Injured doing compressions?

[dbabz]

I'm in a new grad residency program in SICU...a job that I absolutely love. Second week on the floor, patient coded. We had to do CPR for 30 minutes and I was doing compressions for a good portion of that time. I'm short and the stool didn't arrive until I had been at it for a while; this guy was big. At any rate, about two days later, my upper back between my shoulder blades really started to hurt. Treated w/ibuprofen and rolling on the foam roller and seemed to improve. Now, late last week, my class was doing code drill and I did compressions again. Injury came right back. Fortunately, I was able to see chiropractor the following day but it's not improving much. I'm getting no sleep because the pain and tightness wake me up in the middle of the night. My questions:

1. Should I mention this to the nurse manager? I don't want to appear difficult, but I feel like she should be aware of this since it was an on-the-job injury.

2. I'm terrified of another code. I know that this is an occupational hazard and I've been researching proper technique for giving compressions. Should I just try to find a different role during code for the next few months until it heals (and hopefully it will.)

I know it's ridiculous to think I can work in an ICU (or any floor for that matter) if I can't do compressions. Does this mean my career is over before it even started? Any guidance would be much appreciated.

[meanmaryjean, DNP, RN]

Pain two days later indicates you are using seldom used muscles excessively. That is not really an 'injury' per se- it's like doing spring yardwork after being sedentary all winter.

I'm kind of stunned that you think your career is over because you're sore after doing CPR. Really?

Learn to do compressions properly (shoulders DIRECTLY over hands), ask for a break after a few minutes (per BLS guidelines) if you do end up doing compressions, and let your colleagues know you need another role.

[K+MgSO4, BSN]

You probably have DOMS. If you are still having pain see a physio and get some stretches. If you are still in pain after treatment talk to your manager.

Get up on the bed the next time if you are too short. Knee on the edge of the bed.

Stop over thinking this.

[dbabz]

K+MgSO4 said:

You probably have DOMS. If you are still having pain see a physio and get some stretches. If you are still in pain after treatment talk to your manager.

Get up on the bed the next time if you are too short. Knee on the edge of the bed.

Stop over thinking this.

But overthinking is what I do best!

You're right. I'll just try getting on the bed next time. I'm also looking up proper position for compressions as we speak. I've (very fortunately) not had much back pain in the past so I guess it kind of freaked me out.

[dbabz]

meanmaryjean said:

Pain two days later indicates you are using seldom used muscles excessively. That is not really an 'injury' per se- it's like doing Spring yardwork after being sedentary all Winter.

I'm kind of stunned that you think your career is over because you're sore after doing CPR. Really?

Learn to do compressions properly (shoulders DIRECTLY over hands), ask for a break after a few minutes (per BLS guidelines) if you do end up doing compressions, and let your colleagues know you need another role.

Yup. Lesson definitely learned. I kind of knew in the back of my head that I was overdoing it, but no one else was stepping up. Next time, I'll be more assertive.

[meanmaryjean, DNP, RN]

dbabz said:

Yup. Lesson definitely learned. I kind of knew in the back of my head that I was overdoing it, but no one else was stepping up. Next time, I'll be more assertive.

In a code- no one is thinking "Gosh, I bet dbabz is getting tired". Everyone is focused on the patient and the situation and you must advocate for yourself. Truthfully, the quality of compressions is so critical to outcomes that if you are tiring or feel you are not doing a good job- you SHOULD ask for relief for the sake of the patient.

[dbabz]

meanmaryjean said:

In a code- no one is thinking "Gosh, I bet dbabz is getting tired". Everyone is focused on the patient and the situation and you must advocate for yourself. Truthfully, the quality of compressions is so critical to outcomes that if you are tiring or feel you are not doing a good job- you SHOULD ask for relief for the sake of the patient.

Good point.

[Nurse SMS, MSN, RN]

I am short too and compressions are MUCH harder work than most people ever realize. I always have to climb up on the bed itself to get compressions correct. Even with a stool I am not tall enough, but kneeling on the bed? No problem.

Always call out for your next relief. Most codes I have been part of have three people rotating doing compressions. That is their only role - to spell one another and help coach for effective depth and rate.

[AnnieOaklyRN, BSN, RN, EMT-P]

Also, PLEASE don't ever do compressions for that long again! The more tired the compressor gets the less affective compressions become, switch out as soon as you are getting fatigued (or if you have pain), and for everyone that is well before 30 minutes (even if you are switching with another compressor every 2 minutes or so).

This isn't just about your back pain, it's about not doing effecting compressions on a patient that may be viable.

I would suggest not saying anything as this is very unlikely an injury, and more an overuse problem as someone else said. Try and avoid being the compressor for a while. Maybe even suggest the Lucas device to your nurse manager!!

Annie

[MunoRN, RN]

Compressions are strenuous, so unless you're in pretty good shape it's expected that you'll be sore afterwards. It doesn't sound like you have a reportable injury, so there's no injury claim to be made, but it usually wouldn't hurt to share your concerns with your manager.

In the future, if you're concerned you've had an on the job injury you should report that first before going to a chiropractor, since seeing a chiropractor often nullifies any injury claims since the employer can claim the injury could have just as likely come from the chiropractor.

[traumaRUs, MSN, APRN]

Per AHA - personnel doing compressions should be rotated every 2 minutes. During a code, no reason to be a hero - switch it out. Don't get tunnel vision - ask for help.

You'll get the hang of it.

[dbabz]

Thanks everyone for the input. Much better now after a couple of visits to the chiropractor (or maybe would have cleared up on its own; don't know.) Anyway, I got lucky and lesson learned.