Tuesday, June 1, 2010
Dialysis patient....and staff
So, today I am working on a basic transfer unit for the private ambulance service. We get called to a local dialysis center for a prescheduled transfer of a patient going back to the nursing home after dialysis treatment. This patient is one of our regulars and we know her well. She is normally nonverbal, but responds to basic commands.
We arrive at her chair to find her flush in color, breathing at about 30 times a min and shallow, and it sounds like she is drowning in her own fluids. I mean she is outright gurgling.
The dialysis tech and the RN on duty want her to go back to the nursing home and don't seem even a little concerned about her current state. Of course we tell the staff that we are taking her to the closest ER. They seem dumbfounded by our assessment and decision.
We promptly move the patient onto our cot and sit her almost completely upright. Next we put her on 15 liters per min of O2 via mask and take her priority one to the ER. When we arrive at the ER they take her right back to a trauma room, perform RSI intubation and place her on a vent. She is later transferred to the ICU.
My question is "How long was she like this prior to our arrival?". Why didn't anyone at the dialysis center seem concerned about this? Why didn't anyone call 911? Do some of our fellow healthcare providers care this little about the patients we treat? What blows my mind was that the RN and tech were more concerned about us not getting a post treatment weight than why we were rushing her out of the center... What do you think? JS