Description of Event or Problem · 0
SITUATION: PATIENT WITH NEW ONSET TACHYCARDIA UP TO 180-190S WHILE CALM, OCCASIONALLY INTO THE 200'S (MAX HEART RATE 210), WHO INITIATED THE RRT (RAPID RESPONSE TEAM). BACKGROUND: 22 MONTHS-OLD MALE ADMITTED WITH RESPIRATORY SYNCYTIAL (RSV) BRONCHIOLITIS AND EAT (ECTOPIC ATRIAL TACHYCARDIA). NASOJEJUNAL TUBE (NJ) IN PLACE FOR MEDS AND FEEDS. ASSESSMENT: PATIENT BASELINE HR 110'S-120'S WHILE IN PEDIATRIC INTENSIVE CARE UNIT (PICU) AND INITIALLY DURING FIRST 10-15 ON UNIT, ABRUPT INCREASE WITH PERSISTENT HR > 180. PATIENT ALSO ON ENTERAL FEEDS WHERE NJ WAS NOTED TO BE TAPED DUE TO BROKEN/LOOSE CONNECTION AND UPON ASSESSMENT WAS LEAKING FEEDS AND LIKELY MEDICATION. LAST DOCUMENTED DOSE OF SOTALOL WAS [TIME REDACTED] IN PICU PRIOR TO PATIENT TRANSFERRING TO PCU 300. THIS DOSE OF SOTALOL LIKELY NEVER REACHED THE PATIENT DUE TO MALFUNCTIONING TUBE, LEADING TO ECTOPIC ATRIAL TACHYCARDIA (EAT). REGISTERED RESPIRATORY THERAPIST (RRT) CALLED WITHIN 5 MINUTES OF RSN BEING CALLED TO ROOM BY BEDSIDE RN AND RSN IDENTIFYING EAT. REQUESTED A STAT EKG AND IVF. RECOMMENDATION: TRANSFER TO ICU TO RESOLVE EAT WITH EITHER IV MEDICATION OR PLACEMENT OF NEW NJT AND NJ SOTALOL ADMINISTRATION. AFTER REVIEW WITH THE BEDSIDE, RN LEARNED THE SIDE PORT OF THE NJ TUBE HAD TAPE ON IT. ONCE MEDICATION ADMINISTERED ON PCU 300 NOTED VISCOSITY OF MEDICATION AND IF THIS CONTRIBUTED TO THE TUBE SIDE PORT DISINTEGRATING.