You walk into a pt room & they are not breathing, whats the 1st thing... - page 2
by student_nurse24 8,103 Views | 21 Comments
Whats the 1st thing you do AFTER hitting the code blue button? Step by step someone please lay it out. Its one of my biggest fears...... Read More
- 0Apr 15, '10 by ~Mi Vida Loca~RNYou hit the staff assist or code button in our hospital and you will have about 20 extremely experienced people in the room within 15 seconds.
First thing we are taught is check their code state, if DNR do nothing and go let the nurse know. (do nothing if you see they are not breathing) if they looked like they were struggling to breath then we would do something like give Oxygen, sit them up and stuff.
Oh and before calling codes, make sure you have assessed that something is wrong, not that patient was sleeping and it looked like he wasn't breathing when he was or something.
Guess that happened before, code team and everyone came running it and freaked the poor patient out who was in a deep sleep and perfectly fine :|Last edit by ~Mi Vida Loca~RN on Apr 17, '10
- 0Apr 15, '10 by ~Mi Vida Loca~RNQuote from HyperSaurus, SNThis is an interesting thread. This is something that I've started to worry about--what do I do if I see a pt pulseless or not breathing?
I think it's a pretty common worry, our first pre conference for hospital clinicals one student asked and just about everyone look relieved someone asked LOL. Our instructor was like, make sure they really aren't ok and hit the code button and be a fly on the wall and watch the process. She was like, don't go run and hide in a corner for the next few hours. Guess another student freaked out before and got scares and went and hid but forgot to hit code first :|
If you pull a code and your hospital is anything like mine (where you will have like 15 people in the room with machines and stuff in less then a minute, you can do stuff like move the tray table out of the way, walkers, chairs shove them all in the bathroom or something but try and help clear the room for everyone. That is what me and my friend did for one code.
- 1Apr 15, '10 by Mell BellQuote from ~Mi Vida Loca~OMG, they just left the room and hid!?She was like, don't go run and hide in a corner for the next few hours. Guess another student freaked out before and got scares and went and hid but forgot to hit code first :|
I am pretty scared about haivng to call a code as well. I have been on the hospital floor for only 2 clinicals, and I got home and realized that I don't even know what button to press if my patient codes. Nobody went over that with us, and I was too busy assessing and doing things for my patient to observe where the actual button is. First thing I do today will be to go in my patient's room and scope out the code blue button.
- 0Apr 15, '10 by That GuyCall someone like me into the room to start the thumping Seriously though like others have said, know the code status and do your ABC's. While if you pull the code button tons of people get running into the room, I HIGHLY recommend you participate in as much as you possibly can. It is a truly amazing experience and once you do it the first time, you are that much more comfortable the next time it happens.
- 0Apr 15, '10 by semester1kidi know that you need to know your patient before you get in the room - however, before i began properly working with a patient (this is our first clinical rounds in a long term facility), i was briefly introduced to him. at that time, i hadn't looked at a chart/mar yet and had no idea if he was a dnr client (in hindsight he's not). i did have the instructor with me, who seemed very aware of his status. but if, hypothetically, i was sent in alone just to introduce myself and found my patient in the condition being discussed in this thread and did not know his dnr status, would it be irresponsible not to attempt some cpr until someone on the code team came and notified me not to resuscitate?
according to what i know so far (yes, we're merely halfway through our first semester), rescusitating someone with a dnr order constitutes battery. would i be held liable in that situation?
- 0Apr 15, '10 by jsano19Quote from anticoagulationurseA - Airway (is there something stuck?)
B- Breathing - You already checked this, which is how you know they're not breahting
C - Circulation, check their pulse.
You obviously wouldn't start CPR if they have a pulse.
Well, not entirely true....they need to have an adequate pulse. Meaning, if their pulse is like 10 or 20 bpm, you'd most likely still start CPR. The same for once you defib someone, if they do happen to regain a pulse from the defib, you still continue CPR for 2 minutes, you don't just stop cuz they have a pulse....but this is all semantics.
But, here's my thoughts on finding that person not breathing:
1.) Ensure they are not breathing (try to arouse them, etc.)
2) Call for help (yell into the hall, hit the code blue, etc) --> Whoever comes should come with the defib, monitor, etc.
3) Use an Ambu bag to give 2 breaths
4) Check for a pulse
5) If no pulse, Begin compressions
I am pretty sure that even as a student nurse, it is still our duty to do CPR...We are all BLS certified. I personally performed CPR as a student, but never had to initiate it, but I was able to do it when the situation arose.
JeffLast edit by Silverdragon102 on Apr 15, '10 : Reason: pm to member
- 0Apr 16, '10 by ~Mi Vida Loca~RNQuote from That GuyCall someone like me into the room to start the thumping Seriously though like others have said, know the code status and do your ABC's. While if you pull the code button tons of people get running into the room, I HIGHLY recommend you participate in as much as you possibly can. It is a truly amazing experience and once you do it the first time, you are that much more comfortable the next time it happens.
See it would have been cool if we could have participated more but we were specifically told to be a "fly on the wall" and only help for things like if they need something from supply room. We have a very big response team to all staff assists calls and codes and as students that wasn't the time for us to be "taught" and for sure not get in the way. We were highly encouraged though to watch and do anything "simple". Maybe because we are new to hospital clinicals.
I got to be in the ED last night and stand in on a trauma, that was pretty cool too.
- 0Apr 16, '10 by MC1906Just like how everyone is saying...do this...do that....you will not find a perfect roadmap on what to do in every situation. One of the most important nursing skills--->Assessment. It's also good to validate what you find. If your a nursing student you may not have had enough experience on how to be confident with what you find.
I had this same situation happen to me as a RN...been practicing for about 2 months...and I hit the code button right away. (It causes no harm to have everybody go back to what they were doing if I was not correct and the patient was okay.....if I was right and didnt call right away..hmmm) The objective is to get help ASAP. The patient was not breathing and unresponsive so we started CPR right away....he lived!
The American Heart Assoication has the BLS for HealthCare Provider. Take that CPR course ASAP. If your in school and your doing clinicals and you hear a code being called, ask your instructor if you can go watch.