Cna code blue protocol

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Specializes in Geriatics.

Hey I've been a CNA for about 4 yrs. working in long term care. I work 3-11 and I was making my last round at about 10:15p, when I walked into a pts. room to provide care to him. I called his name but he didn't answer so I walked to his bed to see that he wasn't breathing. I also listened for breathing and checked his pulse and got NO response. My first thought was FULL CODE or DNR I usually have this memorized but he was a new pt. so I wasnt at all sure. So I screamed into the hall for the charge nurse....no one came. So I had to make a QUICK decision...look for the nurse or try to save this man's life. So I ran to the Nurses station pulled his chart and saw "FULL CODE" in red letters. I picked up the intercom but couldn't use it because someone at another nurses station hadn't hang it up from the last page. So I sprinted down to the pts. room with the crash cart, turned on the call light and dragged him onto the floor and started CPR I was screaming into the hall during the chest compressions, about 2 mins later another CNA ran into the room, I screamed go and get the nurse. In about 30 sec later every nurse and CNA in the building was in the room. My charge nurse took over, his oxygen level got up to 94 and EMS came and took him away. He later died at the hosp. But that next morning I was called into the DON's office for what I thought was gonna be a "good job" speech but she actually wrote me up for "not following protocol" she explained to me that I should went and found the nurse before I took matters into my own hands. I explained to her that I could NOT find anyone and I also couldn't page because of the intercom malfunction. I'm CPR certified so thats why I did what I did.....was I wrong what is the protocol at other facilities PLEASE let me know.

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In my LTC facility, regardless of whether or not a CNA is CPR certified, they are not to initiate CPR. For that matter CNA's are not allowed to participate in a full code thats on-going. As a matter of fact, no one in the facitlity other than RN's and LPN's can initiate CPR or participate in the code.

I'm sure you did the best you could under the circumstances. I hope the DON takes that into consideration and you aren't formally reprimanded for what you did.

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Regardless of what your boss says, good job. I probably would have done the exact same thing you did in that situation.

I have only worked at 1 LTC facility where CNAs were allowed to participate in codes; they were allowed to ventilate but not do compressions. Everywhere else I've worked, CNAs were not allowed to do more than go and fetch the AED, Ambu-bag, etc. (big whoop), regardless of CPR certification status.

I think it's totally silly. I have worked with many nurses who disappear for long periods of time and others who flake out easily ("Like OMG!! Is that guy really dead?? Do you think we should do something?? OMG!!"). We shouldn't have to withhold resuscitation just because we get stuck with someone who doesn't let us know where he/she is going or someone who freaks out at everything.

And not all of the nurses I work with are even CPR certified. It's terrible to think that I would have to let someone die (even though I am the only person on the floor "certified" to save him/her) just because I don't have a few extra letters behind my name. I think anyone who knows what they're doing and has the paperwork to back it up, regardless of title, should be allowed to help out.

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I commend you for what you did, I know i would have done the same thing. I think that it's so stupied that we as cna's are the ones who are always there with a resident, we know more about that resident then anyother staff that works at the ltc. hell you could go as far as we get attached to our residents because we spend so much time with them. But when the resident codes we have so sit on the sidelines while the nurse's are too busy gossiping about who knows what and will get to you when they decide to. ( I mean it's not like we sit in the hallways or in a residents room yelling NURSE at the top of our lungs for **** and giggles).

At the LTC that i work at we are allowed to do just that ASSIST, the nursing team, which is alway run and get this this and this and while your out there getting said things can you stop and call for the ambulancetoo if you get a chance.

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I have worked in LTC for 1 year and was not allowed to touch a code patient.

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Well done, I think you did a good job. what else were you supposed to do, let him die?

I work in a hospital and we are allowed to do chest compressions, ventilate and squeeze fluid in if we can't find a fluid-squeezer thing (the name if it's escaping me right now!). I have no idea what its like in LTC, but AFAIK, the LTCs here are staffed by 1 RN and carers, there is no way an RN could do it alone.

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And not all of the nurses I work with are even CPR certified.

Where do you work?! As in what State? Remind me never to travel there!

Every single facitilty I have ever worked at (previously as a CNA and currently as an LPN) nurses have to hold ACTIVE, CURRENT Healthcare Provider CPR as a requirement for employment.

Any facility/hospital I have looked into all have the same thing, current, active healthcare provider CPR as a requirement for employment

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Every single facility I have ever worked at (previously as a CNA and currently as an LPN) nurses have to hold ACTIVE, CURRENT Healthcare Provider CPR as a requirement for employment.

From what I've seen at the places I've worked, nurses have to be CPR certified in order to be hired, but not to maintain employment. I've seen some people be pretty lazy about getting theirs renewed.

When I was a CNA student, my instructor certified us in CPR before we even started clinicals. I went to a LTC facility for them and one of the nurses said, "We'll come and get you if this guy (a resident) starts to go south. I'm pretty sure you're the only person in the building that's CPR certified." ...and then she laughed!! :eek:

To this day I have no idea whether what she said was a joke or not.

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Specializes in geriatrics, dementia, ortho.

OMG that's crazy to me that CNA's aren't allowed to help with a code. At my AL facility, everyone (dining staff, housekeeping, office staff) is expected to help in an emergency; this includes starting CPR until someone from nursing staff can get there. That totally sucks for the people who've requested a full code and are expecting to get one in a timely manner while living in a healthcare facility. Eesh.

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OMG that's crazy to me that CNA's aren't allowed to help with a code. At my AL facility, everyone (dining staff, housekeeping, office staff) is expected to help in an emergency; this includes starting CPR until someone from nursing staff can get there. That totally sucks for the people who've requested a full code and are expecting to get one in a timely manner while living in a healthcare facility. Eesh.

It's the same here. EVERYONE, including the catering and admin staff are CPR/emergency trained in case someone collapses in the canteen or hallway and there is no nurse immediatly available.

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Check with your state cna licensing agency i believe that you will find that had you not started cpr on that patient you would be held liable for witholding care. if that is the case in your state take a copy of the writeup and fax it to your state licensing agency after informing the don and put in your resignation as that facility is in for a fat lawsuit with an future codes that expire due to their policies. one thing though never leave the patient to check a book about code status, that break in compressiins and ventilation can be the difference in whether they come back in decent condition or with brain damage due to hypoxia. i personally wouldnt want to make it back without all my faculties. but great job otherwise. if the patient had been dnr compressions could have been d/c when nurse arrives.

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Specializes in IMCU.

Ridiculous.

Well done to you.

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