Therefore, it became necessary for Security staff to go hands on. Security Officers Alonso and Ayuso using MOAB Techniques had to put the patient down on his bed controlling his arms and legs while the nurse administered the medication. The patient struggled a bit attempting to get up but did not escalate the situation to where it was necessary to use soft restraints to control him. After the medication was given the patient was released by Security and he remained calm and did not try to retaliate or fight back. Officers Johnson and Evans kept on eye on patient Montalvo while this was happening and were not forced to go hands on with the second patient. Security Staff stood by until the medication took effect with patient Atsu who was the aggressor during this…
PROCEDURE IN DETAIL: The patient was taken to the operating room where general anesthesia was induced. Time out was taken indicating the appropriated site, procedure, and patient. Operative site was initialed, one gram of Ancef given IV. Popliteal…
In the case of Mr. J, these were multiple issues that led to and contributed to his unexpected demise after what is usually considered a routinely performed procedure in an emergency department setting. The JCHAO (Joint Commission on Accreditation of Healthcare) defines a sentinel event as “an unexpected occurrence involving death or serious physical or psychological injury”, (Frain, Murphy, Dash, & Kassai, ∂ 1) and in the case of Mr. B, his death would be considered a sentinel event which would warrant a review by a team of interdisciplinary members of the hospital. In this particular case members of the team would include one or more ED physicians, the RN in the scenario and the LPN, a respiratory therapist, a nursing supervisor, a hospital administrator, the ED nurse manager, a hospital pharmacist, and a risk manager. More staff nurses from the ER could also be involved. A credible and successful root cause analysis will identify all of the elements that contributed to the event, an action plan will be developed to prevent the event from reoccurring and ensure that those actions are completed. Action plans should be based on best practices and appropriate standards. (Frain et al., ∂ 10)…
Detailed description of event including timeline: Thursday 3:30 pm Mr. B a 67 year old patient was admitted to the ER after a tripping and falling over his dog at his home by nurse J. He was complaining of 10/10 pain to his left leg and hip region but appears to be in only moderate distress. Mr. B’s vital signs were stable at time of admit with a blood pressure of 120/80, heart rate of 88 and increased respirations of 32. Left leg is shortened, swollen in the calf, bruising present and limited range of motion to left leg. Dr. T looked over data and ordered Mr. B to have medications for pain control and sedation in order to perform a manual manipulation in realigning Mr. B’s dislocated hip. 4:05 nurse J administered IV Diazepam per Dr. T’s orders. With no affect Dr. T. orders Nurse J to give 2mg IVP Dilaudid at 4:15. 4:20 Dr. T. orders nurse J to give 2mg IVP Dilaudid for muscular skeletal relaxation. Dr. T. notes that per patient’s weight and regular usage of Oxycodone, it was making it more difficult to achieve the level of sedation required for manual manipulation. 4:25 Mr. B appears sedated and comfortable and procedure of manual manipulating the dislocated hip back in place goes successfully and concludes at 4:30 with the patient resting and no signs of distress. Nurse J. places Mr. B on an automatic blood pressure machine and oxygen saturation to go off every five minutes and leaves to take care of another patient, with Mr. B’s son at the bedside. 4:35 Mr. B’s blood pressure is 110/62 and saturation of 92% on room air. The LPN hears a “low saturation O2” alarm and notes Mr. B’s saturation is 85% room air and repeats the blood pressure setting and resets the alarm. 4:43…
DESCRIPTION OF OPERATION: Patient was brought to the operating room and identified by name and bracelet. General endotracheal anesthesia was administered in the supine position. Patient was then flipped into the prone position on a Jackson table with a Wilson frame. Neurophysiologic monitoring was applied to the patient.…
2. How does the Prudent Person Rule apply in this case? The prudent rule or "reasonable man" law dictates that a person act in a manner that is consistent with the skills, logic, resources, and knowledge that an average lay-person may have. In medicine, it would apply to a patient in that they are required to take all steps that are reasonable and prudent to affect a positive outcome in their treatment. In other words, you would be expected to follow doctor's orders, do all routine follow up and home therapy, use reasonable judgments and so on. So the answer here is, yes - this does apply to the case because this young girl came into the hospital for a simple surgery removing her tonsils, adenoids, and extra sinus tissues. And was shortly determined brain dead after beginning to bleed profusely, and went through cardiac arrest, meaning the serious dysfunction of an organ.…
