Friday, January 23, 2009

Back in the hopital

Hello. Sarah asked me to make a quick post.

Gracie had a fever, so the lab in lake city drew blood, and something grew on the petri dish, so Gracie had to go back to Nemours in Jax. Everyone thinks they contaminated the sample when they drew the blood (again) but they need to be in the hospital as a precaution. To top it off, they were supposed to fax the test results and send the sample to Nemours so they could identify the suspected bug. Well, they sent it to Shands in G-ville. Brilliant. Naturally, Shands has no idea what is going on, and don't know what sample we are talking about or where it is...

So, they had to have another blood draw in Jax, and are waiting for results. Preliminary data suggests that Gracie's potassium is low. The doc thinks the blood sent to the lab was hemolyzed (all of the blood cells burst - happens sometimes when too much suction used to draw blood). They'll draw again and check again... :(

In summary, they feel good, and think all is ok. That said, they will be in the hospital for a couple more days until it is all figured out. In the meantime, hospitals are very boring - no internet or anything - so feel free to give Sarah a call. I'm sure she'd appreciate it. 386-344-1095.

Uncle Mack

2 comments:

Elizabeth said...

Praying that little Grace is bug free.

Testdriver said...

I am starting to feel a little testy toward the pediatric team at Shands. Actually, I am one of a growing list of Gracie's people who are getting a little testy.

If I understand the current blood culture situation correctly, the offending sample (the one that grew bacteria and sent Gracie back to the hospital) was taken by what can only be called "extreme heel stick". Apparently they were unable to get a venous sample, so the blood was drawn by sticking Gracie's heel (like they do for newborn basic bloodwork that only requires a few drops--kind of like a finger-stick), then squeezing the daylights out of it to get enough blood to fill a couple of vials.

If you can imagine the heel squeezing it must take to get "a couple of vials" of blood, you will imagine a lot of rubbing of skin, and then sending blood over the skin and into the vial. Of course, as any seventh-grade biology student can tell you, everyone's skin is positively crawling with bacteria. Add to this that one of the squeezers was not even wearing gloves, and you can certainly see how the sample might be contaminated.

I would even suggest that this method is so unorthodox as to bear providing an accompanying note describing the method of collection, so the lab will know this is not a regular venous sample.

Apparently, no indication of any trouble with the draw accompanied the sample to the lab, so when bacteria grew on the petri dish, it was assumed to be rampant in Gracie's bloodstream, which I have to assume would bring down some protocol for septicemia, and lots of other labs to look for the source of the bug. The fact is, with this type of draw, you get very little information about what is going on further up the bloodstream, and this is the information the doctors were after. To do such a draw for this purpose is asinine. To fail to label it as an irregular collection is negligence.

An actual venous draw from Nemours grew nothing, but showed potassium levels that were of interest. When the original, inadequately labeled sample was sent for, it was "lost".

I understand that things can get lost, but there is real lost, like losing your wedding ring at the beach, and there is "lost" like losing your bad report card in your locker. There are aspects of this situation that make me wonder.