Re: OK---how about routine use of muscle relaxants? Archived Message
Posted by Mike on August 17, 2007, 4:31 am, in reply to "Re: OK---how about routine use of muscle relaxants?"
Thanks for your response Dave.. I had a patient about ten years ago.. 26yr old that had been on the vent for about ten days. Pulmonologist wrote to wean as tolerated so I got her down to T-piece and got abg's after 1hr.. gases were great, called doc and he ordered extubation.. I pulled tube and she coughed then completely occluded her airway.. I called code and tried bag mask ventilation but could not move any air.. tried to reintubate but she had mouth clamped shut. tried nasal intubation but could not pass tube.. finally she passed out and I was able to intubate but she went into PEA and we could not get her back..From the time I pulled the tube until she coded was maybe fourty-five seconds. The nurses didn't have time to get any drugs for sedation and by the time the ER doc got there she was already in PEA..I cried like a baby when it was over..felt like I should have been able to do more.. looking back I think the only thing I could have done would be to make sure the RN had intubation drugs at the bedside or to do an emergency trach which is really not in my scope of practice. In your opinion is there anything else that I could have done differently?
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Message Thread:
- There are other things to talk about - J July 28, 2007, 11:04 am
- Re: There are other things to talk about - Dave J August 14, 2007, 1:57 am
- OK-- How do you deal with a FMG that does not speak English very Well? - Dave J July 28, 2007, 9:58 pm
- OK---IV NEEDLE SIZE - Dave J July 28, 2007, 9:57 pm
- OK---How about the quality of fiberoptic blades vs bulb blades? - Dave J July 28, 2007, 9:54 pm
- OK---how about using TENS for post op pain management? - Dave J July 28, 2007, 9:52 pm
- OK---how about routine use of muscle relaxants? - Dave J July 28, 2007, 9:50 pm
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