How to perform CPR on a hospital bed?

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Specializes in Progressive Care.

I'm a new grad who has been working on a tele floor for 6 months and I love it. This is something that I've been wondering about and have been kind of embarrassed to ask. How do you go about performing CPR when the patient is on a squishy hospital bed? I know you use the CPR button on the bed to make it flat and you have to put the hard board under the patient, but how do you do so in order not to waste precious seconds? Do you make the bed flat and start CPR while someone runs and gets the board (and the crash cart, etc.) or is it useless to start CPR until the board is placed because the bed is too soft? I guess I'm looking for the proper "steps" (still being a task oriented new grad and all!). Any other possible issues I may run into? I've never done CPR but I want to make sure I'll be effective if I do, since CPR classes seem to assume you're a first responder on a scene, not a nurse who heard the monitor go off. Thanks!

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Specializes in Emergency Nursing.

The last time I had to respond to a code on the floor (I work in the ED and we used to have to send an ER doctor and nurse to assist with codes throughout the whole hospital) the person coding was laying on the floor. So we started compressions there, the patients IV went bad so our ER doctor got an EJ going while the patient was on the floor. Then after we got the crash cart we put the board on the bed first and lifted the patient onto the bed.

You're always better off to start compressions than to stand there not doing anything. So IMO, I would lay the bed flat, make sure someone was coming with the crash cart and start compressions. Then get the board under the patient.

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Specializes in Telemetry.

When my old hospital got new beds, the headboard pulled up and out and was used as the backboard....no need to wait for the crash cart to start compressions....was kinda nifty....

The worst is when someone codes on the toilet. Ugh.

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Specializes in OR, Nursing Professional Development.

Our beds have the removable headboard that is used. Since the code team and major crash cart come from ICU, waiting would pretty much assure death. We also now have the Lucas II, which comes with its own backboard as part of the mechanism, but we don't wait for that to arrive either.

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Start compressions right away, even if no hard board is available. On my (unmonitored) floor we would "find" our coding patients rather then seeing their unstable rhythm first. Most of the time I dont even think a hard board was used. I believe our already thin mattresses deflate once you press the CPR button. The most important thing to remember is to just start compressions and call for help! Others will come and bring supplies to you. Once I entered a code and noticed the bed was still up around 45 degrees. The new grad hadnt pulled the cpr button but hey she was doing a great job w compressions nonetheless!

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Specializes in Progressive Care.

Start compressions right away...got it! Hey I think I remember that from CPR class ;)

Funny that in my 2 years of nursing school nobody mentioned the CPR button on the bed or the board. I didn't find out about them until RN orientation. I guess they were too busy making sure we did our bed baths and vital signs in school :/

That's great that some beds have the removable board. What a great idea.

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Specializes in Short Term/Skilled.

Well, first you must make sure the bed really needs CPR by asking it if it's OK. ;-)

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When I had a patient of mine code, I put the head down (somehow the CPR lever on the bed did not work) and started compressions. And the mattress was a dolphin mattress, one we use for patients at high risk of developing a pressure ulcer, and it's extremely squishy. But I wasted no time in starting compressions, and when someone brought the board, it didn't take long to roll the patient and put the board. Like barely 3 seconds.

Main thing to remember with a patient who codes is keep calm and remember your training. They could be on the floor, in bed, or in the bathroom. Don't waste any time and do what needs to be done.

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Specializes in Critical Care, Education.

This is actually a wonderful question. We (clinical educators) often fail to include this context-specific information in our "code training" for staff. I try to make sure that our educators conduct department-specific code drills on a regular basis - using realistic scenarios. Our facilities have a variety of beds and alarm systems. . . we need to make sure that everyone is prepared to respond appropriately to THAT patient in THAT bed, not the manikin in a sim lab.

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Specializes in HH, Peds, Rehab, Clinical.

Starting compressions on a squishy bed is better than not starting them at all =)

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I've never had to do CPR on an adult (knock on wood), but I believe that at my hospital somebody mentioned that our beds have a button you can push to flatten them out (like letting the air out of an air mattress). It probably depends on your facility policy and what type of beds you use on your unit. I'd ask your educator or supervisor if you feel comfortable. I don't think that's a stupid question at all. Plus, if that scenario does ever arise, you don't want to be there doing compressions and thinking "Shoot, I almost asked this question but didn't."

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Specializes in Cardiac/Telemetry.

I heard a story yesterday at work where the PA ran to a code on a med surg floor, upon arrival there were 5 nurses standing at the bed doing nothing! He started compressions and gave instructions on placing the Zoll while the bedside nurses where paralyzed in shock? And unable to perform CPR. I believe heads are going to roll. The pt was 50's and not a DNR.

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