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Feel stupid for having BLS question (getting ambu bag ready first)

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Zithromax Zithromax (New) New

I'm a new RN nurse working in a med-surg unit.

I feel stupid because I had a question over whether in a hospital environment, you would start start assembling the ambu-bag after calling for help (which would arrive in seconds), versus starting compressions first since the patient would not yet be on a backboard and compressions on the soft bed may not be effective until the backboard on the code cart arrives.

I asked on Reddit/nursing (maybe I should have known better) and essentially got reamed for even asking.

Now I feel like I'm extremely stupid and/or a dangerous nurse for even having to ask... Am I just a moron? Am I dangerous?

I think it would be stupid of you *not* to ask when you have questions, especially a question about a code. I'm a new grad (haven't taken NCLEX yet), so I sympathize with how you feel--not wanting to feel stupid but also not wanting to harm a patient because I didn't ask a question when I should have. My new rule for myself is to always ask. In a while, I'll forget that I looked stupid anyway.

Do your hospital beds have the CPR button on the beds? Where it automatically firms up? At mine, the beds have that function.

Lev, BSN, RN

Specializes in Emergency - CEN. Has 7 years experience.

Start compressions after calling for help. The bed should have a "max inflate" button or CPR foot pedal (which will lower the head of bed and firm the mattress).

I thought all the CPR function did was immediately lower the bed to the lowest position and lay the patient out flat. I don't know if the one at our facility actually deflates the mattress as well.

Just to add to what the others said...our beds also have a removable headboard that can be placed under the patient.

Never be afraid to ask questions! :)

Double-Helix, BSN, RN

Specializes in PICU, Sedation/Radiology, PACU. Has 9 years experience.

Compressions to restore cerebral perfusion is the most vital aspect of CPR. Your patient needs those compressions far more than they need a breath. At the moment a patient codes, there is still enough useable oxygen in the blood stream that supplemental breaths can wait several minutes, but every second without circulation is critical. I would argue that compressions that may not be fully effective r/t lack of a back board are still more important than setting up an ambu bag. Especially when, as you said, someone will be along in less than a minute who can get the ambu bag.

Farawyn

Has 25 years experience.

No, you aren't a moron. The morons don't ask.

Welcome to AN!

[…]

I feel stupid because I had a question over whether in a hospital environment, you would start start assembling the ambu-bag after calling for help (which would arrive in seconds), versus starting compressions first since the patient would not yet be on a backboard and compressions on the soft bed may not be effective until the backboard on the code cart arrives.

[…]

Actually, I think that this is an excellent question. As Double-Helix stated the priority is to start compressions. If you have a CPR board readily available and can place it yourself without delaying compressions, then do so. Obviously, you need to be more aware of compression depth as the matress will allow some degree of compression, but you certainly can perform effective compressions without a CPR board.

[…]

Now I feel like I'm extremely stupid and/or a dangerous nurse for even having to ask... Am I just a moron? Am I dangerous?

No, you are neither stupid nor a moron, nor should you ever think that you are for asking a legitimate question. As Purple_roses stated, you would be stupid for not asking. Personally, I would rather someone ask me 99 questions, regardless of how silly they might think them, than not ask the one question that they should have, and their patient suffer an adverse outcome.

Although you have received some excellent advice here, I would caution your use of online message boards to ask questions and would suggest that they be directed to your coworkers, as this does two things. First, it demonstrates that you are not someone that thinks you know it all. Second, and more important in my opinion, is that it demonstrates the culture of the unit as to how willing your coworkers to answer your questions.

Best wishes as you start your new career, and never stop asking questions.

AJJKRN

Specializes in Medical-Surgical/Float Pool/Stepdown. Has 6+ years experience.

Believe me, every time I have started chest compressions on a Med-Surg floor it was done on a hospital bed with out a backboard in place yet.

Thankfully each time was successful enough for ROSC.

Each time I was either by myself or with one other team member and they were calling the code and running for the code cart. Usually when a patient goes pulseless (in my experience anyways) it's sudden and medical intervention needs to be ASAP.

Words to the wise...

Always treat/check the patient first though and not the monitor.

CelticGoddess, BSN, RN

Specializes in Palliative, Onc, Med-Surg, Home Hospice. Has 6 years experience.

You start compressions. When the crash cart arrives with additional help, then you worry about the ambu bag. I know the beds at the facility I work at have a CPR lever (or button). It makes it a bit easier to do compressions until you have help and the back board.

And no, you are NOT dangerous. You are new. You are asking questions, which is a good thing. The only way you are going to learn is to ask questions. A nurse who doesn't ask questions when she doesn't know the answer, that is a dangerous nurse!

The only dangerous/stupid question is the one not asked. Keep it up!

Here.I.Stand, BSN, RN

Specializes in SICU, trauma, neuro. Has 16 years experience.

I assemble the Ambu bag when I enter the room and do my safety check. If there's an unused O2 flow meter there, I attach it to that and hang the bag from the wall hanger. In the event of a respiratory arrest, I won't want to waste time assembling the bag.

As far as a cardiac arrest, you start compressions as soon as you hit the code button or yell. Even if it's a regular bed, the pt can't get more pulseless. Compressions on a regular bed might not be ideal, but doing nothing WILL deprive that pt's brain of O2.

If you have questions, YES you need to ask! I'm sure the nurses on Reddit had some "silly" questions when they were new, too. Give yourself a break. ;)

meanmaryjean, DNP, RN

Specializes in NICU, ICU, PICU, Academia. Has 40 years experience.

No, you aren't a moron. The morons don't ask.

Welcome to AN!

^^^^^^^ This x 243,602,402,865

Your question is a good one as it can be confusing, especially since we have always been told "ABC's!" So, everyone is correct; if someone is pulseless call for help/call a code/ and start CPR immediately. When another set of free hands get there you can roll the patient and get the board under them. As soon as the cart gets there attach the monitor and start searching for a shockable rhythm. RT will probably be there by then to start bagging the patient. If not, someone who's not doing CPR or attaching the monitor & dealing with the defibrillator can start managing the airway and bagging the patient. Obviously, that's if the unresponsive patient doesn't have a pulse. If it's Little Granny who had too much Dilaudid who decided to stop breathing (but has a pulse), then calling for help/calling a code and getting the ambu bag first would be appropriate (as well as getting some Narcan). :) And as everyone also said, those nurses on Reddit were wrong. What weird-o's. Thinking things through before something happens is always a good thing.

audreysmagic, RN

Specializes in Psych, Peds, Education, Infection Control. Has 15 years experience.

And as everyone also said, those nurses on Reddit were wrong. What weird-o's. Thinking things through before something happens is always a good thing.

If people think we're harsh on AN sometimes, they REALLY need to go to Reddit for a wakeup call. I've never had a particularly great experience there...

To OP - welcome, and definitely don't be afraid to ask questions! And, to echo others, even less-than-ideal compressions beat no compressions.

Someone told me today that there were no stupid questions. (I had just asked one). I laughed and told her that of course there were but I still needed the answer and everybody is stupid sometimes.