I am a brand new ER nurse, fresh out of nursing school and still in training. Last night an ambulance brought in a 6 month old with a croupy cough. Medics said the kid looked good, had a mild cough, but was non-labored. I saw him briefly before I registered him into the computer and he looked okay. Sating 100% on simple oxy mask, good color, etc. Then about 3 mins later, the tech who was getting his vitals screamed at me to call the RT. When I ran in there, the kid was blue and retracting. We got the whole team in there, established IO's, IV's, at attempted intubation. After multiple unsuccessful intubation attempts we kept him at a high flow oxygen mask and he was later trached in the OR and transferred to a pediatric hospital.
This was my first pediatric code and it was very scary. I still feel nauseated thinking about it. Kids can turn so quickly. Does anyone have any advice on dealing with pediatric codes?
Dec 8, '12
Sounds like you had a rough go of it last night. I'm sorry to hear that.
Pediatric codes are particularly difficult to reconcile As you stated in your post, when they turn, they do so frighteningly quickly. Some of that has to do with the whole lack of reserve they have so when they finally tire, it's an instantaneous downturn.
I don't know if it's ever possible for them to become easier as they are always high intensity for all parties involved--it's a kidlet, after all, but it is possible to become more comfortable with them as your experience grows. Which leads me to my next question: was this your first code in a general manner of speaking? If so, then it carries a deeper significance. As many on this site have stated, you never forget your first code. And you definitely never forget your first peds code.
As you go along, you will develop that sixth sense ability to be able to sniff out the ones that are going to decline on you. Sometimes all you can do is the best you can in the moment you are in. No more, no less. And it sounds to me like you did all you could.
I wish I had something better and more clever to say, but alas, not this time.
Last edit by CheesePotato on Dec 8, '12