I have question about CPR

  1. 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 "Full code." You go back into the room to initiate CPR, then tell the people behind you to grab the crash cart. They cannot find a mask or ambu bag. There is phlegm and drool all over the patients face.


    Question: Are you obligated to do actual mouth to mouth on a patient who is 100 + years old who is not going to make it anyway?

    Thanks
    Mandi
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  2. 24 Comments

  3. by   traumaRUs
    Nope and actually the American Heart Association says compressions are good enough! However, I would question why no ambu bags and masks????
  4. by   tattooednursie
    Quote from traumaRUs
    Nope and actually the American Heart Association says compressions are good enough! However, I would question why no ambu bags and masks????
    Thank you.
    There were no ambubags because no one could figure out where they were. (all new registry people) No one must have shown them where they were. It took like 10 minutes to get an ambu bag in.
  5. by   Agnus
    Standard hospital protochol today is NO MOUTH TO MOUTH. If there is no ambubag you do not initiate mouth to mouth. Give Oxygen do compressions but no mouth to mouth.

    There is today now (American Heart) some feeling that compressions alone can be helpful at least initially.
  6. by   Agnus
    Why oh Why if they grabbed the crash cart could no bag or mask be found. These are on the cart.

    Carts are set up in a standardized fashion. I don't get what the mystery was as to were these items were. It doesn't take 10 minutes to go though a cart especially for an item like this.

    The only thing I can guess is that the cart was NOT checked daily, as should have been standard procedure. Or people were writing down that they checked without actually doing it.
  7. by   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
  8. by   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?
  9. by   merlin100
    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
    I read with interest the article on CPR. I am a nurse in Cardiac ITU, and yes, the crash cart should be checked on a regular basis. BUT....in the Uk, we are taught that under no circumstance need you expose yourself to anyone's "bodily fluids". You are to presume that every patient has HIV/Hep/other disease, until proved otherwise. I also feel the patients age has nothing to do with it. I have come across 100 year old patients i would chose to resus, and 50 year old ones I wouldn't. But then again, we should always endevour to do the best for our patients, and refraining from CPR without an order against it, is taking life in your own hands. I suppose i am lucky in the area i work, as full facilities are always available.
  10. by   flowerchild
    In my clinic I keep the airways, and ambu bags right on top, in a bag, tied to the side. Easy to find. The portable suction machine is always handy too and easy to find.
    I also carry my pocket cpr protector with me. You never know when you'll need it.

    Any unit I have worked on, the FIRST thing I do when orienting is review the crash cart and find the airways. I want to KNOW where these items are BEFORE I take a patient load. I frequently volunteer to do the cart check too which keeps me up knowlegable of it's contents and thier locations.

    One of my first jobs taught me this after seeing a nurse do mouth to mouth on a trach. YUCK. All those secretions. She couldn't find the bag and connector, we soon got her one, but she was pretty grossed out. Lesson learned.
    Also saw a patient start breathing after a couple of blows by the nurse and the patient vomited into her mouth. Double YUCK. Lesson reinforced.
  11. by   flowerchild
    I'd like to learn more about the employee protection policies.
    I have been under the understanding that as a professional, educated, trained nurse, that if I do not act, I could be held liable. In an emergency, I don't think I have the right to choose who to give cpr to and who to withhold it from, no matter what thier diagnosis. 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). It is up to me to protect myself with items that are available. (knowing where things are, or using my pocket cpr protector, and UP). I would be negligent if I did not do everything in my scope of practice and within my training to save the patients life, hopefully. Only the patient, family, doctor, and sometimes judges can say when to with hold life saving treatments.
    Is this something that is mandated by state laws?
  12. by   Nurse Tessie
    I'm presuming this is a hypothetical situation! To the best of my knowledge, you are not obliged to give mouth to mouth unless you are entirely comfortable doing so, whether in a hospital or community setting. We keep a pocket mask stuck on the wall in every room and find these an excellent and hygienic resource until an ambu bag becomes available.
  13. by   scrubs70
    Your own safety is paramount and you are not required to put yourself at any uneccesary potential risks.
  14. by   Whisper
    Quote from merlin100
    BUT....in the Uk, we are taught that under no circumstance need you expose yourself to anyone's "bodily fluids". .
    Merlin, I am doing my training in the UK, and at my last BLS update we were told that refusing mouth to mouth would leave us accountable to the NMC, the trust I work in is a bit disjointed one site has many more face masks than the other.

    But we are told mouth to mouth is a must unless it is an 'acceptable delay'...One of the other hospitals doesn't publish it, but I know one nurse who left/was pushed because of refusal to start mouth to mouth!

    All the research we were given by the university indicated very low infection rates, but maybe it was biased!

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