Video transcript: Matt coming in from outside and he was walking towards me holding onto his right-hand side sort of leaning into it. And I looked at him and I thought, appendix. It didn’t look good, so I thought well let’s go up to the hospital and check this out. And that’s where it all started. We went straight into A&E and he was seen by the surgeon on call that night. And he confirmed that he had appendicitis and that we should, you know, take it out that night. The appendectomy went well and then between theatre and recovery Matt had laryngospasm. So he’d stopped breathing. So they bagged him, gave him reversal agents and got him into the recovery room. And it was taking quite a while I was waiting outside recovery. So eventually they came and got me and brought me in and told me what had happened. You know, Matt he was obviously breathing he was but he was very angry and they’re having trouble calming him down. And then Matt coughed up some pink froth into his mask. And I just watched the nurse wipe it out. So I said to the anaesthetist, ‘Did you see that?’ And her answer was ‘Oh it’s probably just trauma from intubation’. Why would I question what she’s telling me? Because I’m concentrating on calming him down and just being there as his mum. After that they called the nurse from the ward to come and get Matt and take him back to the ward because they felt that he was good to go. You know, I asked Matt to go into the kid’s ward because he wasn’t yet 16 and they had TVs. But I did it on the understanding that if there was any complications or any reason not to go to the ward then that’s fine, we wouldn’t go there. But the ward is where we went. Once we got Matt settled into his room I kissed him, told him I loved him, and I’ll see you in the morning. He’d calmed down by then and I remember looking at the couch bed beside him and thinking I could stay there but he wasn’t in the mood for that. So I just went out his room and I said to the afternoon nurse ‘Look, I’m not comfortable.’ You know. ‘Where are you sitting?’ So I checked and she told me she sits at the desk right outside his room. And I also said ‘Look I want you to keep him on a monitor all night and ring me if anything… or even if he just wants to talk to me, give me a call.’ So I went home. We got the phone call about 6:30am, 6:40am on Saturday morning. Dave answered and the nurse said to him ‘Matt has respiratory arrested.’ And Dave had no idea what that meant but I remember him saying ‘Did you want us to come in?’ So I took the phone off him and asked what happened. They told me ‘Matt’s not breathing’. That was it, you know. I just jumped out the bed Dave’s still looking at me wondering what’s going on. I said ‘Matt isn’t breathing’. When we got to his room they were still bagging him. The doctor, the anaesthetist, the nurses were all either working on him or standing around. I couldn’t believe it. He’d already had a lot of medication given. When you resuscitate people – his pupils [were] really dilated so you know at that stage we didn’t know was it from the medication that he’s been given? Or has he lost a lot of oxygen to his brain. We were unable to tell. Because that looked really bad if you look at it from a nurse’s perspective. But from a mum – I could see they were giving him oxygen, but he was breathing with that oxygen and he had a pulse so he was still there. Then we took him in his bed down to ICU and the doctors were talking with the team in Christchurch about what had gone on and what’s the best things to do for Matt. So they sent a retrieval team for Matthew on the plane. It took a long time to stabilise Matt. Every time we moved him or were just trying to get x-rays to see what was going on with his lungs, his oxygen saturation would just dive. And then it took about eight hours to get him stable enough to be able to move.
1)Examining best practice evidence, explain what ‘Don’t normalise the abnormal’ means and using the A-E systematic approach, review the video and identify the A-E “reg flag” signs of deterioration that were mentioned and how these symptoms were normalised.
2)As the ward nurse looking after Matt on the night shift, highlight the importance of ‘documentation’ and provide an explanation about the nursing care requirements you would have implemented overnight, including when you would have asked for a clinical review and why?