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    Me - final year at a and e placement.
    Today a patient presented and was taken to resus and was pretty on their way out (sats of 73 percent on 15 L O2?with a resp rate of like 50, no joke)
    And the patient seemed pretty gumped anyway, gcs of like 8 etc. Aspirational pneumonia.
    So helping out in resus and then asked to catheterise patient.
    Catheterised patient and literally within a minute of catheterising the patient resp rate drops off, death rattle, colour leaves the patients face and they pass.
    This was the first time I have ever catheterised a patient aswell.
    I know the patient would have probably died anyway.
    But is there anything about me catheterising the patient that would make them give up?
    Like some sympathetic/parasympathetic nervous system I might have triggered by catheterising that made them drop off? I hate to think the last experience the patient had on this planet was a clumsy medical student passing tubing into them past a mountain of Instilligel. Please be brutally honest here I don't want sympathy, I just want to rationalise it.

    On the brighter side at least when the next patient asks me if I've done this before I can tell them yes I have. When they ask me what happened I can be like yeah, they died.
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    I have to dash out to work so can't write too much now, but in short - no, you did the right thing, you couldn't have caused his death by catheterising him and you were presumably appropriately supervised (I assume that no decent resus would leave such a sick patient in the sole hands of a medical student) so I don't think you did anything wrong. I get that it feels horrible, I've had similar things happen, but this patient's death was not because of something you did.
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    #1

    Thank you,
    It was just so instant after catheterising them.
    Yeah I was being talked through it by a gpst and the ED middle grade was talking to the family.
    I think I was just over thinking it last night.
    Better now after having slept.
    Back to it this morning.
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    Thank you to the OP for your hard work. I bet it can be tough sometimes.


    Keep up the good work man/woman!
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    (Original post by Anonymous)
    Me - final year at a and e placement.
    Today a patient presented and was taken to resus and was pretty on their way out (sats of 73 percent on 15 L O2?with a resp rate of like 50, no joke)
    And the patient seemed pretty gumped anyway, gcs of like 8 etc. Aspirational pneumonia.
    So helping out in resus and then asked to catheterise patient.
    Catheterised patient and literally within a minute of catheterising the patient resp rate drops off, death rattle, colour leaves the patients face and they pass.
    This was the first time I have ever catheterised a patient aswell.
    I know the patient would have probably died anyway.
    But is there anything about me catheterising the patient that would make them give up?
    Like some sympathetic/parasympathetic nervous system I might have triggered by catheterising that made them drop off? I hate to think the last experience the patient had on this planet was a clumsy medical student passing tubing into them past a mountain of Instilligel. Please be brutally honest here I don't want sympathy, I just want to rationalise it.

    On the brighter side at least when the next patient asks me if I've done this before I can tell them yes I have. When they ask me what happened I can be like yeah, they died.
    There is a decent lesson to be learned here. What you describe is a clinical mistake.

    The mistake being the failure of one of the doctors supervising you to fully recognise the dying patient and treat them accordingly.
    Unless in painful retention you do not pass a blooming catheter in a dying patient.
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    (Original post by Jamie)
    There is a decent lesson to be learned here. What you describe is a clinical mistake.

    The mistake being the failure of one of the doctors supervising you to fully recognise the dying patient and treat them accordingly.
    Unless in painful retention you do not pass a blooming catheter in a dying patient.
    I was thinking the same thing; why did your supervising doctor ask you to catheterise a dying patient? I would personally ask them afterwards.
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    (Original post by Anonymous)
    Aspirational pneumonia.
    Even prokaryotes have dreams.

    You didn't kill them, I assure you.

    (Original post by Jamie)
    There is a decent lesson to be learned here. What you describe is a clinical mistake.

    The mistake being the failure of one of the doctors supervising you to fully recognise the dying patient and treat them accordingly.
    Unless in painful retention you do not pass a blooming catheter in a dying patient.
    Bit premature given we haven't been told the age, functional status, any context at all.

