Awful night... (vent)

[jbp0529]

I've been involved in more codes than I can remember, but tonight was a first for me.

I was coding one of my patients, when my other patient in the next room began to code also!! What are the odds of that.

The first one was a lady who had been sick for a while, who had multiple complications after her cardiac surgery + sepsis. She went from VT to PEA, to VF, was shocked multiple times, epi/atropine, amiodarone, yada yada. Got her back with an idioventricular rhythm and arterial bp in the 50's. Told one group of docs to call her family to come in, wasn't looking good.

The other pt was post cath from a huge anterior wall MI, who was extubated and weaned off pressors and his IABP earlier that day, who suddenly dropped his pressure and became unresponsive out of the blue, SB to PEA; he bought a tube again, put him on an epi drip, levo, dopamine, + 6 liters of fluid through our rapid infuser + 2 units of O neg; transcutaneous paced in the 90's bc of 3rd deg heart block after all was said and done. Echo'd him at the bedside and r/o'd septal wall and valve rupture, thought it was a retroperitoneal bleed. Hematocrit dropped from 40 to 15 (labs sent before all the fluid).

Spent roughly 2 hours or so running from one room to the next while the other nurses I work with all divided up between the rooms and ran the separate codes. Thank goodness we had a strong and experienced crew tonight.

Of course ER was trying to send us a pt during all of this. Couldnt accept the patient. Told them the unit was too unstable at the moment.

End result at 7 am was the card surgery pt died, family made it in to see, and was howling and screaming in agony. The cath pt next door was barely alive, with a bp in the 60's, nonreactive pupils, gasping-like breaths/mouth movements on the vent, being rushed for exploratory surgery. Silly docs wanted the day shift to take him for a stat CT abdomen/pelvis before, though. Yea right, he's really stable for that, we'd love to do it. He'll probably code again on the table in OR. If he makes it, seems like he might have permanent neurological damage.

Good thing the oncoming shift didn't ask me if I had bathed either of these patients. Might have been a 3rd code up there, with a day shift nurse on the floor lol

Sometimes this job really sucks.

[BBFRN, BSN, PhD]

I am so sorry for you- yuck! Sounds like you handled it very well, though.

[Sabby_NC]

My goodness my hon I am so sorry you went through such an horrific night.

You sound as though you literally had your finger on the pulse but I am exhausted from just reading what you went through.

I hope you managed to get some good rest and have some days off to recouperate.

Good job, thumbs up to you indeed. :up::up::up:

[canoehead, BSN, RN]

We're going to have to write you up for not doing those baths, buddy. A little time management, please?

[txdude35]

We're going to have to write you up for not doing those baths, buddy. A little time management, please?

Hmmm... I think I work with you...

[YellowFinchFan]

I've been involved in more codes than I can remember, but tonight was a first for me.............

Sometimes this job really sucks.

What a horrible night - worst nightmare situation. I've worried sometimes about 2 codes at once - it's not that hard to imagine.

The family's shock and grief is always sobering.

((( hugs ))) you did the best you could!

[BBFRN, BSN, PhD]

We're going to have to write you up for not doing those baths, buddy. A little time management, please?

:rotfl: And don't forget your mouth care. I hope you did all you could to prevent VAP in your patients. :rotfl: