Code blue questions

[SimpleNewGrad]

Hi. I'm a new RN. First ever participating on a code blue I was not the primary nurse for patient.

Anyways my question is,

While we're doing acls for patient, large amount of Dark-brown discharges was coming out from Oral while doing the code. We filled the auction container right away.

What are those dark brown discharges?

When do MD think it's time to intubation the patient? It felt like forever until we incubated the patient.

I know pt was a dialysis patient and hadn't have dialysis for awhile.

Thank you.

[TheCommuter, BSN, RN]

What are those dark brown discharges?

I don't know what the discharge was since I wasn't there to smell it, but I'll conjecture it was probably old blood that had changed colors due to the amount of time spent in the upper GI tract.

[SimpleNewGrad]

I don't know what the discharge was since I wasn't there to smell it, but I'll conjecture it was probably old blood that had changed colors due to the amount of time spent in the upper GI tract.

Thank you. I'm trying to look for answers online.

Clients status changed so quick from rapid response. Client unresponsive but eyes open and dilated w/ pulse to code blue. Client was still speaking this morning. -_-

[nurse.ethel.RN]

My guess would be blood or bowel. His status changed quick but Im willing to bet once his stomach muscles relaxed everything came up.

[calivianya, BSN, RN]

Likely it was feces. I have coded people with bowel obstructions multiple times and the same thing always happens. If it was blocking up in the gut, it's going to go out the path of least resistance once you start doing compressions. Ugh. Nothing worse than the whole room smelling like feces-vomit during a code.

In report it sounds so innocuous. "She's very unstable and probably won't last the night. Oh, and she hasn't had a bowel movement in 9 days. She is getting tube feeds at 60ml/hr and she hasn't had any residuals so far... so I guess it has to go somewhere soon..." Uh huh. That never ends well.

In this case, the patient should have been intubated don't-pass-go-don't collect-$200 immediately, because large amounts of stoolvomit coming out the mouth make it pretty obvious that you didn't have a clear airway to ventilate the patient. The MD should have made the decision to intubate immediately upon the first sign of any vomitus coming out of the mouth, IMO.

Otherwise, if the airway is clear, waiting can be the best decision. Intubating a patient takes time and interruption of compressions. Just about any interruption of compressions for any period of time reduces the chance of a patient getting a pulse back, so if the patient is not vomiting and you're actually seeing chest rise, it's safe to wait until the code is over to intubate the patient.

[RunninOnCoffee]

I agree with the above poster. My other thought was also if the pt was not intubated that meant you were using a bvm. In doing so probably blew a large amount if air into the abdomen. This combined with compressions caused the pt to vomit. Just responded to an ugly code last week where this happened.