    But I get the impression you may be right.
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    Doctors kill people all the time, don't feel bad.
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    (Original post by GettingitDone)
    Doctors kill people all the time, don't feel bad.
    • #2
    #2

    This makes me very nervous for next (final) year. I don't think it is your fault - you did as you were told. I'd like to know more if possible.. Why did the doctor ask you to catheterise the patient? what grade was he/she?
    What age was the patient and gender?
    How have you never catheterised before, is this not a requirement at your medical school before final year?
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    (Original post by z33)
    :cry2:
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    (Original post by Anonymous)
    This makes me very nervous for next (final) year. I don't think it is your fault - you did as you were told. I'd like to know more if possible.. Why did the doctor ask you to catheterise the patient? what grade was he/she?
    What age was the patient and gender?
    How have you never catheterised before, is this not a requirement at your medical school before final year?
    Why would this make you nervous? Patients sometimes die!

    The doctor asked for a catheter because they felt the patient needed a catheter, I suspect! Absolutely no reason why the med student couldn't do it.

    Med schools are far from uniform. Some have huge logbooks and even make you sign into lectures etc, others let you take responsibility for your own education.

    As it happens I'd never done a successful catheter or ABG before I graduated.
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    Unless you catheterised the bladder via the brain stem, I don't think so.
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    (Original post by Anonymous)
    This makes me very nervous for next (final) year. I don't think it is your fault - you did as you were told. I'd like to know more if possible.. Why did the doctor ask you to catheterise the patient? what grade was he/she?
    What age was the patient and gender?
    How have you never catheterised before, is this not a requirement at your medical school before final year?
    We learned on manikins in 5th year, I didn't actually do one on a real patient until 6th year and only did a handful before graduating. The first patient I catheterised actually also died, albeit 2 days later, so slightly less traumatic than the OP's situation!

    Unsure why it makes you nervous though.
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    (Original post by nexttime)
    Even prokaryotes have dreams.
    I feel so evil for laughing at this in a serious thread.

    OP, it doesn't sound like you did anything wrong. Their GCS was 8, their SATs were ridiculously low, they weren't gonna make it regardless of having a tube up their urethra or not.

    :hugs:
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    (Original post by Anonymous)
    Me - final year at a and e placement.
    Today a patient presented and was taken to resus and was pretty on their way out (sats of 73 percent on 15 L O2?with a resp rate of like 50, no joke)
    And the patient seemed pretty gumped anyway, gcs of like 8 etc. Aspirational pneumonia.
    So helping out in resus and then asked to catheterise patient.
    Catheterised patient and literally within a minute of catheterising the patient resp rate drops off, death rattle, colour leaves the patients face and they pass.
    This was the first time I have ever catheterised a patient aswell.
    I know the patient would have probably died anyway.
    But is there anything about me catheterising the patient that would make them give up?
    Like some sympathetic/parasympathetic nervous system I might have triggered by catheterising that made them drop off? I hate to think the last experience the patient had on this planet was a clumsy medical student passing tubing into them past a mountain of Instilligel. Please be brutally honest here I don't want sympathy, I just want to rationalise it.

    On the brighter side at least when the next patient asks me if I've done this before I can tell them yes I have. When they ask me what happened I can be like yeah, they died.


    Forget everything else you aren't to blame and so on but this is what makes you a doctor.
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    (Original post by nexttime)
    Why would this make you nervous? Patients sometimes die!

    The doctor asked for a catheter because they felt the patient needed a catheter, I suspect! Absolutely no reason why the med student couldn't do it.

    Med schools are far from uniform. Some have huge logbooks and even make you sign into lectures etc, others let you take responsibility for your own education.

    As it happens I'd never done a successful catheter or ABG before I graduated.
    You can come and catheterise me if you really want to?
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    (Original post by Thomb)
    You can come and catheterise me if you really want to?
    I've volunteered for an NG before but...

    I commend your commitment.
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    (Original post by nexttime)
    I've volunteered for an NG before but...

    I commend your commitment.
    I don't even know what a catheter is I'd probably order it in a restaurant?
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    (Original post by Thomb)
    I don't even know what a catheter is I'd probably order it in a restaurant?
    a flexible tube inserted through a narrow opening into a body cavity, particularly the bladder, for removing fluid.
 
 
 
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