Saturday, November 14, 2009
Homicidal Family Members
We review all the codes that occur in the medical center to see what happened and do determine how best to improve our responses and to prevent the events that lead to the code. One code this week involved an elderly patient who had a stroke and and as result had severe dysphagia. They had a feeding tube in place and were strickly NPO. The patient suddenly had a respiratory arrest and when the code team went to intubate they had to remove a large portion of fried chicken from the glottis. The family though that since the patient loved fried chicken, that a little bit wouldn't hurt. The second case was in one of the units. The sedation was decreased to allow the patient to start to wake up to begin a weaning trial after bypass and valve surgery. While the patient's family was visiting the nurse went to do her charting outside of the room. Appartently, the family saw the patient was starting to move his arm and decided to undo the restraints. No sooner had they started to release them than the patient reached up and pulled out the ET tube in one swift motion with the cuff up. Luckily the team was able to get the patient re-intubated before laryngeal swelling made it more difficult. The famlily immediately blamed the nurse and the hospital for "poor care" and "letting this happen" and denied that they did anything. We were fortunate that we have each ICU room on CCTV and the whole event was caught on tape. Of course I am sure that the tape is a HIPPA violation but we were able to show the family that it was their fault.