Re: Really Bad Code... Originally Posted by elthia 
The sternum should be wired together, so just compress away. The skin incision will open, and sometimes I've heard of the doctor's opening the sternum to do cardiac massage on the fresher open hearts (I've never seen it on a CABG, but I saw it once on a thoracotomy code).
When I renewed my ACLS, I was told that effective compressions should show up as a rhythm or line of pvc's on the monitor.
I truly believe that after every code the nurses involved need a chance to decompress. Not a fault finding session, but most floor nurses are so rarely involved in a code, and if it's a long drawn out code, or a traumatic code, we need the chance to review it. It not only helps with our practice, it helps prevent stress and burnout.
I assisted in coding a pt of mine-post CABG POD1. We opened the chest in the room, surgeon did open cardiac massage. pt lived and was discharged to rehab a long time later (I think at least a month) Pt went through Hell first though-neuro, renals too a hit but eventually recovered (except neuro).
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