Here is the answer for the question – James is a first-year surgery resident on his first pediatric rotation. His attending (consultant) asks him to start intravenous (IV) replacement fluids on a two-year-old boy who is having vomiting and diarrhea. Having trouble remembering the guidelines for calculating fluid replacement rates for very small children, James asks Maria, a nurse on the unit. Maria responds, “You’re the doctor. It’s your job to decide this.” James picks a rate that is much too high, putting the child into fluid overload.. You’ll find the correct answer below
James is a first-year surgery resident on his first pediatric rotation. His attending (consultant) asks him to start intravenous (IV) replacement fluids on a two-year-old boy who is having vomiting and diarrhea. Having trouble remembering the guidelines for calculating fluid replacement rates for very small children, James asks Maria, a nurse on the unit. Maria responds, “You’re the doctor. It’s your job to decide this.” James picks a rate that is much too high, putting the child into fluid overload.
To prevent this type of error from recurring in this unit, which of the following is MOST important?
(A) Clear medical guidelines for fluid replacement in patients of all ages
(B) An improved culture of safety and teamwork
(C) Closer supervision of residents, especially in the first year
(D) More severe, well-publicized consequences for providers who are reckless
The Correct Answer is
(B) An improved culture of safety and teamwork
Reason Explained
(B) An improved culture of safety and teamwork is correct for James is a first-year surgery resident on his first pediatric rotation. His attending (consultant) asks him to start intravenous (IV) replacement fluids on a two-year-old boy who is having vomiting and diarrhea. Having trouble remembering the guidelines for calculating fluid replacement rates for very small children, James asks Maria, a nurse on the unit. Maria responds, “You’re the doctor. It’s your job to decide this.” James picks a rate that is much too high, putting the child into fluid overload.