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23 September 2007
My dad recently passed with a ruptured AAA that was diagnosed by an ER Doctor as a urinary tract infection? We took him to the ER about 9pm on a Wednesday night, he was finally brought back to be evaluated by the ER physician about 12:15 now Thursday morning. Was sent home about 2:15 with diagnoses of UTI...one problem... 10 hours later he died of ruptured AAA. He was a 65 year old white male that smoked and his major complaint was level 10 low back pain. The only test that was given was a UA and it stated "dipstick results may not be valid due to pigmentation of urine sample". My dad in fact was given a Cystex by my mom which was the culprit. The final ER diagnose was UTI Mild / Low Back Pain. What now? Am I just supposed to suck it up? Given the fact that I am now a 15 year plus ER nurse and decided to let unbiased non-family members triage and treat my dad has left me completely at a loss for words to describe my feelings.
I must say that the ER would not let anyone in triage nor would it let anyone back with my dad...being an ER nurse myself and the decision made to place my trust in others has just about done me in. Am I wrong? Could I or should I have second guessed the final diagnose? It is obvious that if he would have been correctly diagnosed, he would have had some percent of a chance at survival but was not given that choice. I am a traveling ER nurse and I am finding it very hard to accept further contracts. My confidence level is near zero and I am not real sure if I will ever work as a nurse again.
The screening for those at high risk for AAA has a big hole in it at the ER level and in my opinion should carry some sort of accreditation much like BLS, ACLS, PALS etc. Taking into consideration that only a small percent of back pain complaints in the ER comprise AAA, it is somehow swept under the table by Insurance companies and carries no real threat as even those taken to court are hard to prove. Thus, it trickles into the actual education of ER physicians as of not much importance and results as often misdiagnosed as with my dad. There is a real problem here.
My love to you dad and I am sorry for letting you down.
Discussion, comments, or questions: Doug Taylor
© Copyright 2007 Doug Taylor
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