Seizure code blue

  1. I'm one year into nursing and the other night I had my second ever code blue, my patient seized and O2 sats fell to the teens, HR skyrocketed, she was apenic and blue. I called a code, and all I could think about was respiratory support. I immediately grabbed the bag mask to start bagging but her sats started coming back up and the seizure stopped. The code team finally got there and she was fine again.
    I didn't even think to make someone grab Ativan because all I was thinking about was that she stopped breathing, so I was so focused on respiratory support, I completely ignored the cause: the seizure. I feel so stupid and like I totally screwed up... the scariest part was that I was alone in the room the whole time because by the time the code team/docs/staff got there, he was recovering ������
  2. Visit stacylethani profile page

    About stacylethani

    Joined: Dec '14; Posts: 50; Likes: 16
    from WA , US

    15 Comments

  3. by   Triddin
    You wouldn't have been able to give the Ativan without an order. You did well. You prevented a respiratory arrest. Don't be so hard on yourself. In fact, celebrate that you were level minded enough to bag a patient when they turned blue. I know after every code, we debrief and talk about what we could have done better, which is a tool to help us improve for future codes. In my opinion, sending someone to get Ativan would fall under this category. It's not that you did wrong, but an FYI for the future
  4. by   bugya90
    Sucks that you were alone for so long with the code. When we have any code on our floor everyone responds. Even our floor housekeeper will come to see if she can get us anything or get the family out of the room. Might be a suggestion to bring up during the debrief to see if that workflow could be changed so no one is alone after a code is called.
  5. by   cleback
    Why did no one else on your floor check in when they heard the code paged? Thats crazy. You were alone. You did the right thing by attending to their respiratory status.
  6. by   brownbook
    You did great. Seizures alone don't kill anyone. Not breathing, low oxygen, does kill.

    As to you being alone. I hope the time between calling the code and the team showing up was a matter of very few minutes if that.

    Time can be so disorted At an ACLS class the instructor had us wait, do nothing, for three minutes. About 30seconds went by and we we're all squirming in our seats.... certain it was time for another dose of epi.

    Have you ever clicked on a video and an advertisement is showing with a count down clock, "you can skip this ad in 30 seconds". After about 10 seconds I'm already impatient.

    I hope something like that is what actually happened.
  7. by   Horseshoe
    Quote from stacylethani
    I'm one year into nursing and the other night I had my second ever code blue, my patient seized and O2 sats fell to the teens, HR skyrocketed, she was apenic and blue. I called a code, and all I could think about was respiratory support. I immediately grabbed the bag mask to start bagging but her sats started coming back up and the seizure stopped. The code team finally got there and she was fine again.
    I didn't even think to make someone grab Ativan because all I was thinking about was that she stopped breathing, so I was so focused on respiratory support, I completely ignored the cause: the seizure. I feel so stupid and like I totally screwed up... the scariest part was that I was alone in the room the whole time because by the time the code team/docs/staff got there, he was recovering ������
    Nope, you didn't screw up. Your priority was respiratory support. And that you did!

    Think of this as an NCLEX question. You priority in this situation falls in what order? You KNOW you would choose airway first over Ativan.
  8. by   CelticGoddess
    Quote from stacylethani
    I didn't even think to make someone grab Ativan because all I was thinking about was that she stopped breathing, so I was so focused on respiratory support, I completely ignored the cause: the seizure. I feel so stupid and like I totally screwed up... the scariest part was that I was alone in the room the whole time because by the time the code team/docs/staff got there, he was recovering ������
    Don't feel stupid, you did the correct thing. YOu provided respiratory support to a patient who needed just that. It's nuts that you were alone until the code teamshowed up. Sorry that happened to you. LIke a previous poster said: the seizure itself won't kill the patient, but the not breathing will. And very fast!
  9. by   KelRN215
    Most seizures stop on their own without Ativan. You did fine. Rescue meds aren't typically given until a seizure has been ongoing for 5 minutes. It probably hadn't been that long since the seizure ended by the time the code team arrived.
  10. by   Here.I.Stand
    You didn't screw up -- you were by yourself, and the underlying cause is secondary to anoxia. Had it become a status epilepticus situation, the MD or code team leader could have ordered the Ativan -- WHILE someone is bagging. But because YOU immediately saw the pt's need for O2 and acted, that pt recovered before the code team even arrived.

    You may well have saved his LIFE, and definitely saved his brain. You did great, Nurse.
  11. by   JustBeachyNurse
    You did the right thing. Airway, breathing, circulation are all vital to life continuing. Ativan isn't even always the drug of choice and only for seizures >5min. No order = no Ativan.
  12. by   psu_213
    Quote from stacylethani
    I didn't even think to make someone grab Ativan because all I was thinking about was that she stopped breathing, so I was so focused on respiratory support, I completely ignored the cause: the seizure. I feel so stupid and like I totally screwed up... the scariest part was that I was alone in the room the whole time because by the time the code team/docs/staff got there, he was recovering ������
    It is (almost?) always the right thing to think ABC before treating the underlying cause. If you don't breath for them, it is not going to matter how much Ativan you give the pt. You did a great job!

    The real thing you need to ask is why you were alone? When they heard a code called, why did basically the entire unit staff not descend on that room? I would work with you unit leadership to determine how to prevent that from happening in the future. Of course there are times when other nurses can't leave their patients, but why did no one else respond? I think that would be a great project for the future for your unit--and you get a lot of bang for your buck--not really a "hard" project, but you can really show how you are working to make a positive change for the unit. (Also, if no one else responded, who was going to get the Ativan anyway? )
  13. by   markko
    You get just fine. You just do the best you can until help arrives and that seems like it takes forever sometimes.
  14. by   nrsang97
    You didn't screw up. You did the right thing. Good work.

close