Recently at work a patient I was receiving report on, was picked up for a CT scan during report. When I have an elderly patient that is a full code, it does make me nervous at times. this patient happened to be in his 90's. Generally the older a patient is, the harder it is to recover from anything, and thus the reason for my increased concern for very old patients that are sick and still full codes. After report I checked on my other patients and awaited the return of this last patient.
When he returned he was purple. One of my coworkers noticed this as he was being wheeled down the hall in his bed. The aid attempted to get an oxygen reading on the patient while I assessed the situation. I asked a family member who was present if the patient had looked like this earlier. Of course he hadn't. The doctor was paged. I noticed that 3 liters of oxygen was turned on, but the patient wasn't connected to it. I connected the patient to the oxygen. He was conscious, but more confused than he had earlier been. The lack of blood flow and his atrial fibrillation (a-fib) made getting an oxygen reading and blood pressure very difficult. I went and tried to find a non-rebreather mask to deliver 100% oxygen. I found a simple mask. I applied it and had respiratory paged. Two doctors were present now. The respiratory therapist showed up and a non-rebreather mask was applied.
Over the next hour blood tests were ran and the patient was prepared for transfer to the ICU. I reviewed the form we fill out for patients leaving the floor for procedures such as the CT scan this patient had. We refer to the form as SBARQ. This is a common acronym we use to give reports. It stands for Situation, Background, Assessment, Recommendations, Questions. On this form is an area which asks how much oxygen a patient is on. It clearly said he was on 3 liters. At some point somebody did not read the directions. This occurred either when he was picked up, or at some point while he was gone for his CT scan. Reading the directions would have helped this patient. Of course, giving oxygen to a purple patient would have also helped. His whole situation wasn't due merely to being off of oxygen for a few minutes, but it wasn't made better by that fact either. When all else fails, read the directions.
When he returned he was purple. One of my coworkers noticed this as he was being wheeled down the hall in his bed. The aid attempted to get an oxygen reading on the patient while I assessed the situation. I asked a family member who was present if the patient had looked like this earlier. Of course he hadn't. The doctor was paged. I noticed that 3 liters of oxygen was turned on, but the patient wasn't connected to it. I connected the patient to the oxygen. He was conscious, but more confused than he had earlier been. The lack of blood flow and his atrial fibrillation (a-fib) made getting an oxygen reading and blood pressure very difficult. I went and tried to find a non-rebreather mask to deliver 100% oxygen. I found a simple mask. I applied it and had respiratory paged. Two doctors were present now. The respiratory therapist showed up and a non-rebreather mask was applied.
Over the next hour blood tests were ran and the patient was prepared for transfer to the ICU. I reviewed the form we fill out for patients leaving the floor for procedures such as the CT scan this patient had. We refer to the form as SBARQ. This is a common acronym we use to give reports. It stands for Situation, Background, Assessment, Recommendations, Questions. On this form is an area which asks how much oxygen a patient is on. It clearly said he was on 3 liters. At some point somebody did not read the directions. This occurred either when he was picked up, or at some point while he was gone for his CT scan. Reading the directions would have helped this patient. Of course, giving oxygen to a purple patient would have also helped. His whole situation wasn't due merely to being off of oxygen for a few minutes, but it wasn't made better by that fact either. When all else fails, read the directions.
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