30 Minute – Sam Morrish
Sam - a healthy 3-year-old boy. After being ill for around a week (flu symptoms, stomach pain, and vomited) visited first general practitioner (GP) and was sent home with antibiotics. Next day, feeling worse, Sam sees second GP, sent home with cough medicine.
What do you think is going on with this patient?
(everyone to answer)
Initial Assessment ( ~3 min)
Within an hour of returning home, Sam not feeling well, pale, incredibly thirsty, no urine, dark vomit. Mom called NHS Direct and was told to take Sam to local hospital. While waiting in the queue, a passing staff member noticed Sam was critically ill, placed on O2, sent via ambulance to larger hospital.
Share what you are most concerned about.
(everyone to answer)
Assessment Review (~5 min)
Sam arrives larger hospital at 10:30pm. Diagnosed with pneumonia, prescribed antibiotics, concerns of possible sepsis, transferred to pediatric unit.
Pediatric unit, antibiotics administered at 1:30am. Sam continues to deteriorate.
Pediatric unit, antibiotics administered at 1:30am. Sam continues to deteriorate.
Summary:
Sam died December 23, 2010 from sepsis, 12 hours after seeing second GP.
GP 1 - Diagnosed with flu and sent home with antibiotics
GP 2 - Diagnosed with flu, sent home with cough medicine
Local Hospital - Deteriorating while waiting in queue, placed on O2 and sent to large hospital
Large Hospital - Dx pneumonia, possible sepsis, prescribed antibiotics, transferred to pediatric unit, antibiotics given 3 hrs later, Sam dies 4 hours later.
Sam died December 23, 2010 from sepsis, 12 hours after seeing second GP.
GP 1 - Diagnosed with flu and sent home with antibiotics
GP 2 - Diagnosed with flu, sent home with cough medicine
Local Hospital - Deteriorating while waiting in queue, placed on O2 and sent to large hospital
Large Hospital - Dx pneumonia, possible sepsis, prescribed antibiotics, transferred to pediatric unit, antibiotics given 3 hrs later, Sam dies 4 hours later.
