"Shelf Life" of O2 humidification

[emtwacker710]

emtwacker710 has a very valid point. Even in the confines of a secure ICU, we never ASSUME anything. Also for infection control, nothing is spiked until it is to be used.

If would also be very easy for someone that knows your habits to taint a bag while you are in the ED and didn't lock your doors. That could be a disgruntled ex-employee or an unbalanced person unhappy with their bill.

For some CCT and especially on Specialty transports such as neonatal, the team will hang their own fluids and meds. Not that we think anyone in the other hospital is incompetent, we just want our own quality control.

thank you for agreeing, and I'm not only saying that someone could taint the bag, its also more sterile to just hang it when you need it, it doesnt take that long especially if you have 2-3 people to a crew..

 

[emtwacker710]

Okay, this topic is officially back from the dead, and has mutated, thats fine...
I understand your point, it just seems that if you had a vindictive ex-employee, there are easier/more accessible ways to screw you up then then "taint" your spiked bags of IV fluid. There are a lot of "ifs" in that plan.
Are you really THAT worried about sabotage? I'm not going to get dreamy, but it seems like there are easier ways...

no im not THAT worried about sabatoge, anyways I'm just a basic so I assist with the IV process but don't touch sharps or meds anyways, what I'm just trying to do is open peoples eyes to the real world...not everything is as secure as you think..ok I'm done..sorry I brought this tread back from the dead..

 

[VentMedic]

Okay, this topic is officially back from the dead, and has mutated, thats fine...
I understand your point, it just seems that if you had a vindictive ex-employee, there are easier/more accessible ways to screw you up then then "taint" your spiked bags of IV fluid. There are a lot of "ifs" in that plan.
Are you really THAT worried about sabotage? I'm not going to get dreamy, but it seems like there are easier ways...

Unfortunately, it is not "ifs" and it has happened as I referred to the California "incident". It's been 5 years since he go his life sentence but the CA Respiratory Therapist will be doing a 3 hour ETHICS class for the renewal with a "How Thou Shall Not Kill" or "How to Recognize a Killer" theme for a long time. It also got their scope of practice severely scrutinized. That only took one person to almost screw up things for several thousand professionals.

There have also been numerous cases involving RNs that have been tried for murder. Rarely do they do this to their own patients.

And yes, there have been a couple of Paramedics in the mix. One guy was recently featured again on a TV show profiling criminals. He went on to be a physician so he could better carry out his deeds. The older Paramedics on this forum might remember his name which he notoriously made in the early '90s.

We've also had parents euthanize their ailing loved ones including babies in the hospital. Miami had a really frightening death involving a man killing his child who was severely damaged by anoxia in an accident.

About the same time that one went to trial, another man who was a doctor was being tried for shutting off the ventilator on his baby who also had a poor prognosis.

The incident in Florida with the employee as a suspect just occurred although that wasn't deadly but will have some consequences as the investigation continues.

A nasty infection from a bag the gets contaminated during the course of a shift can also be deadly to a patient.

It doesn't have to be with a criminal intent. Someone could have forgotten to throw a bag away that had meds mixed in it and no labels. Now that can occur easily especially on long CCT calls where an extra bag of something might be taken along just incase. Although most bags are premixed and labeled but in an emergency, one can easily grap the wrong one. I myself have reached for something thinking everything was in order and have also given something that could be very harmful. Drawing up meds that are in similar containers is a major cause of medical errors.

We do have to be very careful in hospitals because of the number of people in and out every day. Anybody can also put on an EMT uniform and roam the halls. Agency personnel of various types who you don't know are around working with you. Attorneys also have hired licensed professionals to go into hospitals as agency workers to get info on a case from other employees. I have also sent home a few people in RT as have the nursing supervisors who were not the same person as on the license. That is an entirely different and frightening subject, but yes it makes one cautious and no, it is not a dreamland story.

So, no, I don't leave alot of things open or misplaced. The only times there might be bags ready to go are in trauma rooms and that has been limited at the hospital I work at to now having them in bins near the bed but still in the package. The fluids in the Cardiac Surgery Recovery ICU are not spiked until the 30 minute call from the OR. Then, the pressurer transducer lines are flushed and calibrated.

In may ways EMS is very isolated which can be both good and bad. The world of medicine continues to evolve around them with news that leads to more education about infectious diseases and medical errors. Then, EMS personnel act surprised when something happens in their own backyard. Please see the RSI thread under News. Other professionals, including professional EMS teams, learned long ago that certain steps must be followed to ensure patient safety when doing advanced procedures. Those incidents were deadly mistakes. It may only take one forgotten step or precaution to have loss of life and loss of one's license.

To get slightly back on track, the H2O bottles for humidifiers are meant to be single patient use. However, some ambulances that used to use them left them on the flowmeter for all patients and/or until the bottle was empty. That does become a harbor for many pathogens.

When you are dealing with the life of a patient, you owe it to that patient and the public that trusts you to do everything to prevent medical errors. You owe it to your co-workers not to set them up for mistakes also.

One preventable death is one too many.

EDIT: Sorry emtwacker710 but I had to give a speech. Since the pubicized RSI incident, we have taken time to review all of our P&Ps, competencies and safety issues to make sure nothing bites us in the tail. But, since there are many incidents that we hear about that the press doesn't, we are constantly reviewing and critiquing.

This should have been another thread because safety and preventing medical errors, which can definitely happen at the Basic level also, are very important.

 

[emtwacker710]

no problem at all with you giving the speech, it just helps support what I was trying to say, I was a bit skeptical when the "theory" was brought to my attention the other day and then I thought about it and did some internet searching and found that it does happen...