10.23.2012

Look in the Room

So at work other night I was taking care of a little boy that had pneumonia. I was particularly nervous of caring for this little boy because his history entailed being intubated and he was shipped off to another hospital.
The patient had a pulse oximeter on his foot so it could measure the percentage of oxygen saturation in his blood. The percentage needs to be above 90% but above 95% is even better. If the percentage drops below the set number the machine will alarm. 
The night was progressing smoothly and all of a sudden I realized his sats was not staying above the set number, which was 94%. It kept on dropping. He had on 1 liter of oxygen and the probe was securely affixed to his foot. Well long story short, I started to freak out. I wondered why his sats kept dropping although he was asleep, he wasn't in any signs of distress and he had his oxygen on. 
After about 1 min of staring at the patient and the machine, I decided to call respiratory. While I was waiting for respiratory to show up I stood in the room just in case something changed. As I started to get more worried, something told me to look at the oxygen line and the connection to the wall. To my surprise the line was attached to the oxygen port, but the oxygen HAD TURNED ITSELF OFF!!!! When I turned the oxygen back up to 1 liter, his sats went up to 99-100% OMG. I was dumbfounded and happy at the same time to know the patient was alright. When respiratory therapy FINALLY showed up, I told her what happened and she told me that the pressure may turn the oxygen off sometimes. Lets just say I had a good laugh about that.
Now if this doesn't teach you to always survey the environment, the whole room, I don't know what will. Listen to your instincts and that gut feeling, it may just help you and save your patient.

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