[txspadequeen921]

They teach defib in regular healthcare provider CPR . They also teach it to the people that work in Walmart for in-store emergencies....

[RNREMT-P]

Originally Posted by rgroyer1RNBSN

Oh I think nurses should defib. Im an ICU house Sup., I was just trying to get a new topic started off we could discuss, that, and the fact we have one nurse from the old days whos semi-retired who doesnt think alot of things nurses should be doing-lol, shes always starting good topics in the unit lol.

sorry, I wasn't trying to discredit you or anything, just didn't understand where the question came from. My mom's been an RN for 44 years and she had a hard time when MDs stopped putting in IVs!
I also think that if someone arrests outside of the ICU/ER/OR/etc that the nurse should be able to push epi or vasopressin before the code team arrives. If the patient is pulsesless and apeic, those drugs are indicated regardless of the underlying rhythm. A basic EMT should be able to do the same and some places they can. It may sound cavalier, but "what's it going to hurt at that point?"

[EricEnfermero]

Originally Posted by Miami NightNurse

yeah you are right you do not have to be ACLS to use AED

The flip side of that is that just because something was covered or tested in your ACLS/PALS/NRP/other alphabet soup class, it doesn't automatically become included in your scope of practice.

I do agree with my hospital's current policy. RN's in critical care areas can operate the manual defibrillator, while nurses from other areas must leave the LP12 in AED mode.

My unit is unique to the rest of the hospital though. In the NICU, our nurses don't defibrillate babies. In a non-cardiac NICU, neonatal defibrillation is extremely rare anyway. In the event that we need to cardiovert a persistent SVT (above 220/min after adenosine), our unit policy is that we can turn the knobs and press the buttons only at the MD's direction.

[Miami NightNurse]

Originally Posted by rgroyer1RNBSN

Believe me, Im acls, pals, yata, yata yata, I just wanted to know opinions, thats all. And yes I defib., People all the time, the fact Im on the code team and trauma team, and the great and wonderful rapid response team-lol.

OH good I was worried you were one of those people on ths site pretending to be a nurse. The way you worded the start of this thread I thought you were askng if it was in our scope of practice not what we thought of it--Sorry. Oh and I think it should be something nurses should do. Can you imagine how many people would die if we had to wait on a doc?

Originally Posted by EricEnfermero

The flip side of that is that just because something was covered or tested in your ACLS/PALS/NRP/other alphabet soup class, it doesn't automatically become included in your scope of practice.

I do agree with my hospital's current policy. RN's in critical care areas can operate the manual defibrillator, while nurses from other areas must leave the LP12 in AED mode.

My unit is unique to the rest of the hospital though. In the NICU, our nurses don't defibrillate babies. In a non-cardiac NICU, neonatal defibrillation is extremely rare anyway. In the event that we need to cardiovert a persistent SVT (above 220/min after adenosine), our unit policy is that we can turn the knobs and press the buttons only at the MD's direction.

When it comes to babies I think I'd want the Doctor there too

[nservice]

Speaking of defibing babies...

I got a request from the newborn nursery a few weeks ago requesting an inservice on how to work the defibrilator. It seems they had to cardiovert and had quite a time figuring things out. Since my own child will be delivered in this hospital in about 5 weeks, I was MORE than happy to privide this education!!

The problem with using the defibrillator, as well as ACLS, is that you get recertified every two years and then might not have to use this skill in the interim. I encourage nurses to play with the defibrillator on a regular basis. We crack the cart and have mock codes or just refresh our memory on where things are and how things work when defibing, cardioverting, pacing...etc. At first, the nurses are reluctant to participate because they are either busy or uncomfortable with the equipment. When we are finished they are glad they had the review and without fail, request more frequent inservices like that.

[parko]

Only if you are ALS accredited. RN's on the MET (Medical Emergency Team) take the defib on MET calls. We dont have defibs on resus trolleys in the wards (as odd as that sounds)

if a pt was to arrest (on the ward), you commence BLS and phone a MET (team based in ICU, call goes out for an arrest/pt deterioration, 1x ICU RN and 1x Registrar turn up to the ward) And yes, if the RN makes it to the ward before the Reg, they can shock as per protocol (as was the case a fortnight ago, nurse managed to revert a lady from a witnessed VF arrest all before the doc got there!)

[nursejill155]

Of course, that is what ACLS is for! If you don't know what you are doing, don't do it, but it is in the scope of practice if you have ACLS.

[Critical_Care_RN]

Originally Posted by rgroyer1RNBSN

Do you think properly trained nurses should defib.? Is this in our scope?

It is absolutely within our scope of practice. Having said that, I will tell you that, in the facility where I work, most nurses wouldn't be comfortable doing so. There are only 3 units in our hospital that require ACLS training(ER, CCU, Telemetry). The docs run the codes in ER and do all the defibrillating there. If a patient codes on any other floor INCLUDING the tele floor, the nurse begins cpr and calls the code. They get the crash cart to the room, hook the pt up on the crash cart monitor, and by that time, the code team is usually there and will take over. The CCU nurse(s) is/are responsible for pushing meds and, if the patient is in a shockable rhythm, providing said shock unless the doc wants to do it, which he usually doesn't. The ER nurse may share the responsibility of meds and defibrillation, depending on the situation.

[LoveICU]

Yes, ALL nurses should be able to defibrillate. CPR with AED training (REQUIRED) for this purpose. Research has shown time and time again how important defibrillation is. Just lke a prior post states, AED is used outside the hospital and it is "dumby-proof" for the inexperienced person to use it in the community. This is a small and easy skill to achieve. It doesn't say much for a healthcare provider who isn't able to perform this skill safely.