The first statement from this assignment says it all, distraction are everywhere! From the heart monitor alarms, oxygen alarms, ventilator alarms, IV pumps beeping, bed alarms, vocera’s and more. We are constantly bombarded with noises and it gets exhausting! I am the type of person that hates to hear alarms going off. I end up responding to a lot of alarms that go off around me. Even if those alarms are not attached to my patients. I can not just sit and chart and not respond if I hear an alarm sounding, it drives me crazy.
Last week I had a patient who was in the hospital for GI issues. This person was on room air with oxygen levels in the high 90’s to 100%. He had never needed oxygen support. At 0630 on that day, his oxygen level alarm started to alarm. It showed him being at 80% oxygen on room air. My first thought was no way, it must not be reading properly. I went and checked on the patient and he didn’t appear to be in any distress. At this point, I changed the O2 sticker on his finger to check to see if it was a mechanical issue. After changing the probe his O2 levels were still in the low 80’s. Oxygen was administered to the patient which did not bring up his oxygen levels. Our response team and respiratory therapist were notified and they came to see the patient. They determined that the patient needed to be intubated. The patient had a couple bouts of emmisis throughout the night and it was determined that he had aspirated. After this event was handled I went home because my shift was over. All the while, I just couldn’t believe that my GI patient needed to be intubated. Mind you, my two other patients that night were in respiratory failure…and didn’t need intubation. When I returned that evening for my next shift I was looking for this patient. I wanted to see how he was doing. I was informed that after being intubated he struggled to keep his blood pressure elevated. They struggled all day to maintain his pressures even with being maxed out on 4 different pressure medication. The patient ended up coding that afternoon and was revived. He coded again that evening and the family decided to allow him to pass. This man ended up passing away that evening.
I say all of this to say, what if I didn’t respond to that alarm? The one that when I first saw it thought it was a false alarm. The outcome may not have been much different. But at least we did all we could to help this man in this situation. If evidence would have showed that the alarm was ignored for a period of time we could be looking at a real legal issue.
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