care from around 11AM until 4:30 PM. At 4:30 PM the nurse came in and started to remove his IV (which still had fluid in the bag) and told my wife that he would be going home soon. Then the doctor came behind her and told her to leave the IV in and that he wanted to watch him for "6 to 8 hours longer". He coded at 16:51.
The times in their report do not make sense either. The end times in the IV records are all wrong and they comment that at "13:30 pt in room grimacing". That's not accurate at all. He was sitting up in the bed drinking fluids at that exact time. We know this because my wife had taken a photo of him and sent to my mother at that exact time.
We had taken him in at around 10:30 AM, we didn't have to wait very long for him to be seen. He had been under their care from around 11AM until 4:30 PM. At 4:30 PM the nurse came in and started to remove his IV (which still had fluid in the bag) and told my wife that he would be going home soon. Then the doctor came behind her and told her to leave the IV in and that he wanted to watch him for "6 to 8 hours longer". He coded at 16:51.
This post was edited on 3/20/19 at 8:46 pm
Posted on 3/20/19 at 8:50 pm to lsunurse
quote:
I really hope you and your wife are able to get answers on what happened. I will continue to keep you guys in my thoughts.
Thank you nurse. Thanks for checking in on us.
Posted on 3/20/19 at 8:54 pm to redstick13
Red: I won’t even attempt to pretend that I can relate in any way to what you and your wife are experiencing. I have no children of my own, but, if it’s comforting in any way, know that my heart breaks for both of you.
I’m sorry to ask specific questions during this time of such great loss. I’m just trying to help as you try to get answers. Do you know if the IV in question was still in place at the time of his death? Do you know if it was removed at any point? Were additional IV’s started during his resuscitative efforts or was the original IV used? If that IV was left in place, your knowledge of the difficulties that the medical personnel was having with that IV could be very helpful to the medical examiner.
I’m sorry to ask specific questions during this time of such great loss. I’m just trying to help as you try to get answers. Do you know if the IV in question was still in place at the time of his death? Do you know if it was removed at any point? Were additional IV’s started during his resuscitative efforts or was the original IV used? If that IV was left in place, your knowledge of the difficulties that the medical personnel was having with that IV could be very helpful to the medical examiner.
This post was edited on 3/20/19 at 9:26 pm
Posted on 3/20/19 at 9:02 pm to LSUTigerDoc
quote:
I’m sorry to ask specific questions during this time of such great loss.
Don't be sorry. Searching for answers is helping me to get through this. I poured through the reports all day today trying to make sense of it.
quote:
Do you know if the IV in question was still in place at the time of his death? Do you know if it was removed at any point?
Yes it was still in. It was never removed.
quote:
We’re additional IV’s started during his resuscitative efforts or was the original IV used?
They added a tibia IV at 17:14 during resuscitation.
quote:
If that IV was left in place, your knowledge of the difficulties that the medical personnel was having with that IV could be very helpful to the medical examiner.
I was advised to phone the medical examiner's office and provide all of the information we could. I did this the day after and they took all of the information about the IV problems down and assured me that the medical examiner would have that information while doing his exam.
This post was edited on 3/20/19 at 9:04 pm
Posted on 3/20/19 at 9:08 pm to redstick13
Thanks for your answers. I have no idea how you are in such a clear state of mind right now.
Lean over right now and hug your wife. Tell her that hug is from strangers who hurt for both of you. I hope that the support of others, known and unknown, brings even a hint of comfort.
Lean over right now and hug your wife. Tell her that hug is from strangers who hurt for both of you. I hope that the support of others, known and unknown, brings even a hint of comfort.
Posted on 3/20/19 at 9:11 pm to redstick13
quote:
I can't find anything on other medications they administered but I saw with my own eyes the nurse push something down the IV line with a plunger.
If they had been having troubles with the IV...maybe that was a saline flush to determine the condition of the IV?
Posted on 3/20/19 at 9:13 pm to redstick13
Red did you hear any of the conversation between the medics and hospital staff? I made a thought and posted of what could have happened the other day but I really hate to keep doing that so I won’t. But I would be surprised if it was an air embolism and it wouldn’t have been an iv in an artery, they would have realized that pretty quick. I’m just curious if y’all by chance heard what all the staff told the ambulance crew of what happened and the medics reactions
Posted on 3/20/19 at 9:14 pm to lsunurse
quote:
If they had been having troubles with the IV...maybe that was a saline flush to determine the condition of the IV?
It could have been but I swear I heard her say it was glucose. They had done a saline flush just after taking his blood and before they connected the IV bag. The doctor and the nurse were specifically saying they were trying to get his glucose level higher but it was not extremely low. 62 according to the blood results.
This post was edited on 3/20/19 at 9:18 pm
Posted on 3/20/19 at 9:16 pm to redstick13
I am terribly sorry. As a father I simply can not imagine this... I pray that you and your family find some peace and comfort.
Posted on 3/20/19 at 9:17 pm to redstick13
Where was this IV that the medical personnel was having trouble with? I’m assuming near the elbow?
Posted on 3/20/19 at 9:18 pm to redstick13
quote:
It could have been but I swear I heard her say it was glucose. They had done a saline flush just after taking his blood and before they connected the IV bag. The doctor and the nurse were specifically saying they were trying to get his glucose level higher but it was not very low.
That shouldn’t have caused any problems, just giving glucose. Even giving too much, unless it was a complete fail of epic proportions on how much they gave. Wouldn’t have caused a violent type death as described by you the other day.
Posted on 3/20/19 at 9:18 pm to Isabelle81
quote:
Hate to ask these painful questions, but about how long were you at the clinic? My heart still breaks for you and your family.
These are painful but very important questions. A parent needs to understand. Isabelle, as an RN have you ever heard of a pressure bag used in a mildly dehydrated non critical patient? Is it unusual to dump part of a fluid bag out in a sink instead of counting on setting a pump? Would like to hear the input of the clinical folks- I’m just a pharmacist with some IV admixture experience - but I think dumping part of a bag into a sink and not using an infusion pump and squeezing a pressure bag are not typical.
Posted on 3/20/19 at 9:24 pm to redstick13
My son turned 2 a week ago and your post took my breath away. Took me about 10 minutes to come back and post. I cannot begin to understand how confusing this must be for you and your wife.
You both have my deepest sympathies but honestly I hesitate to even say it because words are so insignificant given the incredible nightmare you two are living through at this time.
You both have my deepest sympathies but honestly I hesitate to even say it because words are so insignificant given the incredible nightmare you two are living through at this time.
Posted on 3/20/19 at 9:25 pm to windshieldman
I wasn't present when the paramedics arrived so I'm not sure about their conversations. I got there less than 10 minutes after he went into arrest. When I arrived the paramedics were doing CPR and trying to restart his heart. The only thing I have to go off of is the comments in the ER doctor's reports where he was pronounced deceased. I also know through the police investigator that this same doctor told him that what happened at the clinic before my son arrived under the ER care was unusual. I'm sure she spoke with the paramedics and took that into consideration.
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