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Naloxone Related Pulmonary Edema and Cardiac Arrest-Patient Study of Mother by Daughter #Narcan



Saturday-September 7, 2019

She is not eating or drinking much of anything and is no longer on any I.V fluids either. Super tired and lethargic and pretty much can only lie there. She feels nauseous when looking at food and rejects it so she is getting zero nourishment as there are no I.V. fluids being pushed. She was drinking fluids last night about 4-8 oz. cups of water and 2-4 oz containers of orange juice and her output from her Foley cath is almost nothing and I am beginning to wonder where the fluid is going. They removed her from taking Lasix to make room for new meds Satolol and Entresto for her Broken Heart Disease and the continued Tachycardia



Walking the lonely hallways underestimating the disaster to come
St. Josephs at The Med

Tuesday, Sept 3 2019

Arrived at 10 am to register my 75-year-old mother for surgery and she had to pay another 400.00 copays for shoulder replacement

Went into outpatient by 11 am

Surgery by 12:34 pm

She came to the room after 4 pm

When the Anesthesiologist brought her into the room she was relaying info to the nurse on duty and said that she had to give my mother a shot of Narcan to wake her up because she wouldn’t wake up. I questioned her at the time because I knew that was the drug used to wake overdosed people. I joked that I was going to kid my mom about it.

Everything moved fast but I caught a few things that were said. One of them was that the anesthesiologist told the nurse on duty that she had no time to document it yet and so she wasn’t going to see it on her chart yet the nurse said that she was almost off of her shift and then turned to me and bragged about how the flow of information worked at The Med and their teamwork was something I would be amazed by. Then she told me to shake her to wake her and give her ice over the next few hours assuming she would wake up. Try to keep her stirred because she was still completely zonked out and so I did for the next three hours but really if I am honest I let her sleep mostly because I knew she was so tired and we had a long recovery ahead. I did talk to her and give her some ice though.

I took a picture of her monitor screen and as I was trying to focus for another shot on my phone the machine beeped and I could see through the screen on my phone a number that read 220 this was at 6:17 pm. At that moment my mom moaned through her sleeping state and it sort of freaked me out, so I felt bad about taking the pics and stopped, assuming the nurses at the desk could read the read-out that her monitor was showing from their station the same as I could. Throughout the night this beep/moan thing happened more often than not.

We never saw the initial nurse that set her up in the room after that initial setup and was alone in the room for a good while. Once the night nurse made her rounds mom finally woke up and was saying that her foot hurt so bad. So I got up and pulled the covers to expose her leg which had a surgical hose, hospital bootie, blood pressure cuff, and an alternating air pump sleeve for clot prevention. The nurse was upset that both were still going and pulled the sleeve and I pulled off the bootie only to reveal that it was acting as a tourniquet and her foot was completely swollen with about an inch indention where the sock band had been. She was loaded with fluid. I expressed concern and told her about the monitor beeping and the 220 number at that time. She got her bedding cleaned up and tossed an iv bag into the trash that was never administered and the original nurse said she was going to let it run since we paid for it. It never ran. She attached the new bag and administered meds and the night went on from there fairly noneventful other than the spikes in her heart that I was only hearing and when I had to get them to do a catheter on her bladder because she was in abdominal pain.400CC was the amount I heard her tell the other nurse in the room. I was sleeping on the cot next to her by the time they got there and it was her and another dr in a white lab coat doing the procedure together and talking over it. I was in and out but they woke me at that time to ask me if she had a history of heart problems and I answered no and there was a look of concern. The answer was no. I think the rhythms that night are logged digitally in the machine. Better be.

Wednesday, September 4, 2019

The next morning we woke up and it is tough and I expected it to be tough because she had a total shoulder replacement. I was trying to mentally prepare for the ride home knowing it would be a tough one but we had prepared and were ready to take on this recovery period hard or not she needed her quality of life back and repairing this shoulder was going to do that. The morning carried on and I was nervous about the car ride knowing how tough it is to get her in a car in the first place but now she was injured with a wound from surgery. Did not matter it was going to happen no matter and I was at least a bit relieved that she had a nerve block that was going to deaden it for about 3 days.

Physical therapy came and went. She had discharge papers ready although nothing was signed and lunch was delivered. I cut up her vegetable medley and she took a bite and immediately began looking for the oxygen cannula. She isn’t an oxygen patient but had it on all night following surgery. I put it on her and she continued to struggle for breath and was begging me for air through a laryngitic voice. I pushed the button on the side on the bed rail (which I later found out probably doesn’t work) then I went into the hall and told a nurse outside of her room that there was an issue and she went down the hall to get my moms' nurse while I went back into the room and pressed the tv remote nurse station button and finally running down the hall yelling for immediate help. The nurse then passed me saying she was coming and I could clearly see the woman was on the phone so I turned back and headed towards the room where other nurses asked what was wrong and I told them that she could not breathe. They then hurried into the room lying her back on the bed. A Dr. came in noting that she was turning blue and her O2 sats had plummeted from 96 to 40 in 5 seconds. She was experiencing Flash Pulmonary Edema

The next thing I know she is a CODE BLUE I am kicked out of the room and they do an EKG and X-ray BiPAP and I have no other idea what else because I was in there. They stabilized her heart and lungs and let me back in telling me they were taking her into ICU. Several doctors at that time asked me about her heart and one came to me with an EKG sheet talking to me about it looks like a heart attack another nurse followed me into the stairwell saying it was pulmonary edema. I told them about the Narcan at that point.

We get to ICU and I get in trouble for taking a pic with them in it. I left to clear out the room we were in and by the time I got back family was beginning to flow in. We were supposed to be home not ICU. Shoulder. We visited and we were told she was stable and she suffered a heart attack and were doing an ultrasound and scheduled a Cath for in the morning. We left for the evening to let whatever just happened to be tended to. Throughout the night her heart rate was out of control and staff were all over her telling her they were in control. Dr. Lichin told her at some point that she had suffered massive heart muscle damage and then later came back saying maybe it wasn’t as bad as it first looked. Backtracking. All the hospital could talk about was a possible pre-existing heart issue condition, talking about the "blockages" she had to have. I stopped the ICU nurse to