Monday, September 29, 2008

ALWAYS Remove That Tourniquet!

It was a quiet day on 300, a Pediatric Floor of T.C. Thompson Children's Hospital. A group of young Southern students were standing at the nurse's station looking for something interesting to do, as their patients didn't require a lot of monitoring.
Seeing an opportunity for a learning experience, the clinical instructor sent two of them down to the Children's ER for some observation time. Upon arriving at the ER, they were saddened that there weren't any patients with life threatening situations. It was mostly kids with fevers who would rather pay $500 for a note to get out of school then to just skip school itself. They had just missed out, they were informed, as a half an hour earlier they had saved a small infants life who had been seizing continuously and wasn't breathing.

Not to be deterred, these two assertive nursing students started asking the nurses (and the Dr's) if they would like to have an IV started on them. None of them volunteered their services but they did provide the supplies for the nursing students to practice on each other.

After one failed stick, the first student, let's call her Christy, hit crimson gold and successfully threaded the catheter up the vein, attached the tubing, and flushed it. Now it was her turn to be "practiced" on.

She sat on with an almost convincing stoic expression on her face as her friend, let's call her Dellyn, attempted a stick on her left hand. After a bit of fishing (apparently it wasn't the right type of bait), she attempted again on the right AC. It was a direct hit! In her excitement, Dellyn forgot to release the tourniguet that was milking that liquid gold. The force of the blood against the needle began to push it out from the cather before Dellyn had pushed the catheter fully into the vein. Blood began to flow freely down Christy's arm. She looked on in a calmed daze, seemingly indifferent to the pool of blood forming beneather her arm and dripping onto her white clinical pants.

Dellyn (royally freaking out): "What should I do!? Did I hit an artery! I'm just going to take this thing out! Uh, we're bleeding over here. Hey! Nurse! You! We have a small problem!".
Christy: "Um... maybe you should put some more pressure on it"
Dellyn: "That's not stopping it!"
Nurse 1 (quite calm - they're very used to this kind of thing) : "Well, first, you might want to remove the tourniquet."
Dellyn: "Oh! Yeah, probably should do that"
Nurse 2: "And you might want to push the little white button on your needle"

Christy stared on, realizing that the needle Dellyn had hurriedly taken out of her arm was dangerously close to her clinched fist.

Well, the rest of their observation time was spent cleaning up the blood all over the counter, floor and Christy's arm, hands, and pants. Peroxide worked wonders for the stains on the pants. Christy was excited because they sent for a pair of surgery scrubs (which, if you've read my blog for a while, are the most comfortable things EVER) but they didn't arrive in time.

Despite loss of blood on Christys part and fright on Dellyn's, they both learned a valuable lesson. ALWAYS remove the tourniquet on first sight of blood.

p.s. While this isn't as cool as last week's rescue (Oh wait, I never posted about that one. Well here's the basic gist: Friend falls 45 feet while rock climbing. Christy is first on the scene. Exciting!? Yep, that's what I thought too! Thankfully, friend wasn't dead, far from it in fact. We carried him out but he only injured his left foot. It was quite the miracle) it does give you a look into a day at the hospital for a SAU nursing student.

1 comment:

Francis said...

You crazy nursing students...

I seriously didn't know you would practice IV insertions on each other for fun. That sounds, how do I say it, scaaaaaaaaaaaaaary? O_O

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