I have question about CPR - page 2

Scenario: You find your patient lifeless. there is absolutley no code status on their wrist band. You ask from down the hall to the nurses station on what their code status is. 3 people yell at once... Read More

  1. by   TREBORICUNURSE
    The key question here is : Why there was no ambubag on the crash cart? You MUST, just must know where is CPR equipment No need for mouth to mouth if ambubag is there. I also feel the patients age has nothing to do with it. If code is present, dont think just act.
  2. by   telenurse04
    AHA did recently say compressions alone can help because it pumps oxygen rich blood into the brain...or something like that. The crash cart would be there very soon..then they can start ACLS.
  3. by   CarVsTree
    Quote from Whisper
    One of the hospital I work in the standard procedure is you MUST do mouth to mouth, unless there is a high risk of infection, such as TB or HIV.

    I think it is assumed as this in most UK hospitals... I have a face mask that fits on my key rings just in case!!

    whisper
    In our litigious nation, pt. could sue you if they had so much as a sniffle after you performed MTM w/o a barrier.
  4. by   Whisper
    i never even considered patients sueing staff for performing mouth to mouth!
  5. by   Tweety
    Quote from Nurse Ratched
    I also question why there was no ambu bag on the crash cart. Where else should it be?

    Another question is why is a person who is 100 years old (presumably frail, sickly?) a full code? Maybe I'm crass, but isn't that something that ought to have been addressed?

    Really. CPR on a 100 year old should be declared a crime. But of course, I'm sure you know, if there is no family, and the person has no living will, then it must be assumed they would want everything done. We ran into this situation with a confused and dying patient in his 90s. We sent him to ICU, where he was intubated, coded and died. Sad.
  6. by   pmanrnbflo
    Protocol at the hospital where I work is that ALL CPR venilations are done with a barrier device, and they are on the cart. Also, our crash carts are checked every day.

    I would question why the bag/mask/ barrier device is not on the cart.
  7. by   tattooednursie
    Thank you for all your help.

    I agree that a 100 year old should not have been a full code. If I live that long (which I hope I don't) I would want to be left to peacefully die. I would not want tubes down my throat, machines keeping me hanging on or people jumping up and down on my chest.

    Mandi
  8. by   suzanne4
    :uhoh21: It is a scary thought to think that a nurse would even consider doing mouth to mouth on a patient. Who is going to be there for you IF you actually caught something from that patient and they were no longer around for you to prove it. Why doesn't your facility provide appropriate equipment? In the US it is against OSHA standards not to provide protective gear for the staff. The facility can actually be fined.

    And for the staff that worked the facility without a staff person and not knowing where emergency supplies are kept: "Shame on you." It is your responsibility to know where those things are at all times, first thing that you should find out when starting your shift. I worked agency for most of 25 years and never would even consider being on a shift without knowing how to page for an emergency, and where supplies and crash cart were kept.
    Plain old common sense..............................
  9. by   Gompers
    Quote from telenurse04
    AHA did recently say compressions alone can help because it pumps oxygen rich blood into the brain...or something like that. The crash cart would be there very soon..then they can start ACLS.
    Yep, when I recertified in January my instructor reinforced that information. Whether in the hospital or community, you are NOT liable if you refuse to do mouth to mouth, so long as compressions are being done.

    p.s. SOOOOOOO glad to work in an ICU where each patient has bedside suction up and running, with an ambu bag connected to O2 right behind the bed. But even if these malfunctioned, we all are assigned to check the cart often enough (it's checked Q shift) and the Omnicell is pretty organized, so it would only take a minute to grab new equipment.
    Last edit by Gompers on Apr 13, '04
  10. by   kids
    Quote from flowerchild
    <snip>I could be held negligent for driving by an accident and not stopping to help (if someone saw me and knew I was a nurse).<snip>
    I know that "Good Samaritan" laws vary from State to State but it has always been my understanding that as a nurse I am under no obligation to render aid when off duty in the community.

    It is also my understanding that if I do choose to render aid that the "Good Samaritan" laws protect me ONLY as long as I do not exceed the level of education available to a lay person via CPR and First Aid courses offered in the community.
  11. by   critcarenurse16
    Quote from Whisper
    One of the hospital I work in the standard procedure is you MUST do mouth to mouth, unless there is a high risk of infection, such as TB or HIV.

    I think it is assumed as this in most UK hospitals... I have a face mask that fits on my key rings just in case!!

    whisper
    Our hospital has face shield at the head of every bed. In our ICU we have our cart stocked with ambus on the side but also have ambus at the HOB as well for each pt. I personally would not do mouth to mouth even with the face shield- to flimsy and not an effective barrier if the pt vomits. We follow current guidelines from the AHA stating compressions are enough initially. We just never got around to taking down the face shields from the HOB.
  12. by   critcarenurse16
    Quote from kids-r-fun
    I know that "Good Samaritan" laws vary from State to State but it has always been my understanding that as a nurse I am under no obligation to render aid when off duty in the community.

    It is also my understanding that if I do choose to render aid that the "Good Samaritan" laws protect me ONLY as long as I do not exceed the level of education available to a lay person via CPR and First Aid courses offered in the community.
    This is correct. Check your state laws for details. In my state we are NOT obligated to stop at the scene of an accident and administer aid but I would feel a moral obligation personally. Thankfully I've never had that encounter.

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