Which nurse called it?

[garciadiego]

90 yo male is no code, he stops breathing, Nurse A says call a code, nurse B says don't call a code. Which nurse is correct?

[caroladybelle, BSN, RN]

Most floors have a code cart from which to get supplies. Thus no need to call a code to get supplies.

There are many different levels of "code/no code" as well as "comfort measures" patients. In some cases, RT might be called to provide better/different options for optimizing oxygenation.

How was the pt found, did they have a pulse or spontaneous respirations, or were they no pulse/no resp?

The answers to your OP are dependent in these details.

[icuRNmaggie, BSN, RN]

Let him go peacefully.

That means no code as per his wishes.

Is this a homework question?

[SWM2009]

If he's no code then nurse B was in the right. Am I missing something? The answer is pretty straightforward based on the info OP gave. You don't call a code on a no code.

[psu_213, BSN, RN]

"No code" is a pretty imprecise term. I don't know how it is in every hospital, but where I work, there are varying levels of "no code." Some patients choose "drugs only" in arrests; some choose every intervention except intubation. Some choose nothing at all. Generally though, "no code" is not used.

[motherof3sons]

If the resident was a DNR that means do not resuscitate which means to me no ambu bag, no cpr, no intubation. I would not call a code and make sure the resident was comfortable.

How ever---there are different levels of DNR---some have very specific guidelines and those need to be followed.

[CapeCodMermaid, RN]

Our advanced directives can get pretty specific:

DNR

DNI

No hospitalization

No feeding tube

No IV

In reality, I've never seen one in which the resident was just a Do Not Intubate

This is the precise reason the MOLST is so important. It spells out in detail what the person does and does not want done to them at the end of life.

[garciadiego]

What do you think should be done, if anything?

Put an airway if need be.

[kbrn2002, ADN, RN]

From the info given in your question, Nurse B is correct. No code, so do not call a code or initiate a code. If we had more information the answer might be different. Is there an advance directive in place? How specific is it for what the pt wants and doesn't want done?

If a code is initiated for a pt that very clearly states no code, no interventions if respiration and/or pulse stops I can see a scenario not only ripe for a civil lawsuit but possibly criminal assault charges as well.

[morte, LPN, LVN]

I think the problem here, is that the OP clearly didn't state the patient was with out pulse, do we let a person die of suffocation?

[ktwlpn, LPN]

"No code" means no code, no bagging,no airway.