Anne Carle, RN, Telehealth Clinical Coordinator at Cornerstone VNA shared with HRS a story about how she was able to save a patient’s life twice while on telehealth.*

Peter was placed on telehealth to help manage pneumonia, COPD, and A-Fib. One morning, while remotely monitoring her telehealth patients, Carle noticed that Peter’s oxygen saturation readings were critically low at 78%. When she was alerted, she immediately video called Peter. Peter answered her video call with his wife, Linda, by his side. During their video communication, Carle asked Peter to put on his oxygen mask which he uses at night. In doing so, Peter was able to increase his oxygen saturation levels to 93%.

However, Carle was concerned about Peter. She noticed that Peter was still wheezing, so she immediately called his doctor’s office and discussed Peter’s condition with the doctor’s nurse.  Thanks to the video chat feature, Carle was able to visually see Peter’s feet and ankles and answered the nurse’s questions regarding a possible edema. Since Carle was able to perform a clinical assessment remotely, she was able to schedule an appointment for Peter to see his doctor for that same day.

After coming back from his appointment that afternoon, Carle called Peter once again to check in on him. That night, Peter developed a fever, and went to the hospital where he was admitted for four days due to a respiratory infection.

After his discharge from the hospital, he returned home and continued with the telehealth program. On his first day back, Peter used the tablet’s daily symptom survey and indicated that he was experiencing abdominal pain, which was another cause for concern for Carle.

Carle video called Peter again and learned that his stools were black. While video conferencing with Peter and Linda, Carle reviewed his medication list and noticed that Peter was placed on Eliquis.  With this particular medication, she became worried that he may have internal bleeding.

Carle then called Peter’s doctor office to report Peter’s current situation and asked the nurse if the doctor would like a stool sample to be obtained or labs drawn. The doctor ordered labs, and a CBC, to be done at home by a skilled nurse, which Carle made arrangements for that day. Since Peter’s results showed that his Hematocrit and Hemoglobin were too low, the doctor asked Peter to visit the ED for a blood transfusion. Peter was taken to the ED by Linda and was transfused 2 units of blood. Thankfully, Peter was able to go home afterwards and has not been readmitted since.

Peter's doctor and his nurse called Carle to thank her for being able to intervene in his condition, they said, "the doctor and I want to thank you for all your help keeping us informed of [the] patient, helping us prevent a serious condition from happening. We are pleased with how the  telehealth program played a part."

Peter currently remains on telehealth and has avoided exacerbations because of Carle’s interventions.

 

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*All patient names mentioned in the article have been changed to maintain the patient's privacy.