CPR on the floors

[Sallysame]

Hello fellow nurses!

It's always busy busy time for us but I wanted to take a few minutes to share an experience.

Last week I came into my shift on a med/surg floor and right after report, the PCT came to get me that the patient had inadvertently extubated himself. We called a code and within minutes everyone was in the room and the patient safely reintubated. I sound very calm telling you the story but during those few minutes, I felt a pang of panic and quite petrified.

I was wondering if you'd be willing to share your experience. Do you feel that regular renewal of the BLS prepares us on the floors to act during those first few minutes?

Thanks and keep up the good work!

Sal

[AZQuik]

Sorry, but I deal with a lot of codes, and people freeze. It's not a matter of "oh I've been trained, CPR is pretty simple, I got this" people that say it's that simple are not being truthful.

Don't beat yourself up, figure out what you can do better next time. Replacement ready? Bag valve mask where it needs to be, code cart ready? Etc etc.

Had a pt seize after getting "too sober" I inherited her and had her for two hours while she was sleeping in the Ed. The adult bvm kit was there, but someone had opened it from the back to remove the mask. Hence no adult bvm in a room on an apnic seizing pt. oh yeah, I was on lunch. You think that nurse who lunched me let me have it? Of course she did. M

When I said I checked the room and saw the bag hanging there she backed off.

Guess who checks every bvm bag to make sure "it's all there"

Learn, get better, move on.

When people are DEAD it's difficult to be at the very top of your game.

Edrn regional lvl1 trauma/stroke/heart/whateveruo'ded on ER.

NOBODY is a rockstar in their first,second,third,fourth.......code

[Here.I.Stand, BSN, RN]

Pt "decannulated" himself. You may have done better than you think you did; those seconds draaaaaaaaag in moments like those.

[RNbubu]

I have had a couple of vent dependent patients who had their trach removed inadvertently. Thankfully i did not have to call a code on them, I just bagged them until RT or ENT MD arrived and reinserted the trach. In my unit RNs are not trained on how to reinsert the trachs, we are only trained on what to do in case it comes out.

We are all ACLS certified in my unit so if I call a code my co-workers are expected to drop what they are doing and come help me run the code. We do have a code team who will arrive fairly quickly granted there are no other codes happening at the same time. They will take over and the primary nurse will obviously stay.

We have mock codes - scheduled one and surprise ones - that are videotaped, and then the nurse edicators give us feedback on what we could have done better. Besides the ACLS classes we are also offered classes in simulation labs when all we do is run or assist on all kinds of codes.

Despite all the training and support, I always feel scared in a code situation. I have not been in that many codes, thankfully. The panick is always there though, despite all the support.

[irishicugal]

Every trach pt, whether on room air, or a vent, should have a set of tracheal dilators above the bed, and trach tubes of the same size and one smaller to hand. This should be part of your bedside assessment at the start of shift. If you have regular trach patients, ask to attend a tracheostomy study day. You can't always wait for doc or RT to put it back in, you need to learn how to do it yourself!!

[FloatRN19]

I work in a level one trauma center, we code frequently and we don't have a code team.

The first time doing compressions on a person, it was weird for the first couple seconds, but then that disappears quickly.

Just remember to throw your stethoscope down and take anything off your collar and out of your breast pocket.

I always throw my watch timer on so we can get a good rotation going.

Last one I was in we actually coded the patient three times that night. Left that night extremely sore and tired...also sweaty.