So today I had a pain in the butt lady code on me. The whole time we had her she was feisty, and reluctant to cooperate and just incredibly difficult. I went to start an IV on her with a nurse. We went in ready to restrain her and do what was necessary. The nurse began searching for an IV location and I held down the patients arm, she flopped a little bit, but no where near as much as we had expected. We noticed she had gotten quiet once the needle was in, so I looked to make sure she was breathing, the nurse and I concurred that she was and I pulse checked and felt a pulse (carotid). I had an incredibly odd feeling in the pit of my stomach but didn't say anything. I went to start a line on my side and noticed her skin was very very cold. I looked up with the OS look and took out my penlight to check the pupils. And of course no reaction. I did a pulse check and she had become pulse less. We called the code and began working her, getting VFib once but consistent asystole. After 25 minutes of CPR the physician called TOD. I can't help but feel that I only originally felt a pulse because my subconscious wanted me too, and in fact she was in arrest the whole time. I watched the fight go out of this ladies eyes, and feel that maybe if I would have noticed earlier, she would be torturing someone still... I understand death is a part of life, and it usually doesn't get to me. But this one is, and I feel like I failed my patient.
Get over the guilt
- Thread starter Zredmond
- Start date
BOS 101
Forum Crew Member
- 54
- 9
- 8
One of two things
A) you were confident (at the time) that you felt a pulse, in which case I still may have been worried, but regardless you would be sure of the pulse and the nurse confirmed breathing. Now if something scary like that happens you can always ask said nurse or someone to check a pulse with you, or you can check two sites for namesake. But not really a big fault in my eyes. You felt what you felt, then things took a turn.
B)You weren't sure at the time of your pulse check. In which case I say you should have done what I said above, have the nurse check as well, or check twice yourself. Lessons learned, if you aren't sure, get a second opinion, or do the best you can with yourself.
I wont go into anything but the check and the confidence in your check.
A) you were confident (at the time) that you felt a pulse, in which case I still may have been worried, but regardless you would be sure of the pulse and the nurse confirmed breathing. Now if something scary like that happens you can always ask said nurse or someone to check a pulse with you, or you can check two sites for namesake. But not really a big fault in my eyes. You felt what you felt, then things took a turn.
B)You weren't sure at the time of your pulse check. In which case I say you should have done what I said above, have the nurse check as well, or check twice yourself. Lessons learned, if you aren't sure, get a second opinion, or do the best you can with yourself.
I wont go into anything but the check and the confidence in your check.