She was given the wrong dose of epinephrine for a food allergy.
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Saw the same thing happen at my hospital. I was called code blue to the CT suite. A woman had been given her contrast dye for a outpatient CT of her sinuses. She got short of breath and became a little hypotensive. Te radiologist had rushed in to save the day and pushed the cardiac dose of epi IV. 1 mg. IV! The lady of course developed crushing chest pain and had positive troponins. I had her maxed out on pressors for awhile, I seriously thought she was going to die. I asked the radiologist why he gave her so much epi and he said that they had all just re-certed in ACLS. Forget the fact that the correct response is posted all over the damn suite. Not sure if the lady ever found out what went wrong.
Brave of you not to tell her or report the doc. Yeah, that self-policing thing goes so well.
As Does the self-poicing in the legal community for such gods of litigation as John Edwards and Mike Nifong.
Oh Elliott…. You must have been quite the tattletale the bullies loved to beat-up after school. I suppose you are a perfect angel that never did anything in a less than perfect way.
Maybe the above poster knows the reality is that he or she would be dragged into a lawsuit for being the white knight. And who knows if there was any damage done.
FYI my father-in-law had the same thing happen during a trip to the ER for an allergic reaction. He had a heart attack and subsequent heart failure, which eventually claimed his life. He was a chronic smoker with hypertension. His two daughters are both in the medical profession and know full well what happened. No, they didn’t report anyone nor sue. He had risk factors and the epinephrine pushed him over the edge. Nobody intentionally did any harm.
Maybe if the radiologist in the story above hadn’t just recertified in ACLS this would not have happened. I bet it won’t happen again and that the lesson was learned.
AH, the law of unintened consequences. I bet is was some silly policy made by the suits of the hospital that the radiologist take an ACLS course once every two years that he should not need to take. (leave the codes for the code team) If he hadn’t taken the course they probably would have wondered “what the f*** do we do now?” and then looked at the chart on the wall to find the dose of epi.
And yes Elliot, the legal profession has made it prohibitive to say “I am sorry”, “I f***** up”, or “He f***** up” As the saying goes, no good deed goes unpunished.
Yes, it’s always someone else’s fault you haven’t apologized and done the right thing, isn’t it?
By the way, Mike Nifong’s right to practice law is going to trial in May or June. John Edwards has done nothing that would warrant losing his license. You not agreeing with verdicts you’ve never seen the evidence in does not constitute grounds for taking away his license.
Keep up the good work!
Anytime I think the feckless cowards of kevinmd can’t top themselves, they prove me wrong. Is there a counterweight to this ugliness; a blog of a doctor who addresses political issues and is not always concerned with only themself. Dr. Charles (who generally keeps his selfishness in check) and the Cheerful Oncologist both sound like good people, but they don’t address politics.
I’m shocked she even got epinephrine. Most ERs won’t give it despite it being the ONLY viable treatment in anaphylaxis. Of course, it is NOT supposed to be administered via IV. It is supposed to be an IM shot.
The literature tells you exactly what to give – and to increment it if the first dose does not reverse the reaction.
I’m a patient with severe allergies and have NEVER had any luck in an ER. I have an extremely competent allergist with competent nurses who know how to do this even in an office setting – btw, they have crash carts in a lot of clinics hidden in cabinets. I once had a reaction that took 3 shots to reverse – he did incrementally.
Pax,
MLO
Epi is not the only viable tx, just the first (IV is an acceptable route, if it’s faster, as is endotracheal). The ACLS dose is not acceptable. I am shocked that someone didn’t get the proper dose (and that an experienced nurse would have to look it up) at an ED. I’ve worked at several, and at instacares and multispecialty clinics and it was always a standing order for the nurses, along with IM benadryl, O2, IV (code blue) if necessary before we got the doc. We could stack the epi. Then the doc could decide whether or not steroids were indicated.
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