Care should be taken at all times when administrating medication as it could be given to the wrong person which could lead to them suffering, or something as simple as the wrong dose. This type of mistake can have a devastating result for example in 2005 2 nurses miscalculated the dose of a drug needed to slow down a baby boys heart rate. He was given 10x the dose and he died.…
A patient presented to the Emergency Department with the complaints of hip and leg pain. The patient rated the pain 10/10 on the standard pain scale. His (L) leg appeared shortened with swelling, ecchymosis, and limited range of motion. The leg was stabilized and then he was further evaluated and discharged to a room in the nursing department. The patient was also noted to have a history of impaired glucose tolerance and prostate cancer. The patient’s current medications were atorvastatin and oxycodone for chronic back pain. The patient was placed in a room and prepared for a procedure. The physician evaluated the patient and proceeded to order Valium, when unsuccessful hydromorphone was ordered. The patient had not achieved appropriate sedation for the procedure and additional medication was ordered. The patient was not placed on a cardiac monitor and a baseline oxygen level was not obtained prior to the administration of sedatives. The patient was receiving “Conscious sedation” in order for the physician to perform a manipulative procedure. The patient eventually had a decrease in oxygen saturation and became hypotensive- an arrest occurred. The patient was resuscitated and then transferred to a tertiary center. The patient was found to have brain damage and after…
This is just one of many incidents to illustrate the need for the reduction of waiting time in emergency rooms across the nation. Although this is an isolated incident that shows gross negligence, similar events that are not as negligent, but just as irritating for patients, happen every day. The "wait" in the emergency room…
I would have handled the situation the same way that the guards did. To think that there could be a cure to fix someone who was going to die. Why not take the risk to save that person from dying? The warden's wife was going to die, and the doctors had no way to help her. Paul devised a plan to get John Coffey to the warden's house to fix his wife. The guards risked losing their jobs or worse to save his wife, and they felt it was the right thing to…
DeLamar, L.(2007) ‘ Anaesthesia’ in Rothrock J (ed) Alexander’s care of the patient in surgery. 13th edn. Missouri: Mosby. Pp.120 – 122.…
Those directly involved in the incident could agree or highly disagree with the inferences I have drawn. The hospital may believe that the nurse was negligent, while she believes she performed a mistake that any nurse could have in this situation. Do to the fact that this mistake had cost someone their life, it is difficult to comprehend all the participating parties thoughts. The family of the patient sees someone who made a mistake that cost their loved one their life and the hospital sees a mistake that cost them their reputation. More importantly the nurse will now how to live with the mistake that she made for the rest of her life. From the nursing perspective Julie had made an honest error that she was forever sorry for, and she was left out to dry for her…
General anesthesia- Completely unconscious and will not remember anything that is done at the moment.…
that the medication Midazolam makes its receiver forget any pain inflicted, but does not take the pain…
During a recent placement in an Endoscopy day unit, I met Mrs Smith who was attending to undergo a Gastroscopy. She had a history of acid reflux and had been referred for the procedure as an outpatient but had not attended her Pre-Admission Clinic appointment. Upon her arrival, myself and a staff nurse took baseline observations and spoke with the patient to ensure that she had fasted from midnight which was necessary for the procedure. On advising her on anaesthesia, I informed her that she had two options. The first was a throat spray to numb the local area and she could leave almost immediately afterwards. The second was sedation and analgesia in the form of Fentanyl and Midazolam which would be given through intravenous cannulation; however, she would have to remain with us for several hours post procedure. Mrs Smith began to panic and became quite irate. She stated that she had been under the impression that she would be given a general anaesthetic and would be asleep the entire time. I explained that the doctor required her to be awake for this procedure and that general anaesthetic was not an option.…