Codes in outpt HDU's???

MJB2010 · Jun 8, 2011

We are not ACLS certified, and our code cart has meds but only the Physician can give them if they are present during a code. They never are. The physician makes rounds once a month, their PA is supposed to round once a week but we rarely see her. She does pop in on occasion but doesn't actually do anything.

I check the code cart every morning to make sure the aed works, the suction works, and there is o2 in the tank.

I do not feel comfortable with codes, did a mock code once during initial training was told we do this once a year. All they did was read the scenario to us, we did not actually DO the mock code. I wish we had. I have not participated in a code yet, but they do happen at my clinic occasionally.

We are a small clinic, there at times is very little staff, and it would be difficult to code someone with only 2 staff present. One needs to call 911, other grabs the code cart. Yikes.

Trauma Columnist · Jun 9, 2011

Wow!

Well first I'm one of 4 mid-level providers (PAs, NP, CNS) that do dialysis rounds and I go to four dialysis units within a 65 mile radius of my home and I see pts every single week and I'm at each dialysis unit at least twice/week or more.

My units are big and small:

32 chairs - 140 pts

10 chairs - 40 pts

8 chairs - 30 pts

5 chairs - 15 pts

I've been doing this for 5 years now and have codes at least 2-3 times/year when I'm present, let alone the number of codes where I'm not present.

Thanks for the info.

MJB2010 · Jun 11, 2011

I wish you worked at my clinic!

Trauma Columnist · Jun 11, 2011

Lol..

3cdn1usa · Jun 12, 2011

The last code I was involved in seemed to be textbook. Everything went exactly how it should. AND had a good outcome. He walked in got his bp cuff on, standing pressure good....then BAM full cardiac arrest. Had a wonderfull knowledgeable team. Even the other pts complimented on how well we handled it. Still, don't want to do it again.

We do a mock code quarterly. Probably why we all knew our role, what to do and how.

ldyjstce · Jul 1, 2011

At my clinic (30 chairs) all nurses are required to be BLS and ACLS certified. All PCTs are required to be BLS certified. A code sheet is made out weekly (sometimes daily) as to who does what in the case of a code. Since I started 8 months ago we have had 1 full code and 1 partial (respiratory arrest for appx 15 sec / cardio was fine). We all acted as a team should. Some of the younger staff were "frozen" but everything was done in a precise and proper manner.

rogosin123 · Sep 25, 2015

Does anyone have an algorithm for doing a mock code in an outpatient dialysis unit?

AcuteHD · Sep 26, 2015

The outpatient clinic I was at (12 chairs) was pretty much how MJB2010 described above, except in the 2+ years I was there we NEVER got a mock code, not even as basic as that.

GeauxNursing · Nov 17, 2015

I have been at my clinic for 10 years now, and there has only ever been 1 code. And I was there that day. It went pretty smooth. EMS came QUICK. I'd say the LVNs that day ran the code, the RNs were clueless. (I'm an LVN, I was doing crowd control, making sure other patients were ok).

We don't do mock codes. There has been talk of it over the years, but never seen it happen.

Chisca, RN · Nov 17, 2015

There never seems to be time for it but post code reviews help clarify what could have been done differently. Clearly defined roles, who is recorder, who is pushing meds, who is managing the airway, also help.