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Discussion

CPR questions

A question regarding CPR. If a patient faints in the hospital or LTC, and a nurse is present, do they immediately call the doctor, or does both (call doctor, and perform CPR). Do they perform CPR mouth to mouth or use some sorta other equipments?

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    The first thing to do when someone falls down unexpectedly is to assess unresponsiveness. If they don't come around when you shout in their ear and pinch their trapesius muscle, you'd call loudly for help and then check for a pulse. If there's no pulse then you'd start CPR. Bystanders are now being taught only to do compressions at a rate of 100 per minute. Health care professionals may use a barrier device to do mouth-to-mouth if available, while waiting for a bag-valve-mask resuscitator. But if all they do is compressions while waiting for the BVM, nobody would fault them. I have a barrier device in my purse, but if I'm at work, I don't tote my purse around so I wouldn't have one with me. I work in a huge hospital that fortunately has BVMs and automated external defibrillators strategically located all over the building and crash carts on several floors.

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    It also would depend on the patient's code status.If a patient is a DNR you wouldn't do anything if they were in cardiac arrest.

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    It also would depend on the patient's code status.If a patient is a DNR you wouldn't do anything if they were in cardiac arrest.

    Wouldn't you just start CPR until told the pt was DNR? If you don't know the code status, you assume they are full code until proven otherwise...at least, that's how it is where I work (not LTC).

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    Yeah I guess you would if you didn't know.On the floor where I work it wouldn't take long to check their status and call off the code.It does happen that way but those of us who work on the floor pretty much know who's a code and who's not(most of our patient's are DNRs)

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    loriangel14...

    do you work as in LTC or in hospital?

    janfrn.....Have you ever performed direct mouth-to-mouth resuscitation, or do you only perform compressions while waiting for BVM?

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    In my hospital "no codes" wear purple bracelets. No purple bracelet? You get the code blue call. I work acute care.

    Wouldn't you just start CPR until told the pt was DNR? If you don't know the code status, you assume they are full code until proven otherwise...at least, that's how it is where I work (not LTC).
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    I work in a hospital.

    Actually our patients have a symbol that denotes a DNR.It is on the spine of their paper chart,and is on a little card above the bed,as well as on their ID bracelet.

    We only do compressions until the crash cart arrives and then we use the ambubag.

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    I HAVE done direct mouth-to-mouth resuscitation, but it was 40 years ago and was part of a lifesaving course I was taking at the time. Having said that, in our annual updates for BLS as health care providers, we're told that without a barrier device we are not to perform mouth-to-mouth.

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    I work in a LTC facility in NY. We just recently had a code on our rehab unit. We have "crash carts" - without drugs, IV's etc... but it does contain BVM's, oral and nasopharengial airways, oxygen, paperwork, gloves, suction, AED etc.... We call a "code blue", once checking for responsiveness if none, we begin CPR. Someone calls 911, and we continue CPR until EMS arrives and they take over. We are not allowed mouth to mouth, but since we have ambu bags and masks, it's not necessary. As a former critical care nurse, it is very difficult for me to work a code in a LTC facility. I want to get that IV, give EPI, Atropine, blah, blah, blah.... it's sort of like nursing with your hands tied behind your back. It's an adjustment for sure. BTW, he didn't make it. It wasn't a wittnessed code, but in MHO, they should never have started CPR in the first place, as he was dead, dead - he had dependent lividity and was cold to touch. He must have died about an hour before being found, because he was seen eating dinner in the dining room an hour before, he had to have crashed within a few minutes of returning to his room.

    '

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