i am an administrative RN at a ltc facility. i'm still a fairly new nurse... had clinical at a huge level 1 trauma center... saw codes all the time there. well at my ltc facility, our crash cart consists of an O2 tank, some tubing, an oral airway, suction machine with suction catheters, a backboard, etc. it is my understanding that in my state there must be a difibrillator anywhere that cardiac arrest may occur once a year or something like that. clearly, we have residents arrest several times a year, so why don't we have one?
what's your crash cart like at your facility?
also - how to you check the code status without running back to the nurses station. if my patient is a full code, i have to run back to the nurses station which is at least a 2 minute RUN back and forth. that's valuable time! and on night shift, we only have 3 nurses working, you're lucky to even get help. i'm terrified of a code on 11-7. luckily all the ones i've had have been during the day when lots of us were there.
Jan 21, '12
We have 3 AEDs for the building. We grab them and run if someone calls a Dr. Blue. The crash cart is pretty basic. I wish I could help with identifying the code status. We've tried different colored dots on the charts, tags on the door jamb, hearts on the name bracelet. Nothing works 100% of the time. We joke about having DNR tattooed on an inconspicuous place!
Jan 22, '12
My current facility does not have any AED's in the facility. They did not even have a "crash cart" setup when I arrived. That got fixed quick. It's pretty much as you describe but crazy to think they didn't have everything setup in one central location.
Our company policy is to have blue arm bands on everyone who is a full code. This is suppose to be checked every shift but it would be niave to believe this really happens. Luckily it is a quick dash to the nurses station from every spot in my building.
Jan 28, '12
we have crash carts on all the units (O2, suction, gloves, etc). we have an AED centrally located in the building. Sadly, we do not have a plan in place to identify exactly who is Full code and who is DNR/DNI.
Jan 30, '12
We have an AED and a basic crash cart. I actually have used it many times now, but I have to tell you, AEDs shock when they detect v- tach or v- fib, thats it. It doesn't shock for asystole, it just tells you to continue CPR. Its nice because our rehab unit does have many younger residents, but the likelihood of it assisting a little old lady or gentleman is slim.
Jan 31, '12
We put a heart on the door jam and a heart on the spine of the chart. The CNA cue cards also state the code status. The resident also signs an emergency sheet that states their wishes which is in front of the chart.
Jan 31, '12
Trouble is....suppose you find them away from their room? My resident don't wear name bracelets and my campus is huge.
Jan 31, '12
My campus is not huge... 120 beds. We are not allowed to put bracelets on... dignity issue.
Feb 3, '12
thanks for all your comments! we have had our annual survey this week, been very very busy! but we did better this year than last year and that's always the hope, right?! i'm glad to know that we are not the only ltc facility without an AED. it stressed me out at first. but now i realize i'm not alone!