your first "patient emergency"

[pinkiepieRN]

I've called "rapid response" on patients before, but never on anyone in my direct care. Today, my patient called out, complaining of n/v. I came in, and although I didn't note anything funny, there was something about him that just didn't seem right. I questioned him as to what was going on and he spaced out. Just like that, the right side of his body started twitching. Instinctively, I looked at the clock as I told the CNA to get another nurse. What followed actually flowed pretty perfectly in my opinion. We got vitals, he stopped seizing after ~5 minutes, I called the doc, filled out paperwork and gave him a stat dose of Dilantin, with labs to be drawn in the morning. I was certain that I would have been more freaked out at the onset of the seizure, but I stayed calm.

I hope that he's either better when I get back on Tuesday or they ship him out (I'm in LTC/rehab). Either way, I came home knowing that I made a difference today!

I was in psych before, so I've handled "behavioral emergencies" but nothing medical like this!

Anyone else want to share their "first"?

[dandk1997RN, MSN, RN]

My first rapid response on my pt was in my first couple months on my own. I got an ICU push-out with severe anxiety problems. He was getting neb tx but wanted his albuterol inhaler. He needed to hold it in his hand to feel less anxious...told his wife I knew nothing about asthma bc he needed that inhaler despite the albuterol neb...okay, whatever, it's not like I have a daughter with asthma or anything. I called respiratory (though we were all in agreement that the prob was anxiety and not asthma) and got an order for the inhaler to hold and Ativan (0.5, not enough to fix this prob.). I went to get the Ativan and by the time I got back to the room with it and the inhaler, the RT had called the RR and the intensivist was on his way. The guy had gotten himself so worked up he earned himself a bedside intubation (our nighttime intensivist tends to go overboard) and a return trip to the ICU. I think he could have done w/o the intubation if he just had an adequate dose of anti-anxiolytic in time, but I can only move so fast when I have to wait for the doc to give the order. Total time on my floor? 30 minutes plus the RR time. I still harass the ICU charge (a friend) who brought me this (mentally) unstable pt. And FWIW, I understand anxiety- I had a problem for years- but sheesh, who knew you could end up intubated bc of it?

[Morainey, BSN, RN]

Will never forget checking my hospice patient's feet to discover smelly, necrotic flesh.