Nurse says she 'didn't think about' screening dying child Chloe Longster for sepsis during critical hours before her death
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The second day (Tuesday, October 8) of an inquest into the death of Chloe Longster has heard how the youngster hit a vital sepsis trigger point in the hours before she suffered a cardiac arrest.
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Hide AdBut medical staff did not initially screen her for the condition after a nurse believed her symptoms could be related to pain or another illness.
The inquest at Northampton’s Guildhall heard from experienced nurse Tanya Ball who started her bank shift at 7pm on the night Chloe was admitted to Skylark Ward at Kettering General Hospital.
Ms Ball said that Chloe’s mum Louise Longster had gone to the nurses’ desk twice during their half-hour handover to say her daughter was in pain.
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Hide AdThe nurse then went to see Chloe. She told the hearing: “She was complaining of a lot of pain. She didn’t look quite right so I put a monitor on her and went to find a doctor to see if we could give her anything for the pain."
The doctor told Ms Ball he would return later to fit a cannula so Chloe could be given intravenous drugs.
All hospitals use the national Paediatric Early Warning System (PEWS) to ensure they track any deterioration in young patients.
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Hide AdMs Ball told the court that Chloe’s PEWS score went up from five at admission to Skylark, to eight when she checked again around midnight. Despite this, the nurse did not start the sepsis screening.
Coroner Sophie Lomas asked her if that score should have triggered a sepsis screening.
She said: “Yes it should have. I didn’t consider doing the sepsis screening. I thought it was pain related.
"I just didn’t think about it to be honest.”
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Hide AdThe nurse had asked doctors to repeat Chloe’s blood gas test and x-ray as she believed that the pain may be related to another condition like pneumothorax.
Chloe’s blood results then showed she had influenza A so she was moved to a side room for infection control.
"As we were moving her on the bed she was complaining about a lot of pain and was unable to take a proper breath due to the pain,” Ms Ball told the inquest.
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Hide Ad"She was in quite a lot of distress so I asked mum was this out of character for her. She said yes.
"We got her into the cubicle and I went back to the doctor and said she’s in a lot of pain. At this point she still didn’t have a cannula.”
On moving Chloe, Ms Ball noted the raised PEWS score and a registrar named Doctor Saw came in to fit a cannula. While she was in the room, Chloe’s monitor began to beep and her saturation level dropped to 88 per cent but Dr Saw did not appear to Ms Ball to have taken any action.
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Hide AdMs Ball was also asked about Mrs Longster’s two visits to the nurses’ station to ask for pain relief for her daughter earlier in the evening.
The coroner said: “From their perspective they felt they were being fobbed off. Do you recognise that?”
Ms Ball said: “I feel that I took it seriously. I’m sorry that it didn’t come across like that.”
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Hide AdToday’s hearing also heard evidence from Dr Saw, the registrar who was part of the team that cared for Chloe in the hours before her death.
She said that the paediatric consultant, Dr Mya Mya Yee had asked her to go and fit Chloe’s cannula so she could be given intravenous medicine.
Dr Saw went to the Skylark ward at about 12.30am and fitted a cannula into each of Chloe’s hands.
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Hide Ad"She was talking with me and engaging with me,” said Dr Saw.
“When I looked at her I didn’t feel that she was very, very unwell. She didn’t look like someone who was going to deteriorate within a few hours.”
Later in the evening she was present when Chloe suffered a cardiac arrest.
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Hide Ad"She’d had intubation and difficulty with secretions then she had a cardiac arrest,” said Dr Saw.
"CPR was administered and she had a return of spontaneous circulation and was stabilised.”
Chloe was taken to the ITU but her condition did not improve and she again collapsed before dying at 6.48am when doctors took the decision to withdraw life support.
The inquest continues.
Read our previous story here: ‘Chloe asked me if she was going to die’