Sunday, May 29, 2011

$200 worth of oops

This Saturday I was “on duty” in the large animal hospital, meaning that I was in the hospital for about 12 hours, theoretically helping with the treatments on all the animals (mostly horses, but we have gotten a few baby alpacas, or crias), along with one of my rotation mates. I say ”theoretically” because in practice, I just worked on my actual patient, a post-colic surgery horse who was extremely time consuming. My rotation mate and the techs handled the other animals, who needed many fewer treatments.

My horse was hooked up to a bunch of bags of IV fluids. In our large animal hospital, we suspend all the fluids from a hanger on the ceiling, and they run along coiled (therefore extendable) lines into a catheter in the horse’s neck. This way the horse can walk around his stall without getting his legs tangled, although the lines will inevitably tangle among themselves if you have multiple of them, which this guy definitely does. And with horses, the amounts of fluids and medications going in are fabulous. He had two five-liter bags of fluids hung at all times, plus a one liter bag of antibiotics, and a one liter bag of painkillers. This is aside from the medications I needed to inject into his catheter periodically, plus the oral meds I had to put down the tube which runs from his nose into his stomach.

The time came to change one of the bags of fluids. One of the techs stood outside the stall and lowered the hanger with all the bags. I removed the empty bag and hung the new one (with much grunting, as it was over my head and heavy). I disconnected the line from the old bag and went to connect it to the new bag — but since the line was also still connected to the second bag of fluids, it immediately started spewing saline all over the stall. I stuck my finger over the open tube to stop the flow just as the tech yelled “It’s sterile, don’t touch it!”

Well, I did know that you shouldn’t be sticking your finger over a sterile tube opening, but I had panicked and done it anyways. I stood there looking sheepish while the techs conferred. Yes, the line would have to be replaced. A new line cost $100. We obviously could not charge the client for this. The hospital would have to eat it. (The hospital is currently not profitable, which made me feel extra guilty.) These things happen when you are learning, but it is still super embarrassing. Also, changing the line was very complicated, and therefore annoying for the tech who did it.

Later in the day I was giving my horse his IV medications, injecting them into the new line. The second medication started turning into a solid powder inside the clear tube. It was precipitating! Just like in chemistry class! Except that that is bad to put into a horse’s bloodstream. I stopped and called a tech. I should have flushed the line with saline between injections. Oops. I flushed the line again and again to get all the precipitate out, but some was just too firmly adhered to the side of the tube. So, you guessed it, we had to change the line a second time, for another $100 eaten by the hospital.

So much to learn! So many embarrassing mistakes to make! I will never make these two mistakes again, though, I am pretty sure.

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